Billing code 93278: Signal-averaged ECGMedicare rate & RVUs
Reports signal-averaged electrocardiography used to assess cardiac electrical patterns, including late potentials associated with ventricular arrhythmia risk.
Medicare pays $33.07 for 93278 nationally in the office. Local office rates run $29.30–$44.42.
Medicare rate · 93278
Signal-averaged ECG
Swap in your local Medicare rate.
- Work RVUs
- 0.24
- Total RVUs
- 0.99
- Global days
- XXX
National rate · 2026
$33.07
Office setting, before claim adjustments.
See every locality for 93278 → · 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 93278 covers
Signal-averaged electrocardiography combines repeated cardiac electrical signals and applies specialized filtering to identify subtle late potentials that may be difficult to detect on a routine tracing. Cardiology diagnostic staff typically acquire the study in an outpatient testing area; a qualified practitioner interprets the results and prepares a report. Clinicians may use the findings when assessing a patient’s ventricular arrhythmia risk or evaluating a suspected arrhythmogenic substrate.
Report 93278 for the signal-averaged study, not for a routine 12-lead ECG or prolonged rhythm monitoring. The record should support the clinical reason for testing and include the study and its interpretation. Billing without a modifier represents the global service; modifier 26 identifies the professional interpretation and report, while modifier TC identifies the equipment and staff portion when those services are billed separately. 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 93278 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
$29.30 to $44.42
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $29.73 | Unavailable |
| Alaska* | $38.36 | Unavailable |
| Arizona | $32.21 | Unavailable |
| Arkansas | $29.30 | Unavailable |
| Atlanta | $33.62 | Unavailable |
| Austin | $34.42 | Unavailable |
| Bakersfield | $35.30 | Unavailable |
| Baltimore/Surr. Cntys | $35.13 | Unavailable |
| Beaumont | $30.83 | Unavailable |
| Brazoria | $32.76 | Unavailable |
| Chicago | $34.11 | Unavailable |
| Chico | $35.23 | Unavailable |
| Colorado | $34.58 | Unavailable |
| Connecticut | $35.24 | Unavailable |
| Dallas | $32.95 | Unavailable |
| Dc + Md/Va Suburbs | $37.92 | Unavailable |
| Delaware | $32.75 | Unavailable |
| Detroit | $32.67 | Unavailable |
| East St. Louis | $31.79 | Unavailable |
| El Centro | $35.24 | Unavailable |
| Fort Lauderdale | $33.92 | Unavailable |
| Fort Worth | $32.71 | Unavailable |
| Fresno | $35.23 | Unavailable |
| Galveston | $32.85 | Unavailable |
| Hanford-Corcoran | $35.23 | Unavailable |
| Hawaii, Guam | $36.13 | Unavailable |
| Houston | $33.21 | Unavailable |
| Idaho | $30.76 | Unavailable |
| Indiana | $30.94 | Unavailable |
| Iowa | $30.59 | Unavailable |
| Kansas | $30.39 | Unavailable |
| Kentucky | $30.30 | Unavailable |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | $37.63 | Unavailable |
| Madera | $35.23 | Unavailable |
| Manhattan | $37.92 | Unavailable |
| Merced | $35.23 | Unavailable |
| Metropolitan Boston | $38.05 | Unavailable |
| Metropolitan Kansas City | $31.56 | Unavailable |
| Metropolitan Philadelphia | $34.34 | Unavailable |
| Metropolitan St. Louis | $31.90 | Unavailable |
| Miami | $35.09 | Unavailable |
| Minnesota | $33.30 | Unavailable |
| Mississippi | $29.50 | Unavailable |
| Modesto | $35.23 | Unavailable |
| Montana** | $33.07 | Unavailable |
| Napa | $41.00 | Unavailable |
| Nebraska | $30.77 | Unavailable |
| Nevada** | $32.98 | Unavailable |
| New Hampshire | $33.98 | Unavailable |
| New Mexico | $31.18 | Unavailable |
| New Orleans | $31.72 | Unavailable |
| North Carolina | $31.19 | Unavailable |
| North Dakota** | $32.67 | Unavailable |
| Northern Nj | $37.52 | Unavailable |
| Nyc Suburbs/Long Island | $38.76 | Unavailable |
| Ohio | $30.95 | Unavailable |
| Oklahoma | $30.31 | Unavailable |
| Oxnard-Thousand Oaks-Ventura | $37.48 | Unavailable |
| Portland | $35.73 | Unavailable |
| Poughkpsie/N Nyc Suburbs | $35.88 | Unavailable |
| Puerto Rico | $33.33 | Unavailable |
| Queens | $38.31 | Unavailable |
| Redding | $35.23 | Unavailable |
| Rest Of California | $35.23 | Unavailable |
| Rest Of Florida | $32.33 | Unavailable |
| Rest Of Georgia | $30.56 | Unavailable |
| Rest Of Illinois | $31.32 | Unavailable |
| Rest Of Louisiana | $30.23 | Unavailable |
| Rest Of Maine | $30.86 | Unavailable |
| Rest Of Maryland | $33.38 | Unavailable |
| Rest Of Massachusetts | $34.35 | Unavailable |
| Rest Of Michigan | $31.03 | Unavailable |
| Rest Of Missouri | $29.68 | Unavailable |
| Rest Of New Jersey | $35.70 | Unavailable |
| Rest Of New York | $31.65 | Unavailable |
| Rest Of Oregon | $32.77 | Unavailable |
| Rest Of Pennsylvania | $31.03 | Unavailable |
| Rest Of Texas | $31.76 | Unavailable |
| Rest Of Washington | $34.30 | Unavailable |
| Rhode Island | $33.95 | Unavailable |
| Riverside-San Bernardino-Ontario | $35.45 | Unavailable |
| Sacramento-Roseville-Folsom | $37.02 | Unavailable |
| Salinas | $36.88 | Unavailable |
| San Diego-Chula Vista-Carlsbad | $37.78 | Unavailable |
| San Francisco-Oakland-Berkeley (Marin Cnty) | $43.46 | Unavailable |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | $43.44 | Unavailable |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | $44.42 | Unavailable |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | $44.32 | Unavailable |
| San Luis Obispo-Paso Robles | $36.28 | Unavailable |
| Santa Cruz-Watsonville | $38.17 | Unavailable |
| Santa Maria-Santa Barbara | $37.03 | Unavailable |
| Santa Rosa-Petaluma | $38.56 | Unavailable |
| Seattle (King Cnty) | $38.88 | Unavailable |
| South Carolina | $31.11 | Unavailable |
| South Dakota** | $32.62 | Unavailable |
| Southern Maine | $32.60 | Unavailable |
| Stockton | $35.23 | Unavailable |
| Suburban Chicago | $34.30 | Unavailable |
| Tennessee | $30.54 | Unavailable |
| Utah | $31.54 | Unavailable |
| Vallejo | $40.96 | Unavailable |
| Vermont | $32.49 | Unavailable |
| Virgin Islands | $33.33 | Unavailable |
| Virginia | $32.46 | Unavailable |
| Visalia | $35.23 | Unavailable |
| West Virginia | $30.16 | Unavailable |
| Wisconsin | $31.58 | Unavailable |
| Wyoming** | $32.89 | Unavailable |
| Yuba City | $35.23 | Unavailable |
93278 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.
$29.30
$39.83
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 | $38.36 | 1 |
| AL | $29.73 | 1 |
| AR | $29.30 | 1 |
| AZ | $32.21 | 1 |
| CA | $35.23–$44.42 | 29 |
| CO | $34.58 | 1 |
| CT | $35.24 | 1 |
| DC | $37.92 | 1 |
| DE | $32.75 | 1 |
| FL | $32.33–$35.09 | 3 |
| GA | $30.56–$33.62 | 2 |
| GU | $36.13 | 1 |
| HI | $36.13 | 1 |
| IA | $30.59 | 1 |
| ID | $30.76 | 1 |
| IL | $31.32–$34.30 | 4 |
| IN | $30.94 | 1 |
| KS | $30.39 | 1 |
| KY | $30.30 | 1 |
| LA | $30.23–$31.72 | 2 |
| MA | $34.35–$38.05 | 2 |
| MD | $33.38–$37.92 | 3 |
| ME | $30.86–$32.60 | 2 |
| MI | $31.03–$32.67 | 2 |
| MN | $33.30 | 1 |
| MO | $29.68–$31.90 | 3 |
| MS | $29.50 | 1 |
| MT | $33.07 | 1 |
| NC | $31.19 | 1 |
| ND | $32.67 | 1 |
| NE | $30.77 | 1 |
| NH | $33.98 | 1 |
| NJ | $35.70–$37.52 | 2 |
| NM | $31.18 | 1 |
| NV | $32.98 | 1 |
| NY | $31.65–$38.76 | 5 |
| OH | $30.95 | 1 |
| OK | $30.31 | 1 |
| OR | $32.77–$35.73 | 2 |
| PA | $31.03–$34.34 | 2 |
| PR | $33.33 | 1 |
| RI | $33.95 | 1 |
| SC | $31.11 | 1 |
| SD | $32.62 | 1 |
| TN | $30.54 | 1 |
| TX | $30.83–$34.42 | 8 |
| UT | $31.54 | 1 |
| VA | $32.46–$37.92 | 2 |
| VI | $33.33 | 1 |
| VT | $32.49 | 1 |
| WA | $34.30–$38.88 | 2 |
| WI | $31.58 | 1 |
| WV | $30.16 | 1 |
| WY | $32.89 | 1 |
How the 93278 rate is calculated
Each of 93278’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 · 93278
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 0.24Practice expense 0.73Malpractice 0.02
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 93278
The CMS indicators that decide how 93278 is paid alongside other services.
CMS payment indicators · 93278
Signal-averaged ECG
| 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
93278 without 26 · national office
$33.07
Signal-averaged ECG
93278-26 · Professional component
$12.36
Pays only the interpretation and report.
93278 compared with similar codes
Compare codes
93278 vs 93000 vs 93268 vs 93272: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 93000Electrocardiogram (ECG)
- 93000 reports a conventional 12-lead ECG with interpretation and report. Choose 93278 when the service is specifically signal-averaged analysis for late potentials.
- 93268ECG monitoring
- 93268 describes an external event-monitor service used to capture ECG data over time. 93278 is a signal-averaged study, not prolonged symptom-triggered monitoring.
- 93272Event monitor
- 93272 represents interpretation of an external event-monitor recording. It is not the professional portion of 93278, which is reported with modifier 26.
93278 billing questions
When should 93278 be selected instead of a routine ECG?
Use 93278 for a signal-averaged study that analyzes filtered, combined cardiac signals for late potentials. A routine ECG such as 93000 records a conventional tracing.
Can the professional and technical portions be billed separately?
Yes. Modifier 26 identifies the interpretation and report, and modifier TC identifies the equipment and staff portion. Without a modifier, the claim represents the global service.
Does the multiple-procedure reduction affect both portions?
No. The cardiovascular diagnostic multiple-procedure reduction applies to the technical component of 93278.
What documentation supports 93278?
Document the clinical reason for signal-averaged testing, the study performed, and the practitioner’s interpretation and report.
Is 93278 the same as ambulatory event monitoring?
No. 93278 analyzes a signal-averaged ECG; event-monitor codes describe recording, monitoring, or interpretation of ECG data collected over time.
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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