How much does Medicare pay for CPT 93297?

Medicare allowed an average of $45.47 per service and paid $34.23 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $155.15, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 93297?

Evaluation of implantable heart and blood vessel monitoring system, remote up to 30 days. It was billed 801,728 times to 183,678 Medicare beneficiaries by 2,697 providers in 2024.

Does 93297 pay differently in an office than a hospital?

Yes. The allowed amount averaged $47.62 in an office setting and $23.36 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 93297 most?

Clinical Cardiac Electrophysiology, with 303,752 services from 888 clinicians. Next are Cardiology, Independent Diagnostic Testing Facility (IDTF), Interventional Cardiology.

CPT 93297

Evaluation of implantable heart and blood vessel monitoring system, remote up to 30 days

$45.47Medicare-allowed amount per service, averaged across 801,728 services

Providers submitted

$155.15

Asking price, not received

Medicare allowed

$45.47

The fee schedule figure

Medicare paid

$34.23

Balance is patient coinsurance

Providers submitted an average of $155.15 for this code and Medicare allowed $45.47 — 3.4× 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 $34.23 (75%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $47.62
Hospital / facility: $23.36

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. 730,636 services were billed in an office setting and 71,092 in a facility.

Services: 801,728
Beneficiaries: 183,678
Providers billing it: 2,697
Total allowed: $36,454,572

What Medicare pays for CPT 93297

Across 801,728 services billed by 2,697 providers to 183,678 beneficiaries, Medicare allowed an average of $45.47 per service. That is 4.4 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 93297

Specialty	Services	Beneficiaries	Avg allowed	Providers
Clinical Cardiac Electrophysiology	303,752	78,481	$46.80	888
Cardiology	224,746	51,146	$46.24	1,219
Independent Diagnostic Testing Facility (IDTF)	180,103	27,601	$42.42	16
Interventional Cardiology	38,041	8,109	$48.82	255
Nurse Practitioner	23,432	8,520	$35.83	140
Internal Medicine	15,382	3,425	$49.27	86
Advanced Heart Failure and Transplant Cardiology	6,515	2,380	$48.50	30
Physician Assistant	5,882	2,610	$42.29	41
Undefined Physician type	1,213	373	$65.68	4
Certified Clinical Nurse Specialist	1,145	356	$37.08	4
Hospitalist	347	245	$60.43	2
Intensive Cardiac Rehabilitation	327	101	$26.27	1
Cardiac Surgery	299	169	$42.44	4
Interventional Radiology	167	36	$39.20	1
Neurology	150	22	$56.42	1

93297 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	152,984	$47.20	$30.45	211
California	121,501	$49.02	$32.07	350
Texas	72,397	$42.73	$32.27	228
Florida	60,336	$48.92	$38.17	311
New Jersey	29,574	$56.22	$38.36	94
Arizona	26,190	$33.42	$26.45	86
Virginia	24,234	$30.80	$23.15	78
Tennessee	24,157	$46.42	$36.98	66
Pennsylvania	20,617	$54.54	$40.14	110
Ohio	19,939	$44.93	$37.74	88
Colorado	19,191	$42.25	$27.63	30
South Carolina	19,174	$48.78	$39.65	78
Illinois	15,700	$45.80	$33.71	73
Michigan	13,358	$50.80	$37.87	67
Maryland	13,289	$47.40	$34.36	59
Indiana	12,931	$46.21	$36.48	42
Georgia	12,606	$47.15	$36.93	56
North Carolina	11,468	$40.94	$32.15	49
Massachusetts	10,535	$46.98	$34.47	51
Missouri	10,484	$44.86	$33.25	63
Kansas	10,305	$41.97	$33.56	59
Oklahoma	9,911	$44.17	$35.88	38
Minnesota	8,845	$39.16	$29.92	16
Louisiana	7,686	$36.48	$29.13	53
Alabama	7,184	$40.60	$33.48	44
Nebraska	6,607	$48.01	$37.67	24
Nevada	6,241	$28.56	$21.78	13
Kentucky	5,951	$49.01	$38.75	31
Mississippi	5,603	$37.70	$31.14	26
West Virginia	5,383	$46.91	$35.30	8
Arkansas	5,181	$25.73	$19.84	28
Iowa	4,644	$29.89	$23.81	20
New Mexico	3,490	$23.29	$17.76	10
Alaska	3,288	$59.84	$37.06	4
Connecticut	3,180	$55.17	$37.22	20
Delaware	3,095	$51.44	$40.42	22
Wisconsin	2,755	$24.21	$19.23	17
New Hampshire	1,954	$32.57	$23.05	14
Washington	1,821	$36.82	$25.51	16
Montana	1,713	$41.90	$30.14	5
Idaho	1,231	$34.88	$28.53	5
North Dakota	1,204	$27.81	$21.20	4
Vermont	962	$30.21	$22.11	5
Rhode Island	792	$27.01	$19.46	7
Oregon	710	$44.45	$33.05	7
Utah	483	$53.42	$42.85	4
South Dakota	335	$26.82	$18.98	2
District of Columbia	276	$48.28	$36.09	2
Wyoming	218	$23.40	$16.77	2
Puerto Rico	15	$25.34	$47.19	1

Related codes

93296Evaluation of single$21.59
93294Evaluation of single$28.57
93298Evaluation of cardiac rhythm monitor system$76.45
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.