CPT 93272Cardiology

Ecg/review interpret only

CPT code 93272 is used when a physician reviews and interprets an electrocardiogram (ECG/EKG) heart tracing that was performed and recorded separately. This is for the professional interpretation only, not the technical performance of the test.

Showing rates for

National Average

Base Medicare rate

$22.97

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

0.52

PE RVU (NF)

0.17

MP RVU

0.02

Total RVU

0.71

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

NCCI bundling edits

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Billing tips

Verify the facility is billing the technical component (93005 or 93000-TC) before billing 93272 to avoid duplicate billing issues
Impact: Prevents 100% claim denial and potential audit flags for unbundling violations
Document the date and time of interpretation separately from the date/time of ECG acquisition, especially when interpretation occurs on a different calendar day
Impact: Supports medical necessity for delayed interpretations and prevents timely filing denials worth $22.97 per claim
Ensure the written interpretation report includes all required elements: rate, rhythm, intervals, axis, wave morphology, comparison to prior if available, and clinical correlation
Impact: Comprehensive documentation reduces audit risk and supports the 0.52 work RVU valuation
For high-volume interpretation services, implement batch billing with careful tracking to ensure each interpretation has corresponding documentation and is linked to correct patient encounter
Impact: In practices performing 100+ interpretations weekly, proper tracking prevents 5-10% revenue loss from mismatched or missing documentation
Do not bill 93272 on the same date as global ECG codes (93000, 93005) by the same provider for the same patient unless distinct encounters with modifier 59 justification
Impact: Prevents bundling denials and potential OIG scrutiny for duplicate billing
When billing for nursing facility patients, link 93272 to the appropriate E/M visit or use separately if performed as a standalone interpretation service requested by facility
Proper encounter linkage supports medical necessity and prevents denials, protecting $22.97 per interpretation

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Frequently asked questions

What is the difference between CPT 93272 and 93010?

CPT 93272 is used for review and interpretation of electrocardiographic data from monitoring services, while 93010 represents the professional component of a standard 12-lead ECG. Code 93272 is typically used in conjunction with ambulatory or event monitoring codes, whereas 93010 pairs with the technical component 93005 for routine ECGs.

How much does Medicare pay for CPT code 93272 in 2025?

Medicare pays $22.97 for CPT 93272 in 2025 based on the national average non-facility rate. This represents 0.71 total RVUs multiplied by the 2025 conversion factor of 32.3465. Both facility and non-facility rates are identical at $22.97.

Can I bill 93272 with an E/M code on the same day?

Yes, you can bill 93272 with an E/M service on the same day if both services are medically necessary and separately documented. The ECG interpretation is typically a component of the medical decision-making for the E/M service, so ensure the interpretation is distinctly documented with a separate signed report to justify separate billing.

Do I need modifier 26 when billing CPT 93272?

Generally no, because 93272 inherently represents only the professional component (interpretation). However, some payers may require modifier 26 for clarity in split billing scenarios. Check with individual payer policies, but Medicare does not require modifier 26 with 93272 as the code descriptor already specifies interpretation only.

What documentation is required to bill 93272?

Required documentation includes a complete written interpretation report signed and dated by the physician, containing heart rate, rhythm, intervals (PR, QRS, QT), axis, wave morphology analysis, identification of abnormalities, comparison to prior studies when available, and clinical correlation. The report must be separately identifiable from any E/M note.

Can cardiologists bill 93272 for ECGs performed at nursing homes?

Yes, cardiologists and other qualified physicians can bill 93272 for interpreting ECGs performed at nursing homes, provided there is a split billing arrangement where the facility bills the technical component (93005) and the physician bills only the interpretation (93272). Documentation must clearly show the physician provided only professional interpretation services.

What are common denial reasons for CPT code 93272?

Common denials include duplicate billing when the facility already billed a global code (93000), inadequate interpretation documentation, missing physician signature or date, billing on the same date as 93010 by the same provider, and medical necessity issues when supporting diagnosis codes are not provided or do not justify the service.