How much does Medicare pay for CPT 93750?

Medicare allowed an average of $39.06 per service and paid $30.87 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $193.17, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 93750?

Evaluation of lower heart chamber assist device. It was billed 53,511 times to 13,945 Medicare beneficiaries by 644 providers in 2024.

Does 93750 pay differently in an office than a hospital?

Yes. The allowed amount averaged $45.14 in an office setting and $38.73 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 93750 most?

Advanced Heart Failure and Transplant Cardiology, with 22,954 services from 251 clinicians. Next are Cardiology, Nurse Practitioner, Internal Medicine.

CPT 93750

Evaluation of lower heart chamber assist device

$39.06Medicare-allowed amount per service, averaged across 53,511 services

Providers submitted

$193.17

Asking price, not received

Medicare allowed

$39.06

The fee schedule figure

Medicare paid

$30.87

Balance is patient coinsurance

Providers submitted an average of $193.17 for this code and Medicare allowed $39.06 — 4.9× 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 $30.87 (79%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $45.14
Hospital / facility: $38.73

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. 2,777 services were billed in an office setting and 50,734 in a facility.

Services: 53,511
Beneficiaries: 13,945
Providers billing it: 644
Total allowed: $2,090,140

What Medicare pays for CPT 93750

Across 53,511 services billed by 644 providers to 13,945 beneficiaries, Medicare allowed an average of $39.06 per service. That is 3.8 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 93750

Specialty	Services	Beneficiaries	Avg allowed	Providers
Advanced Heart Failure and Transplant Cardiology	22,954	5,462	$40.29	251
Cardiology	14,555	3,386	$40.01	165
Nurse Practitioner	7,498	2,903	$33.36	120
Internal Medicine	3,099	723	$40.07	32
Physician Assistant	1,665	645	$34.14	25
Thoracic Surgery	1,166	179	$40.70	11
Cardiac Surgery	1,145	219	$42.05	11
Interventional Cardiology	458	97	$39.87	7
Critical Care (Intensivists)	236	78	$41.61	6
Certified Clinical Nurse Specialist	156	78	$35.35	4
Adult Congenital Heart Disease	119	40	$40.63	3
Hospitalist	112	30	$42.66	2
Anesthesiology	111	53	$41.75	4
Interventional Radiology	101	14	$35.82	1
General Practice	86	27	$35.75	1

93750 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	5,612	$41.30	$30.62	49
Texas	4,937	$39.05	$30.29	63
Illinois	4,837	$41.82	$29.55	58
Florida	3,445	$40.77	$30.73	40
Pennsylvania	2,822	$39.12	$29.83	34
New York	2,770	$42.70	$30.23	47
Massachusetts	2,202	$40.27	$30.32	34
District of Columbia	2,191	$42.14	$30.67	14
Georgia	2,111	$39.41	$30.43	21
Ohio	2,088	$34.78	$27.94	24
New Jersey	1,794	$41.97	$30.43	11
South Carolina	1,661	$36.63	$29.83	19
Tennessee	1,636	$39.26	$31.16	14
North Carolina	1,605	$35.04	$29.37	26
Indiana	1,383	$35.54	$30.26	16
Arkansas	1,379	$33.06	$28.65	10
Virginia	1,343	$38.45	$30.69	16
Minnesota	1,302	$34.81	$29.21	24
Oklahoma	869	$32.49	$26.74	6
Maryland	846	$42.60	$32.01	15
Arizona	756	$35.85	$28.81	4
Michigan	678	$37.72	$27.60	18
Kansas	662	$34.05	$28.39	11
Wisconsin	633	$33.81	$30.80	8
Louisiana	604	$38.22	$30.17	6
Alabama	526	$33.77	$30.55	7
Washington	421	$41.73	$31.22	10
Kentucky	370	$36.08	$29.06	4
Delaware	295	$35.85	$28.48	6
New Hampshire	241	$40.18	$31.05	1
Nebraska	239	$31.37	$27.20	5
Connecticut	235	$40.33	$29.92	5
Missouri	216	$42.31	$33.72	6
Iowa	195	$35.60	$30.20	3
Mississippi	178	$39.33	$33.40	3
North Dakota	144	$40.07	$34.59	1
Oregon	121	$39.03	$30.54	3
Colorado	111	$32.95	$25.80	1
West Virginia	53	$40.21	$28.41	1

Related codes

93793Anticoagulant management of patient taking warfarin$10.67
93798Outpatient heart rehabilitation$21.02
93797Outpatient heart rehabilitation$13.89
93702Measurement of lymphedema extracellular fluid$118.63
93790Ambulatory blood pressure monitoring$17.75
93784Ambulatory blood pressure monitoring$46.29
93701Measurement of heart blood flow and respiration$29.65

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.