CPT code 93797: Cardiac rehab, without ECG monitoring2026 Medicare rate & RVUs in Michigan

Report this service for a physician- or qualified-health-care-professional-directed outpatient cardiac rehabilitation session conducted without ECG monitoring.

CMS RVU26DEffective Oct 1, 20262 payment localities12.5K Medicare services in 2024

Medicare pays $16.76–$17.53 for 93797 in the office in Michigan, from Rest of Michigan to Detroit, MI. Which amount applies depends on the service address.

$16.76–$17.53Office (non-facility)
$7.61–$7.86Hospital or facility

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 9 sections
  1. Rate in Michigan
  2. What 93797 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. Sources

What 93797 covers

This code represents an outpatient cardiac rehabilitation session without ECG monitoring. A physician or other qualified health care professional directs the service, which may include exercise-based recovery, risk-factor education, and counseling. Patients may be referred for rehabilitation after events or procedures such as myocardial infarction, coronary artery bypass surgery, or coronary intervention. The service is furnished in an outpatient rehabilitation program or another appropriate outpatient setting.

Report one unit for each session, selecting this code when the session is performed without ECG monitoring; use the monitoring distinction to separate it from 93798. Documentation should support the session provided and whether ECG monitoring was used. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. Bilateral adjustment is inappropriate. Assistant-at-surgery payment requires documented medical necessity; co-surgeon and team-surgery billing are not permitted.

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 93797 pays more and less in Michigan

93797 office and facility rates by payment locality
Payment localityOfficeFacility
Detroit, MI$17.53$7.86
Rest of Michigan$16.76$7.61

How the 93797 rate is calculated

Each of 93797’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 · 93797

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.18

0.18 RVUs× 1.000 GPCI

Practice expense0.34

0.34 RVUs× 1.000 GPCI

Malpractice0.01

0.01 RVUs× 1.000 GPCI

Adjusted RVUs

0.5300

Conversion factor

$33.4009

Medicare rate

$17.70

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

Payment rules and modifiers for 93797

The CMS indicators that decide how 93797 is paid alongside other services.

CMS payment indicators · 93797

Cardiac rehab, without ECG monitoring

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures0No multiple-procedure reduction.
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/technical0Physician service: no professional/technical split.

93797 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 93797

    Cardiac rehab, without ECG monitoring0.18 wRVU

    $17.70

  • 93798

    Cardiac rehabilitation, continuous ECG monitoring0.28 wRVU

    $26.05+$8.35

  • G0422

    Cardiac rehabilitation, intensive program with exercise2.05 wRVU

    $131.60+$113.90

  • G0423

    Cardiac rehabilitation, without exercise2.05 wRVU

    $131.60+$113.90

How to choose

93798Cardiac rehabilitationContinuous ECG monitoring
Both describe outpatient cardiac rehabilitation sessions; 93797 is for a session without ECG monitoring, while 93798 is for one with monitoring.
G0422Cardiac rehabilitationIntensive program with exercise
G0422 describes intensive cardiac rehabilitation with exercise. Use it for that program rather than a conventional session reported with 93797.
G0423Cardiac rehabilitationWithout exercise
G0423 describes intensive cardiac rehabilitation without exercise. It is distinct from a conventional cardiac rehabilitation session reported with 93797.

93797 billing questions

When should 93797 be chosen instead of 93798?

Choose 93797 for an outpatient cardiac rehabilitation session without ECG monitoring. Report 93798 when ECG monitoring is part of the session.

How many units are reported for a session?

Report one unit for each cardiac rehabilitation session. The documentation should identify the session and whether ECG monitoring was used.

Can 93797 and 93798 both be reported for the same session?

The codes distinguish sessions without and with ECG monitoring. Do not use both to describe the same session.

Does modifier 50 apply?

No. CMS identifies bilateral adjustment as inappropriate for this service.

What does the 0-day global period mean?

Same-day preoperative and postoperative care is included in the global service. The code does not carry a multi-day postoperative global period.

What documentation supports reporting 93797?

Record the outpatient cardiac rehabilitation session and the services furnished, including that ECG monitoring was not used. The record should support the physician- or qualified-health-care-professional-directed service.

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 93797PPRRVU2026_Oct_nonQPP.csv, line 12,270 (RVU26D)

Open CMS sourceHow we calculate rates

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