Billing code 93261: Defibrillator checkMedicare rate & RVUs
Report an in-person interrogation of an implanted subcutaneous defibrillator when its stored data and device function are reviewed without programming changes.
Medicare pays $69.81 for 93261 nationally in the office. Local office rates run $62.90–$91.47.
Medicare rate · 93261
Defibrillator check
Swap in your local Medicare rate.
- Work RVUs
- 0.72
- Total RVUs
- 2.09
- Global days
- XXX
National rate · 2026
$69.81
Office setting, before claim adjustments.
See every locality for 93261 → · 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.
On this page 10 sections
What 93261 covers
This service is an in-person check of an implanted subcutaneous cardioverter-defibrillator, or S-ICD. A device clinician retrieves stored information, such as detected arrhythmias, delivered therapies, and battery status; a physician or other qualified clinician analyzes the findings and prepares a report. It may be performed during an electrophysiology or cardiology device-clinic visit, including when a patient reports a shock or comes in for a routine device check.
Select 93261 when the encounter evaluates the subcutaneous system through interrogation rather than programming. The record should identify the device, the information retrieved, the clinician’s analysis, and the report. If the device is evaluated through programming adjustments, distinguish that service from interrogation alone. Medicare prices the complete service when 93261 is billed without a component modifier; modifier 26 identifies interpretation, and modifier TC identifies the equipment-and-staff portion. The cardiovascular diagnostic multiple-procedure reduction applies to the technical component when applicable.
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 93261 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
$62.90 to $91.47
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $63.68 | Unavailable |
| Alaska* | $84.12 | Unavailable |
| Arizona | $68.24 | Unavailable |
| Arkansas | $62.90 | Unavailable |
| Atlanta | $70.86 | Unavailable |
| Austin | $72.28 | Unavailable |
| Bakersfield | $74.01 | Unavailable |
| Baltimore/Surr. Cntys | $73.75 | Unavailable |
| Beaumont | $65.71 | Unavailable |
| Brazoria | $69.31 | Unavailable |
| Chicago | $71.93 | Unavailable |
| Chico | $73.86 | Unavailable |
| Colorado | $72.65 | Unavailable |
| Connecticut | $73.99 | Unavailable |
| Dallas | $69.66 | Unavailable |
| Dc + Md/Va Suburbs | $79.16 | Unavailable |
| Delaware | $69.26 | Unavailable |
| Detroit | $69.17 | Unavailable |
| East St. Louis | $67.61 | Unavailable |
| El Centro | $73.87 | Unavailable |
| Fort Lauderdale | $71.46 | Unavailable |
| Fort Worth | $69.23 | Unavailable |
| Fresno | $73.86 | Unavailable |
| Galveston | $69.46 | Unavailable |
| Hanford-Corcoran | $73.86 | Unavailable |
| Hawaii, Guam | $75.33 | Unavailable |
| Houston | $70.19 | Unavailable |
| Idaho | $65.55 | Unavailable |
| Indiana | $65.88 | Unavailable |
| Iowa | $65.23 | Unavailable |
| Kansas | $64.88 | Unavailable |
| Kentucky | $64.76 | Unavailable |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | $78.47 | Unavailable |
| Madera | $73.86 | Unavailable |
| Manhattan | $79.33 | Unavailable |
| Merced | $73.86 | Unavailable |
| Metropolitan Boston | $79.27 | Unavailable |
| Metropolitan Kansas City | $67.07 | Unavailable |
| Metropolitan Philadelphia | $72.32 | Unavailable |
| Metropolitan St. Louis | $67.68 | Unavailable |
| Miami | $73.67 | Unavailable |
| Minnesota | $70.16 | Unavailable |
| Mississippi | $63.28 | Unavailable |
| Modesto | $73.86 | Unavailable |
| Montana** | $69.81 | Unavailable |
| Napa | $84.79 | Unavailable |
| Nebraska | $65.56 | Unavailable |
| Nevada** | $69.63 | Unavailable |
| New Hampshire | $71.46 | Unavailable |
| New Mexico | $66.39 | Unavailable |
| New Orleans | $67.37 | Unavailable |
| North Carolina | $66.35 | Unavailable |
| North Dakota** | $69.01 | Unavailable |
| Northern Nj | $78.52 | Unavailable |
| Nyc Suburbs/Long Island | $80.89 | Unavailable |
| Ohio | $65.95 | Unavailable |
| Oklahoma | $64.76 | Unavailable |
| Oxnard-Thousand Oaks-Ventura | $78.06 | Unavailable |
| Portland | $74.78 | Unavailable |
| Poughkpsie/N Nyc Suburbs | $75.39 | Unavailable |
| Puerto Rico | $70.28 | Unavailable |
| Queens | $80.02 | Unavailable |
| Redding | $73.86 | Unavailable |
| Rest Of California | $73.86 | Unavailable |
| Rest Of Florida | $68.53 | Unavailable |
| Rest Of Georgia | $65.27 | Unavailable |
| Rest Of Illinois | $66.70 | Unavailable |
| Rest Of Louisiana | $64.64 | Unavailable |
| Rest Of Maine | $65.75 | Unavailable |
| Rest Of Maryland | $70.47 | Unavailable |
| Rest Of Massachusetts | $72.28 | Unavailable |
| Rest Of Michigan | $66.12 | Unavailable |
| Rest Of Missouri | $63.64 | Unavailable |
| Rest Of New Jersey | $74.99 | Unavailable |
| Rest Of New York | $67.19 | Unavailable |
| Rest Of Oregon | $69.23 | Unavailable |
| Rest Of Pennsylvania | $66.09 | Unavailable |
| Rest Of Texas | $67.41 | Unavailable |
| Rest Of Washington | $72.16 | Unavailable |
| Rhode Island | $71.59 | Unavailable |
| Riverside-San Bernardino-Ontario | $74.31 | Unavailable |
| Sacramento-Roseville-Folsom | $77.29 | Unavailable |
| Salinas | $77.00 | Unavailable |
| San Diego-Chula Vista-Carlsbad | $78.62 | Unavailable |
| San Francisco-Oakland-Berkeley (Marin Cnty) | $89.58 | Unavailable |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | $89.54 | Unavailable |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | $91.47 | Unavailable |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | $91.28 | Unavailable |
| San Luis Obispo-Paso Robles | $75.77 | Unavailable |
| Santa Cruz-Watsonville | $79.24 | Unavailable |
| Santa Maria-Santa Barbara | $77.24 | Unavailable |
| Santa Rosa-Petaluma | $80.04 | Unavailable |
| Seattle (King Cnty) | $80.85 | Unavailable |
| South Carolina | $66.23 | Unavailable |
| South Dakota** | $68.92 | Unavailable |
| Southern Maine | $68.92 | Unavailable |
| Stockton | $73.86 | Unavailable |
| Suburban Chicago | $72.21 | Unavailable |
| Tennessee | $65.15 | Unavailable |
| Utah | $67.01 | Unavailable |
| Vallejo | $84.73 | Unavailable |
| Vermont | $68.70 | Unavailable |
| Virgin Islands | $70.28 | Unavailable |
| Virginia | $68.66 | Unavailable |
| Visalia | $73.86 | Unavailable |
| West Virginia | $64.56 | Unavailable |
| Wisconsin | $67.02 | Unavailable |
| Wyoming** | $69.46 | Unavailable |
| Yuba City | $73.86 | Unavailable |
93261 rates by state
Office rate range in each state. Select a state to see its payment localities.
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.
$62.90
$84.12
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $84.12 | 1 |
| AL | $63.68 | 1 |
| AR | $62.90 | 1 |
| AZ | $68.24 | 1 |
| CA | $73.86–$91.47 | 29 |
| CO | $72.65 | 1 |
| CT | $73.99 | 1 |
| DC | $79.16 | 1 |
| DE | $69.26 | 1 |
| FL | $68.53–$73.67 | 3 |
| GA | $65.27–$70.86 | 2 |
| GU | $75.33 | 1 |
| HI | $75.33 | 1 |
| IA | $65.23 | 1 |
| ID | $65.55 | 1 |
| IL | $66.70–$72.21 | 4 |
| IN | $65.88 | 1 |
| KS | $64.88 | 1 |
| KY | $64.76 | 1 |
| LA | $64.64–$67.37 | 2 |
| MA | $72.28–$79.27 | 2 |
| MD | $70.47–$79.16 | 3 |
| ME | $65.75–$68.92 | 2 |
| MI | $66.12–$69.17 | 2 |
| MN | $70.16 | 1 |
| MO | $63.64–$67.68 | 3 |
| MS | $63.28 | 1 |
| MT | $69.81 | 1 |
| NC | $66.35 | 1 |
| ND | $69.01 | 1 |
| NE | $65.56 | 1 |
| NH | $71.46 | 1 |
| NJ | $74.99–$78.52 | 2 |
| NM | $66.39 | 1 |
| NV | $69.63 | 1 |
| NY | $67.19–$80.89 | 5 |
| OH | $65.95 | 1 |
| OK | $64.76 | 1 |
| OR | $69.23–$74.78 | 2 |
| PA | $66.09–$72.32 | 2 |
| PR | $70.28 | 1 |
| RI | $71.59 | 1 |
| SC | $66.23 | 1 |
| SD | $68.92 | 1 |
| TN | $65.15 | 1 |
| TX | $65.71–$72.28 | 8 |
| UT | $67.01 | 1 |
| VA | $68.66–$79.16 | 2 |
| VI | $70.28 | 1 |
| VT | $68.70 | 1 |
| WA | $72.16–$80.85 | 2 |
| WI | $67.02 | 1 |
| WV | $64.56 | 1 |
| WY | $69.46 | 1 |
How the 93261 rate is calculated
Each of 93261’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 · 93261
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 0.72Practice expense 1.33Malpractice 0.04
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 93261
The CMS indicators that decide how 93261 is paid alongside other services.
CMS payment indicators · 93261
Defibrillator check
| 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
93261 without 26 · national office
$69.81
Defibrillator check
93261-26 · Professional component
$35.40
Pays only the interpretation and report.
93261 compared with similar codes
Compare codes
93261 vs 93260 vs 93289 vs 93288: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 93260S-ICD programming
- Both involve an implanted subcutaneous defibrillator. Choose 93261 for an in-person interrogation; choose 93260 when the evaluation involves programming adjustments.
- 93289Device interrogation
- Both describe in-person defibrillator interrogation. Code 93261 identifies a subcutaneous system, while 93289 identifies a conventional implanted defibrillator system.
- 93288Pacemaker interrogation
- Use 93288 for in-person interrogation of a pacemaker. Code 93261 is specific to an implanted subcutaneous defibrillator.
93261 billing questions
When is 93261 used instead of 93260?
Use 93261 for an in-person interrogation of the subcutaneous defibrillator. Code 93260 describes a programming evaluation involving adjustments to the device’s settings.
Does 93261 describe a check of a conventional transvenous ICD?
No. Code 93261 is specific to a subcutaneous defibrillator system; 93289 describes in-person interrogation of a conventional implanted defibrillator system.
How are the professional and technical portions billed?
Bill 93261 with modifier 26 for the interpretation or modifier TC for the equipment-and-staff portion. Billing without either component modifier represents the global service.
What documentation supports 93261?
Document that the subcutaneous defibrillator was interrogated in person, the device information reviewed, and the clinician’s analysis and report.
Can payment for the technical portion be reduced when other cardiovascular diagnostic tests are performed?
Yes. Medicare’s cardiovascular diagnostic multiple-procedure reduction applies to the technical component of 93261.
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
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