Pm device progr eval dual
CPT code 93280 covers the programming and evaluation of a dual-chamber pacemaker or implantable cardioverter-defibrillator (ICD). This involves checking device settings, battery status, and heart rhythm data through a specialized computer interface.
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
Verify dual-chamber device type before coding - single-chamber devices use 93279, not 93280
Impact: Prevents denials and ensures correct $75.04 reimbursement versus $61.98 for single-chamber 93279
Document both atrial and ventricular channel evaluation explicitly in the report
Impact: Dual-chamber documentation requirement; missing either chamber may result in downcoding to 93279 and loss of $13.06
Bill only once per in-person session regardless of number of parameter changes
Impact: Multiple programming attempts during single encounter are bundled; avoid duplicate billing that triggers audit
Separate in-person evaluations (93280) from remote interrogations (93296-93299) by 30-day intervals when possible
Impact: Many payers limit frequency to every 90 days for pacemakers; documentation of medical necessity required for more frequent checks
Ensure physician interpretation and signature present within 24-48 hours of device interrogation
Impact: Missing signature is leading audit finding resulting in 100% claim denial ($75.04 lost per encounter)
Use time-of-service edit checks to prevent billing 93280 with other device evaluation codes (93281-93289) on same date
Impact: NCCI edits bundle these services; violations result in automatic denial of secondary code
Common denials
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