CPT 93287Cardiology

Peri-px device eval & prgr

CPT 93287 covers the evaluation and programming of a pacemaker device immediately before and after a surgical procedure. This ensures the device is properly configured for the patient's safety during surgery and optimized afterward.

Showing rates for

National Average

Base Medicare rate

$49.81

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

0.45

PE RVU (NF)

1.07

MP RVU

0.02

Total RVU

1.54

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

NCCI bundling edits

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Billing tips

Document the distinct peri-procedural nature by specifying pre-procedure device settings, intra-procedure modifications (such as magnet mode, VVI backup pacing, rate changes), and post-procedure restoration with verification
Impact: Prevents bundling denials that result in 100% payment loss ($49.81); payers frequently deny when documentation appears routine rather than procedure-specific
Bill 93287 separately from the primary surgical procedure with clear time documentation showing evaluation occurred immediately before and after the procedure, not as part of routine device follow-up
Impact: Ensures payment is not bundled into surgical global period; can recover $49.81 per case that is often incorrectly bundled
Do not bill 93287 on the same day as routine device interrogation codes (93288-93294) unless the services are truly distinct and separately documented
Impact: Avoids duplicate service denials; if both are billed together without modifier 59/XU and proper documentation, expect denial of one or both services
Verify that the primary procedure requires pacemaker programming changes; document medical necessity such as use of electrocautery, MRI, or other electromagnetic interference risk
Impact: Medical necessity documentation reduces denial rate by approximately 30-40%; many payers require specific justification beyond mere presence of device
For procedures requiring both pre- and post-procedure evaluations performed on different calendar days, bill 93287 only once for the complete peri-procedural service, not separately for each date
Impact: Prevents overbilling flags and potential audits; code includes both components within single payment of $49.81

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Frequently asked questions

What is the Medicare reimbursement rate for CPT 93287 in 2025?

The 2025 Medicare national average payment for CPT 93287 is $49.81 for both facility and non-facility settings. This is based on 1.54 total RVUs multiplied by the 2025 conversion factor of 32.3465.

Can CPT 93287 be billed on the same day as the surgical procedure?

Yes, CPT 93287 is specifically designed to be billed on the same day as the surgical or invasive procedure it accompanies. However, documentation must clearly show it is a separate, medically necessary service performed immediately before and after the procedure for device safety, not a routine device check.

What is the difference between CPT 93287 and routine pacemaker interrogation codes?

CPT 93287 is for peri-procedural evaluation specifically related to a surgical procedure requiring temporary device programming changes, while codes 93288-93294 are for routine in-office device monitoring. The key difference is timing (immediately before/after surgery) and purpose (procedural safety versus routine follow-up).

Do I need a modifier when billing CPT 93287 with other device evaluation codes?

Yes, if billing 93287 on the same day as other device interrogation codes, you typically need modifier 59 or XU to indicate they are distinct services. However, this is uncommon - most peri-procedural evaluations should not occur on the same day as routine interrogations unless clearly documented as separate encounters.

How many RVUs is CPT code 93287 worth?

CPT 93287 has 1.54 total RVUs for 2025, consisting of 0.45 work RVUs, 1.07 practice expense RVUs, and 0.02 malpractice RVUs. The PE RVU is the same (1.07) for both facility and non-facility settings.

Can CPT 93287 be billed for pacemaker evaluation before an MRI?

Yes, CPT 93287 is appropriate for pacemaker evaluation before and after an MRI when programming changes are necessary for patient safety during the scan. Documentation must include specific parameter changes made for MRI compatibility and post-MRI restoration and verification of proper function.

Who can perform and bill CPT 93287 services?

CPT 93287 must be performed by or under the direct supervision of a physician trained in cardiac device management, typically cardiologists or electrophysiologists. While technical staff may perform the actual interrogation and programming, physician involvement in reviewing data and making clinical decisions is required for billing.