How much does Medicare pay for CPT 93294?

Medicare allowed an average of $28.57 per service and paid $20.40 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $105.65, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 93294?

Evaluation of single, dual, multiple lead or leadless pacemaker system, remote up to 90 days. It was billed 1,877,558 times to 902,347 Medicare beneficiaries by 7,475 providers in 2024.

Does 93294 pay differently in an office than a hospital?

Yes. The allowed amount averaged $28.69 in an office setting and $28.15 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 93294 most?

Clinical Cardiac Electrophysiology, with 958,195 services from 2,124 clinicians. Next are Cardiology, Interventional Cardiology, Nurse Practitioner.

CPT 93294

Evaluation of single, dual, multiple lead or leadless pacemaker system, remote up to 90 days

$28.57Medicare-allowed amount per service, averaged across 1,877,558 services

Providers submitted

$105.65

Asking price, not received

Medicare allowed

$28.57

The fee schedule figure

Medicare paid

$20.40

Balance is patient coinsurance

Providers submitted an average of $105.65 for this code and Medicare allowed $28.57 — 3.7× 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 $20.40 (71%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $28.69
Hospital / facility: $28.15

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. 1,461,512 services were billed in an office setting and 416,046 in a facility.

Services: 1,877,558
Beneficiaries: 902,347
Providers billing it: 7,475
Total allowed: $53,641,832

What Medicare pays for CPT 93294

Across 1,877,558 services billed by 7,475 providers to 902,347 beneficiaries, Medicare allowed an average of $28.57 per service. That is 2.1 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 93294

Specialty	Services	Beneficiaries	Avg allowed	Providers
Clinical Cardiac Electrophysiology	958,195	467,300	$28.75	2,124
Cardiology	672,694	309,314	$28.77	3,895
Interventional Cardiology	104,371	45,388	$28.57	809
Nurse Practitioner	63,076	37,207	$24.98	280
Internal Medicine	42,174	21,997	$28.55	221
Physician Assistant	22,684	13,600	$25.25	74
Cardiac Surgery	2,714	1,420	$28.27	12
Advanced Heart Failure and Transplant Cardiology	2,160	927	$28.39	14
Undefined Physician type	1,556	941	$29.45	6
Hospitalist	1,456	1,161	$28.50	8
Certified Clinical Nurse Specialist	1,415	887	$24.14	6
Critical Care (Intensivists)	1,348	492	$28.70	2
Family Practice	917	433	$27.89	1
Emergency Medicine	577	177	$28.12	2
Nuclear Medicine	527	206	$29.17	5

93294 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
Florida	143,926	$29.16	$20.90	709
California	135,585	$30.30	$20.61	723
Texas	126,486	$28.26	$20.44	574
New York	91,510	$30.77	$20.18	406
Pennsylvania	90,387	$28.64	$20.28	330
Illinois	72,455	$29.51	$19.91	250
Virginia	65,469	$28.93	$20.26	160
Ohio	63,897	$27.93	$20.08	244
North Carolina	61,731	$27.67	$20.41	188
Tennessee	55,799	$27.23	$20.02	158
Massachusetts	55,019	$29.39	$19.53	217
Georgia	52,796	$28.46	$20.23	158
South Carolina	51,910	$27.85	$20.62	206
New Jersey	51,724	$30.91	$20.45	202
Arizona	50,333	$28.02	$20.81	214
Missouri	46,451	$27.60	$19.58	220
Indiana	44,694	$27.20	$19.79	122
Washington	44,627	$29.12	$19.79	159
Michigan	42,563	$28.59	$19.71	234
Minnesota	34,203	$27.77	$19.10	78
Kansas	33,976	$27.27	$20.63	122
Alabama	31,983	$26.93	$19.97	135
Wisconsin	30,314	$27.21	$19.68	131
Colorado	30,190	$28.70	$19.92	109
Oklahoma	29,194	$27.01	$20.10	131
Maryland	28,861	$29.66	$20.48	112
Arkansas	27,831	$26.17	$19.82	92
Kentucky	27,773	$27.79	$20.02	118
Iowa	27,392	$26.78	$19.68	79
Louisiana	26,895	$27.57	$20.00	166
Connecticut	21,220	$29.32	$19.83	122
Oregon	20,551	$28.63	$19.84	87
Nebraska	20,521	$26.62	$19.55	38
Mississippi	16,806	$27.47	$20.24	67
West Virginia	13,317	$28.38	$20.21	30
Utah	12,777	$27.95	$20.40	36
New Hampshire	11,554	$28.01	$19.44	37
South Dakota	9,744	$27.47	$19.03	22
Nevada	9,371	$28.13	$20.24	45
Montana	9,339	$28.37	$19.64	23
Maine	8,645	$28.56	$19.59	41
Delaware	8,198	$27.36	$19.41	37
North Dakota	8,026	$27.94	$19.79	19
Idaho	7,844	$27.30	$19.29	31
New Mexico	7,445	$27.77	$19.42	24
Alaska	7,037	$32.59	$16.37	10
Rhode Island	3,282	$29.29	$20.24	15
District of Columbia	2,051	$30.32	$20.30	16
Hawaii	1,451	$27.14	$19.92	11
Wyoming	1,256	$26.35	$17.88	11
Vermont	1,149	$28.12	$20.26	6

Related codes

93296Evaluation of single$21.59
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
93284Programming of multiple lead implantable defibrillator system$85.19

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.