CPT 93750Cardiology

Interrogation vad in person

CPT code 93750 covers the in-person interrogation (checking and downloading data) from a ventricular assist device (VAD), a mechanical pump implanted to help a weakened heart pump blood.

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

0.75

PE RVU (NF)

0.66

MP RVU

0.13

Total RVU

1.54

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

NCCI bundling edits

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Billing tips

Bill 93750 only when full interrogation is performed with comprehensive device assessment and documentation; do not use for simple visual checks of controller displays
Impact: Prevents denials for insufficient documentation; ensures full $49.81 reimbursement rather than denial
Document all device parameters reviewed including flow rates, power consumption, pulsatility index, alarms, and battery status in medical record
Impact: Critical for audit defense; lack of complete documentation is the #1 reason for recoupment during post-payment audits
When billing with E/M code on same day, append modifier 25 to E/M and document separate medical decision-making beyond device interrogation
Impact: Can increase same-day reimbursement by $100-300 depending on E/M level when properly documented
Verify patient's VAD type and ensure 93750 is appropriate; some temporary devices or ECMO systems are not coded with 93750
Impact: Prevents denials for incorrect code selection; alternative codes may have different reimbursement rates
Do not bill 93750 more than once per day unless repeat interrogation is medically necessary and clearly documented
Impact: Frequency limitations apply; multiple same-day billings without justification will trigger denials and potential fraud scrutiny
Ensure place of service code matches actual location (office=11, outpatient hospital=22) to receive correct facility vs non-facility rate
Impact: Difference of $10.99 between non-facility ($49.81) and facility ($38.82) rates

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Frequently asked questions

What is the Medicare reimbursement rate for CPT 93750 in 2025?

The 2025 Medicare national average payment for CPT 93750 is $49.81 in non-facility settings and $38.82 in facility settings. These rates are based on 1.54 total RVUs multiplied by the 2025 conversion factor of 32.3465.

How often can CPT 93750 be billed for VAD interrogation?

CPT 93750 can be billed as medically necessary based on the patient's clinical condition and VAD management protocol. Most VAD patients require interrogation at each clinic visit, typically every 2-4 weeks during stable periods and more frequently during acute issues. Medical necessity must be documented for each interrogation.

Can CPT 93750 be billed with an E/M code on the same day?

Yes, CPT 93750 can be billed with an E/M service on the same day when the E/M represents a separately identifiable service beyond the device interrogation. Append modifier 25 to the E/M code and document the separate medical decision-making clearly in the medical record.

What is the difference between CPT 93750 and remote VAD monitoring?

CPT 93750 is specifically for in-person interrogation and evaluation of a VAD system. Remote monitoring or telephone consultation would be coded differently. The in-person nature allows for comprehensive device assessment and immediate clinical intervention if needed.

Who can perform and bill CPT 93750?

CPT 93750 must be performed by or under the direct supervision of a physician trained in mechanical circulatory support device management. Common specialists include cardiologists, cardiac surgeons, and advanced heart failure specialists. VAD coordinators may perform the technical component under appropriate physician supervision.

What documentation is required to bill CPT 93750?

Required documentation includes the device type, all interrogated parameters (flow rates, power, alarms, battery status), physician interpretation of findings, patient clinical status, and any actions taken. The medical record must demonstrate that a comprehensive device interrogation was performed, not just a visual check of the controller.

What are the RVU values for CPT 93750 in 2025?

CPT 93750 has a work RVU of 0.75, practice expense RVU of 0.66 (non-facility) or 0.32 (facility), and malpractice RVU of 0.13, for a total of 1.54 RVUs. These values reflect the moderate complexity of VAD interrogation and interpretation.