How much does Medicare pay for CPT 93505?

Medicare allowed an average of $209.72 per service and paid $165.24 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $1176.44, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 93505?

Biopsy of heart muscle. It was billed 3,989 times to 2,851 Medicare beneficiaries by 167 providers in 2024.

Which specialty bills 93505 most?

Advanced Heart Failure and Transplant Cardiology, with 2,181 services from 83 clinicians. Next are Cardiology, Interventional Cardiology, Internal Medicine.

CPT 93505

Biopsy of heart muscle

$209.72Medicare-allowed amount per service, averaged across 3,989 services

Providers submitted

$1176.44

Asking price, not received

Medicare allowed

$209.72

The fee schedule figure

Medicare paid

$165.24

Balance is patient coinsurance

Providers submitted an average of $1176.44 for this code and Medicare allowed $209.72 — 5.6× 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 $165.24 (79%); the rest is the patient’s coinsurance and deductible.

Services: 3,989
Beneficiaries: 2,851
Providers billing it: 167
Total allowed: $836,573

What Medicare pays for CPT 93505

Across 3,989 services billed by 167 providers to 2,851 beneficiaries, Medicare allowed an average of $209.72 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 93505

Specialty	Services	Beneficiaries	Avg allowed	Providers
Advanced Heart Failure and Transplant Cardiology	2,181	1,504	$216.38	83
Cardiology	1,190	882	$203.93	53
Interventional Cardiology	471	363	$194.66	24
Internal Medicine	147	102	$205.98	7

93505 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	584	$226.10	$168.92	23
Florida	526	$209.05	$159.25	18
Texas	418	$204.97	$158.61	17
Tennessee	348	$178.20	$167.23	18
New York	267	$224.78	$153.07	11
Maryland	256	$219.71	$162.07	9
Massachusetts	244	$211.71	$153.35	11
Washington	188	$222.90	$162.76	7
District of Columbia	153	$221.48	$157.64	3
North Carolina	143	$182.46	$170.38	6
Minnesota	127	$186.29	$152.67	6
Colorado	118	$196.48	$153.01	5
Michigan	81	$229.77	$170.93	3
Illinois	74	$260.67	$172.69	4
Ohio	70	$211.27	$169.07	4
Pennsylvania	60	$218.81	$169.42	3
Kansas	52	$187.18	$158.75	3
Nebraska	51	$167.45	$155.24	3
Arizona	50	$212.35	$169.89	3
Virginia	40	$201.84	$163.65	2
Kentucky	34	$213.91	$166.52	2
Mississippi	24	$181.61	$151.60	1
Alabama	22	$159.27	$133.38	1
Georgia	17	$209.47	$150.73	1
South Carolina	15	$193.41	$155.44	1
New Jersey	15	$228.57	$173.03	1
Maine	12	$202.10	$152.39	1

Related codes

93571Ultrasound evaluation of heart blood vessel during diagnosis or treatm$63.31
93503Insertion of tube in pulmonary artery for monitoring$84.96
93567Injection for imaging of aorta above heart valve$36.07
93572Ultrasound evaluation of heart blood vessel during diagnosis or treatm$45.65

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.