CPT 93291Cardiology

Interrog dev eval scrms ip

CPT 93291 covers the interrogation and evaluation of a subcutaneous cardiac rhythm monitoring system in hospitalized patients. This involves checking an implanted heart monitoring device to review recorded data and ensure proper function during an inpatient stay.

Showing rates for

National Average

Base Medicare rate

$46.58

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

0.37

PE RVU (NF)

1.05

MP RVU

0.02

Total RVU

1.44

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

NCCI bundling edits

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Billing tips

Distinguish 93291 (in-person/inpatient) from remote interrogation codes 93296-93298 to avoid denials
Impact: Prevents automatic denials and potential recoupment; incorrect code selection results in 100% claim rejection
Document time of interrogation, findings, clinical correlation, and treatment changes to support medical necessity
Impact: Reduces denial risk by 60-70% and supports appeals; inadequate documentation is the leading cause of denials for this code
Verify device type matches CPT 93291 descriptor (subcutaneous rhythm monitor only, not pacemakers or ICDs)
Impact: Using wrong device interrogation code can result in $50-$200+ payment difference and audit flags
Bill only once per hospitalization unless separate medical necessity documented for repeat interrogation
Impact: Medicare typically allows one interrogation per admission; unbundling can trigger audit and $46.58 recoupment per duplicate
Ensure 30-day interval from previous interrogation unless acute clinical change documented
Impact: Frequency limitations apply; violations result in denial of $46.58 and increased audit scrutiny
Use appropriate place of service code (21 for inpatient hospital) to match inpatient descriptor
Impact: Incorrect POS code triggers automatic denial; resubmission delays payment by 30-45 days

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Frequently asked questions

What is the Medicare reimbursement rate for CPT 93291 in 2025?

The 2025 Medicare national average payment for CPT 93291 is $46.58 for both facility and non-facility settings, based on 1.44 total RVUs and a conversion factor of 32.3465.

How often can CPT 93291 be billed for the same patient?

CPT 93291 is typically limited to once per inpatient admission unless separate medical necessity is documented for additional interrogations due to acute clinical changes, new symptoms, or medication adjustments requiring urgent device evaluation.

What is the difference between CPT 93291 and 93298?

CPT 93291 is for in-person interrogation of subcutaneous cardiac monitors in inpatient settings, while 93298 is for remote interrogation with automated data transmission. The setting (in-person vs remote) and data collection method determine the correct code.

Can CPT 93291 be billed with an E&M code on the same day?

Yes, CPT 93291 can be billed separately from E&M services when the device interrogation is medically necessary and separately documented. No modifier 25 is typically required as 93291 is not subject to standard E&M bundling, but documentation must show distinct services.

What devices are appropriate for billing CPT 93291?

CPT 93291 is specific to subcutaneous cardiac rhythm monitor systems (implantable loop recorders like Reveal LINQ, Confirm Rx). It should not be used for pacemakers (93288-93289) or ICDs (93289-93290), which have separate interrogation codes.

Do I need modifier 26 when billing CPT 93291 in a hospital?

Use modifier 26 only if you are billing for the professional component (interpretation) separately because the hospital owns the equipment and bills the technical component. If you own the equipment or are billing the complete service, no modifier is needed.

What RVU value does CPT 93291 have for 2025?

CPT 93291 has a total RVU of 1.44 for 2025, consisting of 0.37 work RVU, 1.05 practice expense RVU, and 0.02 malpractice RVU, identical for both facility and non-facility settings.