CPT code 93281: Pacemaker evaluation, multiple-lead system2026 Medicare rate & RVUs in Missouri
Report this service for an in-person programming evaluation of a multiple-lead pacemaker, including device analysis, review, and a professional report.
Medicare pays $75.38–$80.26 for 93281 in the office in Missouri, from Rest of Missouri to Metropolitan St. Louis, MO. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
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 in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
3 payment localities
$75.38 to $80.26
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | $79.52 | Unavailable |
| Metropolitan St. Louis, MO | $80.26 | Unavailable |
| Rest of Missouri | $75.38 | Unavailable |
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
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
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| Multiple procedures | 6 | Diagnostic cardiovascular reduction applies to the technical component. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 1 | Diagnostic 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.
93281 compared with similar codes
Compare codes · National
4 codes, side by side
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.
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.
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