How much does Medicare pay for CPT 93793?

Medicare allowed an average of $10.67 per service and paid $7.48 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $42.45, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 93793?

Anticoagulant management of patient taking warfarin. It was billed 915,170 times to 172,183 Medicare beneficiaries by 3,717 providers in 2024.

Does 93793 pay differently in an office than a hospital?

Yes. The allowed amount averaged $10.67 in an office setting and $10.66 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 93793 most?

Cardiology, with 322,488 services from 1,316 clinicians. Next are Nurse Practitioner, Internal Medicine, Family Practice.

CPT 93793

Anticoagulant management of patient taking warfarin

$10.67Medicare-allowed amount per service, averaged across 915,170 services

Providers submitted

$42.45

Asking price, not received

Medicare allowed

$10.67

The fee schedule figure

Medicare paid

$7.48

Balance is patient coinsurance

Providers submitted an average of $42.45 for this code and Medicare allowed $10.67 — 4.0× 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 $7.48 (70%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $10.67
Hospital / facility: $10.66

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. 854,637 services were billed in an office setting and 60,533 in a facility.

Services: 915,170
Beneficiaries: 172,183
Providers billing it: 3,717
Total allowed: $9,764,864

What Medicare pays for CPT 93793

Across 915,170 services billed by 3,717 providers to 172,183 beneficiaries, Medicare allowed an average of $10.67 per service. That is 5.3 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 93793

Specialty	Services	Beneficiaries	Avg allowed	Providers
Cardiology	322,488	64,297	$11.18	1,316
Nurse Practitioner	215,446	37,684	$9.51	541
Internal Medicine	136,773	19,700	$11.02	520
Family Practice	90,108	16,920	$10.86	594
Interventional Cardiology	72,146	15,644	$11.10	355
Clinical Cardiac Electrophysiology	29,068	7,556	$11.22	123
Physician Assistant	27,926	7,109	$9.49	156
Advanced Heart Failure and Transplant Cardiology	6,312	896	$11.07	29
Hematology-Oncology	5,831	659	$11.27	26
Gastroenterology	1,383	189	$11.23	1
Hospitalist	1,187	124	$11.12	4
Medical Oncology	1,085	244	$11.27	7
Geriatric Medicine	953	87	$11.14	6
Emergency Medicine	797	169	$10.81	9
General Practice	716	50	$11.71	3

93793 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
Pennsylvania	80,492	$10.36	$7.48	290
Illinois	79,112	$11.00	$7.54	284
Minnesota	72,263	$10.94	$7.66	166
Wisconsin	54,754	$10.36	$7.42	254
California	53,152	$11.59	$7.55	155
Florida	52,484	$11.03	$7.96	243
Massachusetts	48,380	$10.92	$7.37	103
New York	35,826	$11.07	$7.31	198
Texas	29,413	$10.86	$7.74	142
Missouri	27,910	$9.96	$7.43	65
Colorado	25,463	$11.17	$7.56	104
Indiana	24,939	$9.71	$6.79	60
Virginia	23,339	$10.91	$7.67	144
North Carolina	22,095	$10.64	$7.75	146
Arizona	18,399	$10.83	$7.83	111
Kentucky	18,332	$9.83	$7.14	69
Oregon	17,195	$10.48	$7.19	44
Iowa	16,801	$10.11	$7.36	124
Ohio	16,665	$10.10	$7.35	108
Utah	15,227	$9.27	$6.73	22
Maryland	14,942	$10.63	$7.19	51
Tennessee	12,838	$10.25	$7.43	78
Kansas	12,763	$9.46	$7.04	34
Arkansas	11,713	$9.55	$7.34	29
New Hampshire	10,327	$10.48	$7.28	35
Louisiana	9,568	$10.48	$7.84	39
Mississippi	9,208	$10.11	$7.47	37
Alabama	8,846	$9.75	$7.43	31
New Jersey	8,593	$12.08	$7.87	63
Delaware	8,569	$11.04	$7.75	19
Washington	8,244	$11.06	$7.55	79
South Carolina	7,909	$10.60	$7.77	43
Georgia	7,373	$10.67	$7.67	53
Nebraska	6,703	$10.47	$7.39	53
Michigan	6,243	$11.00	$7.81	45
Connecticut	6,162	$11.19	$7.35	39
North Dakota	5,617	$10.76	$7.51	14
Wyoming	5,486	$11.15	$7.73	29
Nevada	5,437	$10.56	$7.53	31
Oklahoma	3,572	$10.61	$8.05	27
Maine	3,012	$10.32	$7.92	6
New Mexico	2,610	$10.54	$7.95	8
Alaska	2,408	$14.42	$7.02	14
West Virginia	1,615	$10.67	$7.76	11
Idaho	991	$10.49	$7.80	4
Montana	567	$11.16	$8.19	5
Rhode Island	536	$11.91	$7.69	2
District of Columbia	491	$11.98	$7.58	1
South Dakota	390	$10.02	$7.18	4
Hawaii	196	$9.97	$6.38	1

Related codes

93798Outpatient heart rehabilitation$21.02
93750Evaluation of lower heart chamber assist device$39.06
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.