CPT 93282Cardiology

Prgrmg eval implantable dfb

CPT code 93282 covers the programming and evaluation of an implantable cardioverter-defibrillator (ICD), a device that monitors heart rhythm and delivers electric shocks when dangerous rhythms are detected. This code is used when a healthcare provider adjusts the device settings or reviews its stored data during a follow-up visit.

Showing rates for

National Average

Base Medicare rate

$76.01

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

0.85

PE RVU (NF)

1.46

MP RVU

0.04

Total RVU

2.35

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

NCCI bundling edits

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Billing tips

Do not bill 93282 more than once per 90-day period for the same patient unless clinically justified with clear documentation of medical necessity for additional in-person evaluations
Impact: Medicare typically covers one in-person device check per 90 days; additional claims may deny, requiring appeal with documentation of arrhythmias, shocks, or device malfunction
Distinguish between in-person interrogation (93282) and remote monitoring codes (93295-93296); never bill both for the same interrogation session
Impact: Incorrect code selection results in denial; remote codes reimburse differently ($62-$98 range) and have different frequency limitations
Document all required elements: interrogation of device data, battery status, lead impedance, sensing/pacing thresholds, stored arrhythmia events, and any programming changes with clinical rationale
Impact: Missing documentation elements trigger medical necessity denials; complete documentation supports the $76.01 reimbursement and reduces audit risk
When billing with an E/M service on the same day, ensure modifier 25 is appended to the E/M code and documentation shows the E/M addressed separate clinical issues beyond device management
Impact: Without modifier 25 and distinct documentation, the E/M service will bundle into 93282, losing $50-$200+ in E/M reimbursement
Verify patient has a single or dual chamber ICD (not a CRT-D or pacemaker) before using 93282; CRT-D devices require code 93283 and pacemakers use 93280-93281
Impact: Incorrect code selection based on device type results in denial and rebilling delays; 93283 reimburses at $87.10 (2025 rate) versus $76.01 for 93282

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Frequently asked questions

What is the Medicare reimbursement rate for CPT code 93282 in 2025?

The 2025 Medicare national average payment rate for CPT 93282 is $76.01 for both facility and non-facility settings, based on 2.35 total RVUs and the 2025 conversion factor of 32.3465.

How often can CPT 93282 be billed for the same patient?

Medicare typically covers CPT 93282 once per 90-day period per patient. Additional in-person interrogations within 90 days require clear documentation of medical necessity such as ICD shocks, symptomatic arrhythmias, device alerts, or programming issues that cannot be addressed through remote monitoring.

What is the difference between CPT 93282 and 93295?

CPT 93282 is for in-person ICD interrogation and programming with face-to-face physician interpretation, while 93295 is for remote interrogation of an ICD with data transmitted electronically and reviewed remotely. These codes cannot be billed for the same interrogation session and have different frequency limitations.

Can CPT 93282 be billed with an office visit on the same day?

Yes, CPT 93282 can be billed with an E/M service on the same day if modifier 25 is appended to the E/M code and documentation clearly shows a significant, separately identifiable evaluation beyond the device interrogation, such as addressing new symptoms, medication management, or other clinical issues.

What type of device does CPT 93282 cover?

CPT 93282 specifically covers single and dual chamber implantable cardioverter-defibrillators (ICDs) without cardiac resynchronization therapy. CRT-D devices use code 93283, pacemakers use 93280-93281, and implantable loop recorders use 93285 or 93291.

What are the RVU values for CPT 93282 in 2025?

For 2025, CPT 93282 has 0.85 work RVUs, 1.46 practice expense RVUs (both facility and non-facility), 0.04 malpractice RVUs, totaling 2.35 total RVUs according to the CMS Medicare Physician Fee Schedule RVU25A released December 23, 2024.

Do I need special credentials to bill CPT 93282?

CPT 93282 must be performed by or under the direct supervision of a physician or qualified non-physician practitioner with specific training in cardiac device management. The provider must have access to manufacturer-specific programming equipment and the expertise to interpret device data and make appropriate programming adjustments.