How much does Medicare pay for CPT 93296?

Medicare allowed an average of $21.59 per service and paid $15.61 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $92.80, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 93296?

Evaluation of single, dual, multiple lead or leadless pacemaker system or implantable defibrillator system, remote up to 90 days. It was billed 1,969,899 times to 888,160 Medicare beneficiaries by 5,002 providers in 2024.

Which specialty bills 93296 most?

Clinical Cardiac Electrophysiology, with 829,134 services from 1,345 clinicians. Next are Cardiology, Independent Diagnostic Testing Facility (IDTF), Interventional Cardiology.

CPT 93296

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

$21.59Medicare-allowed amount per service, averaged across 1,969,899 services

Providers submitted

$92.80

Asking price, not received

Medicare allowed

$21.59

The fee schedule figure

Medicare paid

$15.61

Balance is patient coinsurance

Providers submitted an average of $92.80 for this code and Medicare allowed $21.59 — 4.3× 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 $15.61 (72%); the rest is the patient’s coinsurance and deductible.

Services: 1,969,899
Beneficiaries: 888,160
Providers billing it: 5,002
Total allowed: $42,530,119

What Medicare pays for CPT 93296

Across 1,969,899 services billed by 5,002 providers to 888,160 beneficiaries, Medicare allowed an average of $21.59 per service. That is 2.2 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 93296

Specialty	Services	Beneficiaries	Avg allowed	Providers
Clinical Cardiac Electrophysiology	829,134	402,251	$20.82	1,345
Cardiology	551,456	254,746	$20.91	2,644
Independent Diagnostic Testing Facility (IDTF)	390,056	131,487	$24.57	16
Interventional Cardiology	87,488	36,952	$20.54	579
Nurse Practitioner	46,640	27,458	$21.32	182
Internal Medicine	36,190	19,265	$20.50	138
Physician Assistant	16,844	9,747	$22.04	56
Cardiac Surgery	2,337	1,338	$19.86	6
Advanced Heart Failure and Transplant Cardiology	1,655	754	$19.55	8
Critical Care (Intensivists)	1,621	515	$21.92	1
Hospitalist	1,275	998	$21.26	6
Undefined Physician type	1,264	898	$22.82	3
Family Practice	1,237	565	$19.75	1
Emergency Medicine	679	203	$18.60	1
Interventional Radiology	632	271	$18.59	2

93296 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
New York	364,249	$24.95	$15.28	319
Texas	152,116	$20.61	$15.41	399
Florida	148,175	$20.45	$15.52	588
California	122,586	$25.51	$15.18	400
Pennsylvania	89,718	$20.71	$14.92	254
Ohio	76,515	$19.23	$14.88	139
North Carolina	64,297	$19.50	$15.19	141
Illinois	59,326	$20.78	$14.67	170
Tennessee	55,838	$18.84	$14.96	121
New Jersey	53,029	$23.77	$15.23	166
South Carolina	52,258	$19.38	$15.57	180
Indiana	46,953	$19.31	$14.70	100
Missouri	46,371	$19.27	$14.58	152
Arizona	46,151	$20.42	$15.30	155
Georgia	44,811	$19.81	$15.14	103
Minnesota	40,608	$21.31	$14.76	57
Colorado	39,428	$23.62	$14.99	64
Massachusetts	39,371	$23.62	$14.49	134
Washington	36,091	$22.30	$14.84	107
Maryland	34,744	$22.85	$15.17	79
Kansas	33,295	$18.87	$15.46	88
Alabama	31,962	$18.19	$14.95	108
Virginia	29,352	$22.20	$15.05	76
Kentucky	28,364	$19.01	$15.01	97
Nebraska	22,787	$18.85	$14.52	26
Louisiana	20,830	$18.58	$14.88	96
Michigan	20,552	$20.28	$15.10	103
Connecticut	19,479	$23.11	$14.66	100
Mississippi	17,851	$18.06	$15.12	48
Oklahoma	17,496	$18.71	$15.30	48
Arkansas	15,886	$17.84	$14.95	40
Iowa	15,144	$18.95	$14.35	41
Utah	13,310	$19.63	$15.08	33
Wisconsin	11,949	$19.98	$14.28	53
Oregon	9,828	$21.62	$14.73	42
Delaware	8,887	$20.83	$14.79	28
Alaska	8,178	$22.57	$12.20	5
West Virginia	7,686	$19.37	$14.69	19
Nevada	6,442	$20.92	$14.86	36
Montana	4,178	$21.12	$14.26	9
Idaho	2,474	$19.19	$14.88	13
New Hampshire	1,888	$22.14	$15.32	6
Rhode Island	1,813	$22.41	$14.41	12
District of Columbia	1,576	$24.39	$14.84	9
New Mexico	1,358	$19.34	$13.82	11
Vermont	1,039	$21.40	$14.59	2
Wyoming	952	$20.83	$12.40	9
South Dakota	932	$20.51	$13.43	3
Maine	928	$24.20	$12.68	2
Hawaii	525	$23.53	$14.11	7
North Dakota	323	$23.06	$15.20	4

Related codes

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
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.