CPT 93264Cardiology

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CPT 93264 covers remote monitoring of a wireless pacemaker or implantable cardioverter-defibrillator (ICD) with peri-procedural device evaluation, typically performed during the first 30 days after implantation. This involves the physician reviewing data transmitted wirelessly from the device to assess its function and the patient's cardiac rhythm.

Showing rates for

National Average

Base Medicare rate

$50.14

This calculator gives a typical-case estimate using standard Medicare modifier rules. Actual payment depends on payer policies, documentation, code-specific CMS status indicators, and locality. Verify before billing.

RVU breakdown

Work RVU

0.7

PE RVU (NF)

0.78

MP RVU

0.07

Total RVU

1.55

Conversion factor: 32.3465 · Source: CMS MPFS RVU25A · Confidence: High

NCCI bundling edits

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Billing tips

Bill 93264 only within the first 30 days post-implantation and ensure documentation explicitly states the date of device implantation and current monitoring date
Impact: Prevents denials due to timing issues; incorrect timing can result in complete claim rejection and loss of $50.14 payment
Verify the device manufacturer supports wireless transmission capability before billing 93264; if device requires wand or direct contact, use different remote monitoring codes
Impact: Billing for wireless monitoring when device is not truly wireless results in 100% denial; saves appeal time and accelerates proper reimbursement
Document physician review with a dated, signed report that includes specific device parameters, lead measurements, battery voltage, and any arrhythmia episodes detected
Impact: Comprehensive documentation reduces audit risk and supports medical necessity; insufficient documentation can trigger recoupment of payments during post-payment audits
Do not bill 93264 on the same date as in-person device interrogation codes (93279-93290); these services are mutually exclusive
Impact: Bundling edits will deny the remote monitoring code, resulting in loss of $50.14 and requiring claim resubmission with corrected dates
Track the 30-day peri-procedural window carefully and transition to appropriate ongoing remote monitoring codes (93294-93296) after the initial period expires
Impact: Using 93264 beyond 30 days post-implant results in denial; proper code selection ensures continuous reimbursement flow
Bill facility rate ($33.96) when service is provided in hospital outpatient department or ASC; non-facility rate ($50.14) applies in office settings

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Frequently asked questions

What is CPT code 93264 used for?

CPT 93264 is used for remote monitoring of a wireless pacemaker or ICD during the peri-procedural period (first 30 days after device implantation). It includes physician review and interpretation of wirelessly transmitted device data to ensure proper function during the critical early post-implant phase.

How much does Medicare pay for CPT 93264 in 2025?

Medicare pays $50.14 for CPT 93264 in non-facility settings and $33.96 in facility settings based on the 2025 Physician Fee Schedule. The code has 1.55 total RVUs (0.7 work RVU, 0.78 non-facility PE RVU, 0.07 MP RVU).

What is the difference between 93264 and 93294 for remote device monitoring?

CPT 93264 is specifically for peri-procedural monitoring within the first 30 days after device implantation, while 93294 is for ongoing remote monitoring of pacemakers after the initial 30-day period. The peri-procedural code (93264) allows for more frequent monitoring during the critical post-implant window.

How often can CPT 93264 be billed?

CPT 93264 can be billed multiple times during the 30-day peri-procedural window following device implantation, though payer policies vary. Medicare and most commercial payers allow billing based on medical necessity during this period, but always verify specific frequency limitations with individual payers.

Can 93264 be billed with an in-person device check on the same day?

No, CPT 93264 should not be billed on the same date as in-person device interrogation codes (93279-93290) due to NCCI bundling edits. These services are considered mutually exclusive, and the in-person interrogation would typically be the separately billable service.

What documentation is required to bill CPT 93264?

Required documentation includes the device implantation date, proof of wireless transmission, comprehensive device parameters (lead measurements, battery status, arrhythmia data), and a dated, signed physician interpretation report. The documentation must clearly show the service occurred within 30 days of device implantation.

Is CPT 93264 only for wireless devices?

Yes, CPT 93264 is specifically for wireless remote monitoring systems that automatically transmit data without patient or clinician intervention. Devices requiring a wand, direct contact, or patient-initiated transmission should be coded with different remote monitoring codes (such as 93294 for pacemakers or 93297 for ICDs with patient-initiated monitoring).