Prgrmg dev eval pm/ldls pm
CPT 93279 covers the programming and evaluation of a pacemaker or leadless pacemaker system with analysis, review, and report. This is the technical work of adjusting device settings and checking performance after initial implantation.
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
Conversion factor: 32.3465 · Source: CMS MPFS RVU25A · Confidence: High
NCCI bundling edits
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Billing tips
Differentiate between 93279 (dual chamber/leadless) and 93280 (single chamber) based on actual device type implanted
Impact: Incorrect code selection can result in undercoding or overcoding; verify device specifications in operative report
Document all required elements: device interrogation, parameter analysis, stored data review, measured data interpretation, and physician report
Impact: Missing any component can trigger audit or denial; complete documentation supports the full $64.37 Medicare payment
Do not bill 93279 within the 90-day global period of pacemaker implantation (33206-33208, 33227-33229) unless modifier is appropriate
Impact: Global period violations result in 100% denial; post-op checks are included in surgical package
Bill only once per in-person encounter regardless of number of times device is interrogated during the visit
Impact: Multiple units on same date are denied; combine all interrogations into single service
Remote monitoring services (93294-93296) cannot be billed in the same 90-day period as in-person interrogation for the same device
Impact: Overlapping services denied per CMS LCD policies; track remote monitoring periods carefully
Ensure physician interpretation and report are signed and dated separately from any E/M note when billing with modifier 25
Impact: Bundled documentation increases denial risk; separate distinct documentation supports both payments totaling $100+ combined
Common denials
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