FeeBase
Log inGet started
Menu

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

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, 2026One payment locality70.9K Medicare services in 2024

In Puerto Rico, Medicare pays $83.41 for 93281 in the office.

$83.41Office (non-facility)
Not available in this settingHospital or facility
+0.7%vs the national office rate ($82.83)

Check a contract rate as a % of Medicare · 93281 nationwide

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

We’ll open 93281 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Puerto Rico
  2. What 93281 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. 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.

How Puerto Rico compares for 93281

Across 109 of 109 payment localities, the office rate for 93281 runs from $74.60 in Arkansas to $109.03 in San Benito County, CA. Puerto Rico pays $83.41. The RVUs are the same everywhere; the geographic indexes change the dollars.

93281 in Puerto Rico vs other payment areas
  1. Puerto Rico · this page$83.41
  2. Los Angeles, CA · California$93.36+$9.95
  3. Washington, DC area · District of Columbia$94.05+$10.64
  4. Miami, FL · Florida$87.08+$3.67
  5. Chicago, IL · Illinois$85.03+$1.62
  6. Manhattan, NY · New York$94.10+$10.69
  7. Alaska · Alaska$99.59+$16.18

Other areas in Puerto Rico first, then benchmark localities. Bars start at $0.

Every other payment area

93281 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$75.53—
ArkansasArkansas$74.60—
ArizonaArizona$80.97—
Bakersfield, CACalifornia$88.00—
Chico, CACalifornia$87.85—
El Centro, CACalifornia$87.85—
Fresno, CACalifornia$87.85—
Hanford, CACalifornia$87.85—

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

See 93281 in every payment locality

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.

The exact Puerto Rico inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

11,992

Code
93281
Physician work
0.83
Practice expense
1.61
Malpractice
0.04

GPCI2026.csv

91

Locality
Puerto Rico
Physician work
1.000
Practice expense
1.011
Malpractice
0.985
Office calculation for 93281 in Puerto Rico
ComponentRVULocality factorAdjusted
Physician work0.83× 1.0000.8300
Practice expense1.61× 1.0111.6277
Malpractice0.04× 0.9850.0394
Total RVUs2.4971
Conversion factor× 33.4009

Office rate, Puerto Rico$83.41

Office: (0.83 × 1 + 1.61 × 1.011 + 0.04 × 0.985) × $33.4009 = $83.41

Open 93281 in the RVU calculator

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

Codes related to 93281

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

Codes related to 93281
CodeHow it relatesOffice range, Puerto Rico
Same family
93279Pacemaker programming, single-lead or leadless systemProgramming evaluation for a single-lead pacemaker system.$67.28
93280Pacemaker programming check, dual-lead system, in personProgramming evaluation for a dual-lead pacemaker system.$79.05
Used instead
93284Defibrillator evaluation, multiple-lead systemProgramming evaluation for a multiple-lead implantable defibrillator, rather than a pacemaker.$104.87
93288Pacemaker interrogation, in person, including leadless systemsIn-person pacemaker interrogation when a programming evaluation is not performed.$55.88
93294Remote pacemaker check, professional review, up to 90 daysRemote interrogation evaluation for a pacemaker, rather than an in-person programming evaluation.$29.46

How 93281 has changed in Puerto Rico

93281 · Office / nonfacility

$83.41

Effective 2026-10-01

The base rate is $3.18 higher than on 2025-10-01, moving from $80.23 to $83.41 (4.0%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $80.23changed to$83.41

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 0.85 changed to 0.83
    • Practice expense RVU 1.58 changed to 1.61
    • Practice expense GPCI 1.007 changed to 1.011
    • Malpractice GPCI 0.982 changed to 0.985

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $83.57changed to$80.23

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 1.61 changed to 1.58

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $82.21changed to$83.57

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $86.49changed to$82.21

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 1.64 changed to 1.61
    • Malpractice RVU 0.05 changed to 0.04
    • Practice expense GPCI 1.008 changed to 1.007
    • Malpractice GPCI 0.984 changed to 0.982

  5. October 1, 2023

    RVU23D

    $86.07changed to$86.49

    • Practice expense GPCI 1.000 changed to 1.008
    • Malpractice GPCI 1.000 changed to 0.984

  6. January 1, 2023

    RVU23A

    $89.38changed to$86.07

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 1.67 changed to 1.64
    • Practice expense GPCI 1.008 changed to 1.000
    • Malpractice GPCI 0.986 changed to 1.000

    Held through RVU23B, RVU23C.

  7. January 1, 2022

    RVU22A

    $85.54changed to$89.38

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 1.54 changed to 1.67

    Held through RVU22B, RVU22C, RVU22D.

  8. January 1, 2021

    RVU21A

    $78.67changed to$85.54

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 1.28 changed to 1.54
    • Malpractice RVU 0.04 changed to 0.05
    • Malpractice GPCI 0.988 changed to 0.986

    Held through RVU21B, RVU21C, RVU21D.

  9. January 1, 2020

    RVU20A

    $71.26changed to$78.67

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 1.08 changed to 1.28
    • Practice expense GPCI 1.007 changed to 1.008
    • Malpractice GPCI 0.990 changed to 0.988

    Held through RVU20B, RVU20C, RVU20D.

  10. January 1, 2019

    RVU19A

    $64.65changed to$71.26

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 0.90 changed to 1.08

    Held through RVU19B, RVU19C, RVU19D.

  11. January 1, 2018

    RVU18AR1

    $63.94changed to$64.65

    • Conversion factor 35.8887 changed to 35.9996
    • Work RVU 0.90 changed to 0.85
    • Practice expense RVU 1.00 changed to 0.90
    • Practice expense GPCI 0.856 changed to 1.007
    • Malpractice GPCI 0.642 changed to 0.990

    Held through RVU18B, RVU18C, RVU18D.

  12. January 1, 2017

    RVU17A

    $57.38changed to$63.94

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 0.98 changed to 1.00
    • Practice expense GPCI 0.705 changed to 0.856
    • Malpractice GPCI 0.293 changed to 0.642

    Held through RVU17B, RVU17C, RVU17D.

  13. January 1, 2016

    RVU16A

    $57.59changed to$57.38

    • Conversion factor 35.9335 changed to 35.8043

    Held through RVU16B, RVU16C, RVU16D.

  14. July 1, 2015

    RVU15C

    $57.30changed to$57.59

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  15. January 1, 2015

    RVU15A

    $56.67changed to$57.30

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 0.97 changed to 0.98
    • Practice expense GPCI 0.692 changed to 0.705
    • Malpractice GPCI 0.271 changed to 0.293

    Held through RVU15B.

  16. January 1, 2014

    RVU14A

    $54.49changed to$56.67

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 1.02 changed to 0.97
    • Practice expense GPCI 0.678 changed to 0.692
    • Malpractice GPCI 0.249 changed to 0.271

    Held through RVU14B, RVU14C, RVU14D.

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: $54.49

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$83.41Not available in this settingRVU26D
2026-07-01$83.41Not available in this settingRVU26C
2026-04-01$83.41Not available in this settingRVU26B
2026-01-01$83.41Not available in this settingRVU26A
2025-10-01$80.23Not available in this settingRVU25D
2025-07-01$80.23Not available in this settingRVU25C
2025-04-01$80.23Not available in this settingRVU25B
2025-01-01$80.23Not available in this settingRVU25A
2024-10-01$83.57Not available in this settingRVU24D
2024-07-01$83.57Not available in this settingRVU24C
2024-04-01$83.57Not available in this settingRVU24B
2024-03-09$83.57Not available in this settingRVU24AR
2024-01-01$82.21Not available in this settingRVU24A
2023-10-01$86.49Not available in this settingRVU23D
2023-07-01$86.07Not available in this settingRVU23C
2023-04-01$86.07Not available in this settingRVU23B
2023-01-01$86.07Not available in this settingRVU23A
2022-10-01$89.38Not available in this settingRVU22D
2022-07-01$89.38Not available in this settingRVU22C
2022-04-01$89.38Not available in this settingRVU22B
2022-01-01$89.38Not available in this settingRVU22A
2021-10-01$85.54Not available in this settingRVU21D
2021-07-01$85.54Not available in this settingRVU21C
2021-04-01$85.54Not available in this settingRVU21B
2021-01-01$85.54Not available in this settingRVU21A
2020-10-01$78.67Not available in this settingRVU20D
2020-07-01$78.67Not available in this settingRVU20C
2020-04-01$78.67Not available in this settingRVU20B
2020-01-01$78.67Not available in this settingRVU20A
2019-10-01$71.26Not available in this settingRVU19D
2019-07-01$71.26Not available in this settingRVU19C
2019-04-01$71.26Not available in this settingRVU19B
2019-01-01$71.26Not available in this settingRVU19A
2018-10-01$64.65Not available in this settingRVU18D
2018-07-01$64.65Not available in this settingRVU18C
2018-04-01$64.65Not available in this settingRVU18B
2018-01-01$64.65Not available in this settingRVU18AR1
2017-10-01$63.94Not available in this settingRVU17D
2017-07-01$63.94Not available in this settingRVU17C
2017-04-01$63.94Not available in this settingRVU17B
2017-01-01$63.94Not available in this settingRVU17A
2016-10-01$57.38Not available in this settingRVU16D
2016-07-01$57.38Not available in this settingRVU16C
2016-04-01$57.38Not available in this settingRVU16B
2016-01-01$57.38Not available in this settingRVU16A
2015-10-01$57.59Not available in this settingRVU15D
2015-07-01$57.59Not available in this settingRVU15C
2015-04-01$57.30Not available in this settingRVU15B
2015-01-01$57.30Not available in this settingRVU15A
2014-10-01$56.67Not available in this settingRVU14D
2014-07-01$56.67Not available in this settingRVU14C
2014-04-01$56.67Not available in this settingRVU14B
2014-01-01$56.67Not available in this settingRVU14A
2013-10-01$54.49Not available in this settingRVU13D
2013-07-01$54.49Not available in this settingRVU13C
2013-04-01$54.49Not available in this settingRVU13B
2013-01-01$54.49Not available in this settingRVU13AR

Price 93281 for an earlier date of service

Where the Puerto Rico rate applies

Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.

  • Aceitunas
  • Adjuntas
  • Aguada
  • Aguadilla
  • Aguas Buenas
  • Aguas Claras
  • Aguilita
  • Aibonito

Browse all communities in Puerto Rico

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)
Geographic factors for Puerto RicoGPCI2026.csv, line 91 (RVU26D)

Open CMS sourceHow we calculate rates

Did this answer your question about what 93281 pays in Puerto Rico?

Tell us what you were actually trying to work out. We’ll answer you directly, or build the page that does.

Fee sheets · Coming soon

Put 93281 and the rest of your codes on one sheet

Your codes at your locality, with payer contracts beside Medicare.

Join the waitlist