CPT 93624Cardiology

Ep f-up study pacg&rec

CPT 93624 covers follow-up electrophysiology studies where a physician evaluates how well an implanted pacemaker or cardiac device is working by testing the heart's electrical pacing and recording the response. This is a routine monitoring procedure to ensure the device is functioning properly and the settings are optimized for the patient.

Showing rates for

National Average

Base Medicare rate

$225.78

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

4.55

PE RVU (NF)

1.56

MP RVU

0.87

Total RVU

6.98

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

NCCI bundling edits

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Billing tips

Document separately from device interrogation codes (93288-93296) by clearly describing the invasive catheter placement, pacing protocol, and electrogram recording distinct from routine device checks
Impact: Prevents bundling denials that could result in loss of $225.78 and ensures appropriate separate reimbursement for both services
Verify medical necessity documentation includes specific indication for invasive EP study beyond routine device follow-up, such as syncope evaluation, medication changes, or device malfunction investigation
Impact: Reduces denial rate by 30-40% and supports medical necessity when documentation links study to specific clinical concerns
Bill globally without modifier 26 when performed in physician-owned EP lab or ASC where you own both professional and technical components
Impact: Captures full $225.78 reimbursement instead of only professional component at approximately $90-113
When performed with comprehensive EP studies (93619-93622), review NCCI edits carefully and use modifier 59 only when separate pacing protocols from different sites are documented
Impact: Appropriate modifier use can add $225.78 to claim when clinically distinct studies are performed; improper use triggers audit risk
For hospital outpatient settings, ensure facility bills technical component with place of service 22 while physician bills professional component with modifier 26
Impact: Proper component billing prevents duplicate payment issues and ensures each party receives appropriate share of $225.78 total
Document exact site of pacing and recording (atrium vs ventricle, right vs left) and number of catheters used to support code selection and defend against downcoding to simpler studies

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Frequently asked questions

What is the Medicare reimbursement rate for CPT 93624 in 2025?

The 2025 Medicare national average reimbursement for CPT 93624 is $225.78 for both facility and non-facility settings. This is based on a total RVU of 6.98 (Work RVU 4.55, PE RVU 1.56, MP RVU 0.87) multiplied by the 2025 conversion factor of 32.3465.

Can CPT 93624 be billed with device interrogation codes on the same day?

Yes, CPT 93624 can be billed separately from device interrogation codes (93288-93296) when the invasive EP study with catheter placement and pacing is clinically distinct from routine device checking. Documentation must clearly differentiate the invasive pacing study from external device interrogation, and modifier 59 may be required to bypass NCCI edits.

What is the difference between CPT 93624 and comprehensive EP studies?

CPT 93624 is a follow-up EP study with pacing and recording from a single site, typically for device monitoring or limited evaluation. Comprehensive EP studies (93619-93622) involve more extensive mapping, multiple pacing sites, induction protocols for arrhythmias, and are usually initial diagnostic procedures rather than follow-up studies.

Do I need modifier 26 when billing 93624 in a hospital outpatient setting?

Yes, physicians should append modifier 26 when billing only the professional component (interpretation) of 93624 in hospital outpatient departments where the facility owns the equipment and employs technical staff. The hospital bills the technical component separately. Without modifier 26, you're billing globally for both components.

How often can CPT 93624 be billed for the same patient?

There is no specific CMS frequency limitation for CPT 93624, but medical necessity must be documented for each study. Typical follow-up intervals are 3-6 months for stable device patients, but more frequent studies may be justified by symptoms, device alerts, medication changes, or clinical deterioration requiring re-evaluation.

What documentation is required to support medical necessity for 93624?

Documentation must include the specific clinical indication beyond routine device monitoring, such as syncope, palpitations, device malfunction alerts, new medications affecting cardiac conduction, or evaluation of arrhythmia recurrence. The invasive nature of catheter placement and pacing protocol must be clearly described, distinguishing it from simple external device interrogation.

What are the work RVUs for CPT code 93624 in 2025?

CPT 93624 has a work RVU of 4.55 in 2025, with practice expense RVU of 1.56 (both facility and non-facility) and malpractice RVU of 0.87, for a total RVU of 6.98. This reflects moderate physician work involving invasive catheter placement, pacing protocol execution, and electrogram interpretation.