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CPT code 93281: Pacemaker evaluation, multiple-lead system2026 Medicare rate & RVUs

Report this service for an in-person programming evaluation of a multiple-lead pacemaker, including device analysis, review, and a professional report.

CMS RVU26DEffective Oct 1, 2026109 payment localities70.9K Medicare services in 2024

Medicare pays $82.83 for 93281 nationally in the office. Local office rates run $74.60–$109.03.

Medicare rate · 93281

Pacemaker evaluation, multiple-lead system

Office or facility?

Work RVUs
0.83
Total RVUs
2.48
Global days
XXX

National rate · 2026

$82.83

Office setting, before claim adjustments.

See every locality for 93281 →Billed by an NP, PA or therapist? →

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 93281 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 93281 covers

A clinician evaluates an implanted multiple-lead pacemaker in person using a device programmer. The work includes assessing device function and available diagnostic information, reviewing the programmed settings, and making iterative adjustments when needed. This code is commonly relevant to cardiology and electrophysiology practices managing patients with a multiple-lead pacing system, such as a biventricular pacemaker. The evaluation produces a report of the findings and any programming performed.

Select this code based on the implanted device’s lead configuration, not simply the patient’s diagnosis or the number of settings changed. Documentation should identify the pacemaker system and support the evaluation, including relevant findings and any adjustments. CMS treats the service as a diagnostic test: report modifier 26 for the professional interpretation, modifier TC for the technical work, or no component modifier for the global service. The cardiovascular diagnostic multiple procedure reduction applies to the technical component.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

Where 93281 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 payment localities

$74.60 to $109.03

$74.60$91.81$109.03
One dot per payment locality, office / nonfacility. Hover a dot to see the locality; select it to open that rate.

109 of 109 payment localities

93281 office and facility rates by payment locality
Payment localityOfficeFacility
Alabama$75.53Unavailable
Alaska$99.59Unavailable
Arizona$80.97Unavailable
Arkansas$74.60Unavailable
Atlanta, GA$84.05Unavailable
Austin, TX$85.86Unavailable
Bakersfield, CA$88.00Unavailable
Baltimore area, MD$87.52Unavailable
Beaumont, TX$77.90Unavailable
Brazoria, TX$82.28Unavailable

93281 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$74.60

$99.59

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
93281 office rate range by state
State / territoryOffice rate rangeLocalities
AK$99.591
AL$75.531
AR$74.601
AZ$80.971
CA$87.85–$109.0329
CO$86.321
CT$87.811
DC$94.051
DE$82.191
FL$81.14–$87.083
GA$77.28–$84.052
GU$89.641
HI$89.641
IA$77.461
ID$77.831
IL$78.91–$85.514
IN$78.221
KS$77.011
KY$76.751
LA$76.59–$79.842
MA$85.86–$94.262
MD$83.65–$94.053
ME$78.03–$81.862
MI$78.33–$81.872
MN$83.451
MO$75.38–$80.263
MS$75.011
MT$82.831
NC$78.751
ND$82.041
NE$77.861
NH$84.871
NJ$89.02–$93.282
NM$78.641
NV$82.661
NY$79.75–$95.925
OH$78.171
OK$76.781
OR$82.22–$88.902
PA$78.35–$85.802
PR$83.411
RI$84.991
SC$78.551
SD$81.951
TN$77.321
TX$77.90–$85.868
UT$79.471
VA$81.53–$94.052
VI$83.411
VT$81.641
WA$85.73–$96.182
WI$79.651
WV$76.371
WY$82.491

How the 93281 rate is calculated

Each of 93281’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 93281

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.83

0.83 RVUs× 1.000 GPCI

Practice expense1.61

1.61 RVUs× 1.000 GPCI

Malpractice0.04

0.04 RVUs× 1.000 GPCI

Adjusted RVUs

2.4800

Conversion factor

$33.4009

Medicare rate

$82.83

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 93281

The CMS indicators that decide how 93281 is paid alongside other services.

CMS payment indicators · 93281

Pacemaker evaluation, multiple-lead system

RuleCMS valueWhat it means
Global periodXXXThe global surgery concept doesn’t apply.
Multiple procedures6Diagnostic cardiovascular reduction applies to the technical component.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical1Diagnostic test with separate professional (26) and technical (TC) components.

What modifiers do to the payment

Modifier 26 · payment effect

With and without the modifier

93281 without 26 · national office

$82.83

Pacemaker evaluation, multiple-lead system

93281-26 · Professional component

$40.75

Pays only the interpretation and report.

When to use modifier 26

93281 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 93281

    Pacemaker evaluation, multiple-lead system0.83 wRVU

    $82.83

  • 93280

    Pacemaker programming check, dual-lead system, in person0.75 wRVU

    $78.49−$4.34

  • 93284

    Defibrillator evaluation, multiple-lead system1.22 wRVU

    $104.21+$21.38

  • 93288

    Pacemaker interrogation, in person, including leadless systems0.42 wRVU

    $55.45−$27.38

How to choose

93280Pacemaker programming checkDual-lead system, in person
93280 is for a dual-lead pacemaker system. Use 93281 when the implanted pacemaker has a multiple-lead configuration.
93284Defibrillator evaluationMultiple-lead system
93284 applies to programming evaluation of a multiple-lead implantable defibrillator. 93281 is for a multiple-lead pacemaker.
93288Pacemaker interrogationIn person, including leadless systems
93288 describes in-person pacemaker interrogation without the programming evaluation represented by 93281. Choose based on the service performed.

Codes related to 93281

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 93281
CodeHow it relatesNational office range
Same family
93279Pacemaker programming, single-lead or leadless systemProgramming evaluation for a single-lead pacemaker system.$60.01–$88.43
93280Pacemaker programming check, dual-lead system, in personProgramming evaluation for a dual-lead pacemaker system.$70.50–$103.66
Used instead
93284Defibrillator evaluation, multiple-lead systemProgramming evaluation for a multiple-lead implantable defibrillator, rather than a pacemaker.$94.69–$135.23
93288Pacemaker interrogation, in person, including leadless systemsIn-person pacemaker interrogation when a programming evaluation is not performed.$49.38–$74.69
93294Remote pacemaker check, professional review, up to 90 daysRemote interrogation evaluation for a pacemaker, rather than an in-person programming evaluation.$27.57–$39.19

93281 billing questions

How does 93281 differ from 93280?

Choose 93281 for a multiple-lead pacemaker system and 93280 for a dual-lead system. Base the choice on the implanted system’s configuration.

Can 93281 be reported if no settings are changed?

The evaluation includes review and analysis of the device, with programming adjustments when needed. Document the assessment and findings even when settings remain unchanged.

Can the interrogation work be billed separately?

The device analysis, review, and report are part of the programming evaluation. Do not separately itemize the same evaluation work as a separate interrogation service.

When should modifier 26 or TC be used?

Use modifier 26 for the professional interpretation and modifier TC for the technical work involving equipment and staff. Without either modifier, the claim represents the global service.

Does the multiple procedure reduction affect the whole service?

The cardiovascular diagnostic multiple procedure reduction applies to the technical component. It does not apply to the professional component.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 93281PPRRVU2026_Oct_nonQPP.csv, line 11,992 (RVU26D)

Open CMS sourceHow we calculate rates

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