How much does Medicare pay for CPT 93289?

Medicare allowed an average of $54.99 per service and paid $40.05 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $172.08, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 93289?

Evaluation of single, dual, or multiple lead implantable defibrillator system. It was billed 31,981 times to 22,759 Medicare beneficiaries by 903 providers in 2024.

Does 93289 pay differently in an office than a hospital?

Yes. The allowed amount averaged $60.56 in an office setting and $34.23 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 93289 most?

Cardiology, with 14,071 services from 409 clinicians. Next are Clinical Cardiac Electrophysiology, Nurse Practitioner, Interventional Cardiology.

CPT 93289

Evaluation of single, dual, or multiple lead implantable defibrillator system

$54.99Medicare-allowed amount per service, averaged across 31,981 services

Providers submitted

$172.08

Asking price, not received

Medicare allowed

$54.99

The fee schedule figure

Medicare paid

$40.05

Balance is patient coinsurance

Providers submitted an average of $172.08 for this code and Medicare allowed $54.99 — 3.1× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $40.05 (73%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $60.56
Hospital / facility: $34.23

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 25,213 services were billed in an office setting and 6,768 in a facility.

Services: 31,981
Beneficiaries: 22,759
Providers billing it: 903
Total allowed: $1,758,635

What Medicare pays for CPT 93289

Across 31,981 services billed by 903 providers to 22,759 beneficiaries, Medicare allowed an average of $54.99 per service. That is 1.4 services per beneficiary, so this is a code patients typically receive more than once. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 93289

Specialty	Services	Beneficiaries	Avg allowed	Providers
Cardiology	14,071	9,133	$59.27	409
Clinical Cardiac Electrophysiology	11,625	8,999	$52.74	298
Nurse Practitioner	3,722	2,725	$47.83	103
Interventional Cardiology	959	683	$53.96	33
Internal Medicine	650	477	$56.62	20
Physician Assistant	596	467	$44.87	28
Advanced Heart Failure and Transplant Cardiology	96	72	$33.79	3
Certified Clinical Nurse Specialist	87	66	$46.30	3
Hospitalist	67	59	$69.17	2
Undefined Physician type	46	46	$72.34	2
Thoracic Surgery	44	20	$36.32	1
Diagnostic Radiology	18	12	$81.03	1

93289 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
California	3,266	$70.97	$45.81	83
Texas	2,939	$53.79	$40.23	87
Florida	2,506	$59.16	$44.20	75
Maryland	2,050	$56.75	$38.23	44
Tennessee	1,432	$51.43	$40.42	30
Illinois	1,404	$57.59	$40.53	34
New York	1,129	$61.58	$40.24	40
Ohio	991	$46.04	$35.64	31
Arkansas	988	$51.14	$39.07	27
Indiana	954	$53.57	$40.70	16
Massachusetts	936	$47.11	$31.06	35
Arizona	803	$47.16	$33.68	27
West Virginia	763	$38.65	$27.49	13
Oklahoma	755	$40.15	$31.69	14
New Jersey	723	$69.78	$47.08	22
Virginia	711	$57.91	$40.45	19
North Carolina	630	$58.76	$40.28	21
Georgia	612	$46.81	$35.05	22
Louisiana	598	$49.42	$39.45	14
Michigan	579	$49.51	$34.99	21
Pennsylvania	577	$59.79	$42.30	22
Wisconsin	563	$52.05	$37.21	8
Kansas	562	$51.74	$38.44	18
Washington	536	$55.27	$37.48	20
Alabama	505	$60.33	$49.00	13
Kentucky	500	$41.63	$31.00	17
Utah	465	$53.20	$40.72	13
Mississippi	461	$59.06	$47.76	9
Missouri	446	$48.40	$35.26	18
Colorado	288	$42.21	$31.22	10
Nevada	268	$52.19	$36.50	9
South Carolina	254	$60.62	$49.52	11
Idaho	234	$33.42	$23.91	4
Hawaii	225	$47.62	$30.49	7
Minnesota	190	$33.69	$26.08	6
Puerto Rico	150	$69.70	$48.20	4
New Mexico	111	$34.09	$24.86	4
Iowa	111	$39.26	$30.07	5
South Dakota	110	$51.96	$39.25	2
Connecticut	98	$54.41	$34.14	5
District of Columbia	97	$59.83	$38.11	4
New Hampshire	92	$55.92	$40.19	2
Delaware	77	$64.22	$47.34	5
Nebraska	67	$61.35	$50.81	3
Alaska	65	$42.89	$21.23	2
Montana	39	$49.52	$38.01	1
Oregon	36	$69.33	$52.59	1
Maine	26	$49.33	$33.16	2
Wyoming	22	$71.01	$54.01	1
Rhode Island	19	$36.31	$24.35	1
Guam	18	$81.03	$51.43	1

Related codes

93296Evaluation of single$21.59
93294Evaluation of single$28.57
93298Evaluation of cardiac rhythm monitor system$76.45
93297Evaluation of implantable heart and blood vessel monitoring system$45.47
93280Programming of dual lead pacemaker system$61.84
93295Evaluation of single$35.37
93229Electrocardiogram (ecg) up to 30 days continuous$1018.21
93247Heart rhythm analysis and report of continous external ekg over 8-15 d$299.31
93248Heart rhythm review and interpretation of continous external ekg over$24.98
93228Electrocardiogram (ecg) up to 30 days continuous$24.32
93243Heart rhythm analysis and report of continous external ekg over more t$279.98
93244Heart rhythm review$22.39

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.