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CMS RVU26D · Effective 2026-10-01

93260 in Delaware

Office / nonfacility

$74.93

Base rate per service

Facility setting

Not available in this setting

Base rate per service

Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.

Cardiac device services

About 93260: In-person subcutaneous ICD programming evaluation

Report this service for an in-person evaluation and programming of a subcutaneous implantable defibrillator, including review of device information and settings.

This service covers an in-person programming evaluation of a subcutaneous implantable cardioverter-defibrillator (S-ICD). A cardiologist or electrophysiology clinician assesses the system, reviews available device information, and adjusts programmable settings when indicated. It is distinct from remote monitoring and from programming evaluations for ICD systems with transvenous leads. The service is typically performed in a cardiology or electrophysiology clinic, with device equipment and staff supporting the evaluation.

Choose 93260 for an S-ICD programming evaluation; use the interrogation service when the encounter involves device review without programming. Documentation should identify the S-ICD, record the evaluation and any programming changes, and support the clinician’s interpretation and report. The service has separately payable professional and technical components: report modifier 26 for the professional interpretation, modifier TC for the equipment and staff, or neither modifier for the global service. When multiple cardiovascular diagnostic procedures are performed, the multiple procedure reduction applies to the technical component.

CMS billing rules for 93260

Professional and technical components
Diagnostic test with a professional component (modifier 26, interpretation) and a technical component (modifier TC, equipment and staff); billing without a modifier is the global service.
Multiple procedures
Cardiovascular diagnostic multiple procedure reduction applies to the technical component.

Where the value comes from

  • Work RVU0.83 · 37%
  • Practice expense (office) RVU1.39 · 62%
  • Malpractice RVU0.04 · 2%

2.1K

Medicare services in 2024 · #2429 by national volume

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.

93260 compared with similar codes

Office rates for Delaware, from the same CMS release.

93261

Defibrillator check

Subcutaneous system, interrogation only

$69.26

Use 93260 for an in-person S-ICD programming evaluation. Use 93261 for S-ICD interrogation when the service is device review without programming.

93282

ICD programming

Single-lead system

$77.90

93282 covers programming evaluation of a single-lead implantable defibrillator system; 93260 is for a subcutaneous ICD.

93287

ICD evaluation

Periprocedural

$51.31

93287 describes periprocedural implantable defibrillator evaluation and programming. 93260 is the in-person S-ICD programming evaluation outside that periprocedural context.

The same code, a different location

How does Delaware compare?

93260 across payment areas

Same release and payment basis · bars start at $0

  1. Delaware · This locality

    $74.93

  2. Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty)

    $84.67

    $9.74 higher than Delaware

  3. Dc + Md/Va Suburbs

    $85.40

    $10.47 higher than Delaware

  4. Miami

    $79.43

    $4.50 higher than Delaware

  5. Chicago

    $77.64

    $2.71 higher than Delaware

  6. Manhattan

    $85.56

    $10.63 higher than Delaware

  7. Alaska*

    $91.77

    $16.84 higher than Delaware

Other payment areas listed in Delaware appear first, followed by selected cross-country examples. The chart compares amounts, not distance.

Across 109 of 109 CMS payment localities with a supported office rate, 93260 ranges from $68.29 in Arkansas to $98.44 in San Jose-Sunnyvale-Santa Clara (San Benito Cnty). This is a geographic range, not an average.

The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.

Compare all 108 other payment areas

  • Alabama

    Alabama · 93260

    Office

    $69.10

    Facility

    Unavailable

    $5.83 lower than Delaware for the office setting.

  • Arkansas

    Arkansas · 93260

    Office

    $68.29

    Facility

    Unavailable

    $6.64 lower than Delaware for the office setting.

  • Arizona

    Arizona · 93260

    Office

    $73.85

    Facility

    Unavailable

    $1.08 lower than Delaware for the office setting.

  • Bakersfield

    California · 93260

    Office

    $79.95

    Facility

    Unavailable

    $5.02 higher than Delaware for the office setting.

  • Chico

    California · 93260

    Office

    $79.79

    Facility

    Unavailable

    $4.86 higher than Delaware for the office setting.

  • El Centro

    California · 93260

    Office

    $79.80

    Facility

    Unavailable

    $4.87 higher than Delaware for the office setting.

  • Fresno

    California · 93260

    Office

    $79.79

    Facility

    Unavailable

    $4.86 higher than Delaware for the office setting.

  • Hanford-Corcoran

    California · 93260

    Office

    $79.79

    Facility

    Unavailable

    $4.86 higher than Delaware for the office setting.

  • Madera

    California · 93260

    Office

    $79.79

    Facility

    Unavailable

    $4.86 higher than Delaware for the office setting.

  • Merced

    California · 93260

    Office

    $79.79

    Facility

    Unavailable

    $4.86 higher than Delaware for the office setting.

  • Modesto

    California · 93260

    Office

    $79.79

    Facility

    Unavailable

    $4.86 higher than Delaware for the office setting.

  • Napa

    California · 93260

    Office

    $91.34

    Facility

    Unavailable

    $16.41 higher than Delaware for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 93260

    Office

    $84.21

    Facility

    Unavailable

    $9.28 higher than Delaware for the office setting.

  • Redding

    California · 93260

    Office

    $79.79

    Facility

    Unavailable

    $4.86 higher than Delaware for the office setting.

  • Rest Of California

    California · 93260

    Office

    $79.79

    Facility

    Unavailable

    $4.86 higher than Delaware for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 93260

    Office

    $80.25

    Facility

    Unavailable

    $5.32 higher than Delaware for the office setting.

  • Sacramento-Roseville-Folsom

    California · 93260

    Office

    $83.43

    Facility

    Unavailable

    $8.50 higher than Delaware for the office setting.

  • Salinas

    California · 93260

    Office

    $83.11

    Facility

    Unavailable

    $8.18 higher than Delaware for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 93260

    Office

    $84.81

    Facility

    Unavailable

    $9.88 higher than Delaware for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 93260

    Office

    $96.43

    Facility

    Unavailable

    $21.50 higher than Delaware for the office setting.

  • San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)

    California · 93260

    Office

    $96.39

    Facility

    Unavailable

    $21.46 higher than Delaware for the office setting.

  • San Jose-Sunnyvale-Santa Clara (San Benito Cnty)

    California · 93260

    Office

    $98.44

    Facility

    Unavailable

    $23.51 higher than Delaware for the office setting.

  • San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)

    California · 93260

    Office

    $98.25

    Facility

    Unavailable

    $23.32 higher than Delaware for the office setting.

  • San Luis Obispo-Paso Robles

    California · 93260

    Office

    $81.79

    Facility

    Unavailable

    $6.86 higher than Delaware for the office setting.

  • Santa Cruz-Watsonville

    California · 93260

    Office

    $85.43

    Facility

    Unavailable

    $10.50 higher than Delaware for the office setting.

  • Santa Maria-Santa Barbara

    California · 93260

    Office

    $83.35

    Facility

    Unavailable

    $8.42 higher than Delaware for the office setting.

  • Santa Rosa-Petaluma

    California · 93260

    Office

    $86.28

    Facility

    Unavailable

    $11.35 higher than Delaware for the office setting.

  • Stockton

    California · 93260

    Office

    $79.79

    Facility

    Unavailable

    $4.86 higher than Delaware for the office setting.

  • Vallejo

    California · 93260

    Office

    $91.27

    Facility

    Unavailable

    $16.34 higher than Delaware for the office setting.

  • Visalia

    California · 93260

    Office

    $79.79

    Facility

    Unavailable

    $4.86 higher than Delaware for the office setting.

  • Yuba City

    California · 93260

    Office

    $79.79

    Facility

    Unavailable

    $4.86 higher than Delaware for the office setting.

  • Colorado

    Colorado · 93260

    Office

    $78.50

    Facility

    Unavailable

    $3.57 higher than Delaware for the office setting.

  • Connecticut

    Connecticut · 93260

    Office

    $79.90

    Facility

    Unavailable

    $4.97 higher than Delaware for the office setting.

  • Fort Lauderdale

    Florida · 93260

    Office

    $77.17

    Facility

    Unavailable

    $2.24 higher than Delaware for the office setting.

  • Rest Of Florida

    Florida · 93260

    Office

    $74.12

    Facility

    Unavailable

    $0.81 lower than Delaware for the office setting.

  • Atlanta

    Georgia · 93260

    Office

    $76.58

    Facility

    Unavailable

    $1.65 higher than Delaware for the office setting.

  • Rest Of Georgia

    Georgia · 93260

    Office

    $70.73

    Facility

    Unavailable

    $4.20 lower than Delaware for the office setting.

  • Hawaii, Guam

    Hawaii · 93260

    Office

    $81.28

    Facility

    Unavailable

    $6.35 higher than Delaware for the office setting.

  • Iowa

    Iowa · 93260

    Office

    $70.73

    Facility

    Unavailable

    $4.20 lower than Delaware for the office setting.

  • Idaho

    Idaho · 93260

    Office

    $71.07

    Facility

    Unavailable

    $3.86 lower than Delaware for the office setting.

  • East St. Louis

    Illinois · 93260

    Office

    $73.13

    Facility

    Unavailable

    $1.80 lower than Delaware for the office setting.

  • Rest Of Illinois

    Illinois · 93260

    Office

    $72.20

    Facility

    Unavailable

    $2.73 lower than Delaware for the office setting.

  • Suburban Chicago

    Illinois · 93260

    Office

    $77.97

    Facility

    Unavailable

    $3.04 higher than Delaware for the office setting.

  • Indiana

    Indiana · 93260

    Office

    $71.41

    Facility

    Unavailable

    $3.52 lower than Delaware for the office setting.

  • Kansas

    Kansas · 93260

    Office

    $70.37

    Facility

    Unavailable

    $4.56 lower than Delaware for the office setting.

  • Kentucky

    Kentucky · 93260

    Office

    $70.22

    Facility

    Unavailable

    $4.71 lower than Delaware for the office setting.

  • New Orleans

    Louisiana · 93260

    Office

    $72.93

    Facility

    Unavailable

    $2.00 lower than Delaware for the office setting.

  • Rest Of Louisiana

    Louisiana · 93260

    Office

    $70.09

    Facility

    Unavailable

    $4.84 lower than Delaware for the office setting.

  • Metropolitan Boston

    Massachusetts · 93260

    Office

    $85.48

    Facility

    Unavailable

    $10.55 higher than Delaware for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 93260

    Office

    $78.12

    Facility

    Unavailable

    $3.19 higher than Delaware for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 93260

    Office

    $79.64

    Facility

    Unavailable

    $4.71 higher than Delaware for the office setting.

  • Rest Of Maryland

    Maryland · 93260

    Office

    $76.21

    Facility

    Unavailable

    $1.28 higher than Delaware for the office setting.

  • Rest Of Maine

    Maine · 93260

    Office

    $71.27

    Facility

    Unavailable

    $3.66 lower than Delaware for the office setting.

  • Southern Maine

    Maine · 93260

    Office

    $74.58

    Facility

    Unavailable

    $0.35 lower than Delaware for the office setting.

  • Detroit

    Michigan · 93260

    Office

    $74.78

    Facility

    Unavailable

    $0.15 lower than Delaware for the office setting.

  • Rest Of Michigan

    Michigan · 93260

    Office

    $71.62

    Facility

    Unavailable

    $3.31 lower than Delaware for the office setting.

  • Minnesota

    Minnesota · 93260

    Office

    $75.89

    Facility

    Unavailable

    $0.96 higher than Delaware for the office setting.

  • Metropolitan Kansas City

    Missouri · 93260

    Office

    $72.62

    Facility

    Unavailable

    $2.31 lower than Delaware for the office setting.

  • Metropolitan St. Louis

    Missouri · 93260

    Office

    $73.26

    Facility

    Unavailable

    $1.67 lower than Delaware for the office setting.

  • Rest Of Missouri

    Missouri · 93260

    Office

    $69.04

    Facility

    Unavailable

    $5.89 lower than Delaware for the office setting.

  • Mississippi

    Mississippi · 93260

    Office

    $68.68

    Facility

    Unavailable

    $6.25 lower than Delaware for the office setting.

  • Montana**

    Montana · 93260

    Office

    $75.48

    Facility

    Unavailable

    $0.55 higher than Delaware for the office setting.

  • North Carolina

    North Carolina · 93260

    Office

    $71.89

    Facility

    Unavailable

    $3.04 lower than Delaware for the office setting.

  • North Dakota**

    North Dakota · 93260

    Office

    $74.69

    Facility

    Unavailable

    $0.24 lower than Delaware for the office setting.

  • Nebraska

    Nebraska · 93260

    Office

    $71.08

    Facility

    Unavailable

    $3.85 lower than Delaware for the office setting.

  • New Hampshire

    New Hampshire · 93260

    Office

    $77.22

    Facility

    Unavailable

    $2.29 higher than Delaware for the office setting.

  • Northern Nj

    New Jersey · 93260

    Office

    $84.75

    Facility

    Unavailable

    $9.82 higher than Delaware for the office setting.

  • Rest Of New Jersey

    New Jersey · 93260

    Office

    $81.00

    Facility

    Unavailable

    $6.07 higher than Delaware for the office setting.

  • New Mexico

    New Mexico · 93260

    Office

    $71.90

    Facility

    Unavailable

    $3.03 lower than Delaware for the office setting.

  • Nevada**

    Nevada · 93260

    Office

    $75.31

    Facility

    Unavailable

    $0.38 higher than Delaware for the office setting.

  • Nyc Suburbs/Long Island

    New York · 93260

    Office

    $87.18

    Facility

    Unavailable

    $12.25 higher than Delaware for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 93260

    Office

    $81.42

    Facility

    Unavailable

    $6.49 higher than Delaware for the office setting.

  • Queens

    New York · 93260

    Office

    $86.30

    Facility

    Unavailable

    $11.37 higher than Delaware for the office setting.

  • Rest Of New York

    New York · 93260

    Office

    $72.77

    Facility

    Unavailable

    $2.16 lower than Delaware for the office setting.

  • Ohio

    Ohio · 93260

    Office

    $71.46

    Facility

    Unavailable

    $3.47 lower than Delaware for the office setting.

  • Oklahoma

    Oklahoma · 93260

    Office

    $70.22

    Facility

    Unavailable

    $4.71 lower than Delaware for the office setting.

  • Portland

    Oregon · 93260

    Office

    $80.74

    Facility

    Unavailable

    $5.81 higher than Delaware for the office setting.

  • Rest Of Oregon

    Oregon · 93260

    Office

    $74.90

    Facility

    Unavailable

    $0.03 lower than Delaware for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 93260

    Office

    $78.15

    Facility

    Unavailable

    $3.22 higher than Delaware for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 93260

    Office

    $71.61

    Facility

    Unavailable

    $3.32 lower than Delaware for the office setting.

  • Puerto Rico

    Puerto Rico · 93260

    Office

    $75.98

    Facility

    Unavailable

    $1.05 higher than Delaware for the office setting.

  • Rhode Island

    Rhode Island · 93260

    Office

    $77.40

    Facility

    Unavailable

    $2.47 higher than Delaware for the office setting.

  • South Carolina

    South Carolina · 93260

    Office

    $71.76

    Facility

    Unavailable

    $3.17 lower than Delaware for the office setting.

  • South Dakota**

    South Dakota · 93260

    Office

    $74.60

    Facility

    Unavailable

    $0.33 lower than Delaware for the office setting.

  • Tennessee

    Tennessee · 93260

    Office

    $70.64

    Facility

    Unavailable

    $4.29 lower than Delaware for the office setting.

  • Austin

    Texas · 93260

    Office

    $78.08

    Facility

    Unavailable

    $3.15 higher than Delaware for the office setting.

  • Beaumont

    Texas · 93260

    Office

    $71.21

    Facility

    Unavailable

    $3.72 lower than Delaware for the office setting.

  • Brazoria

    Texas · 93260

    Office

    $75.00

    Facility

    Unavailable

    $0.07 higher than Delaware for the office setting.

  • Dallas

    Texas · 93260

    Office

    $75.36

    Facility

    Unavailable

    $0.43 higher than Delaware for the office setting.

  • Fort Worth

    Texas · 93260

    Office

    $74.91

    Facility

    Unavailable

    $0.02 lower than Delaware for the office setting.

  • Galveston

    Texas · 93260

    Office

    $75.15

    Facility

    Unavailable

    $0.22 higher than Delaware for the office setting.

  • Houston

    Texas · 93260

    Office

    $75.89

    Facility

    Unavailable

    $0.96 higher than Delaware for the office setting.

  • Rest Of Texas

    Texas · 93260

    Office

    $72.99

    Facility

    Unavailable

    $1.94 lower than Delaware for the office setting.

  • Utah

    Utah · 93260

    Office

    $72.56

    Facility

    Unavailable

    $2.37 lower than Delaware for the office setting.

  • Virginia

    Virginia · 93260

    Office

    $74.30

    Facility

    Unavailable

    $0.63 lower than Delaware for the office setting.

  • Virgin Islands

    United States Virgin Islands · 93260

    Office

    $75.98

    Facility

    Unavailable

    $1.05 higher than Delaware for the office setting.

  • Vermont

    Vermont · 93260

    Office

    $74.36

    Facility

    Unavailable

    $0.57 lower than Delaware for the office setting.

  • Rest Of Washington

    Washington · 93260

    Office

    $77.99

    Facility

    Unavailable

    $3.06 higher than Delaware for the office setting.

  • Seattle (King Cnty)

    Washington · 93260

    Office

    $87.17

    Facility

    Unavailable

    $12.24 higher than Delaware for the office setting.

  • Wisconsin

    Wisconsin · 93260

    Office

    $72.61

    Facility

    Unavailable

    $2.32 lower than Delaware for the office setting.

  • West Virginia

    West Virginia · 93260

    Office

    $69.98

    Facility

    Unavailable

    $4.95 lower than Delaware for the office setting.

  • Wyoming**

    Wyoming · 93260

    Office

    $75.14

    Facility

    Unavailable

    $0.21 higher than Delaware for the office setting.

See how rates vary across the country

93260 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.

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.

$68.29

$91.77

Color shows the midpoint of each state’s locality range.

View all state and territory rates as a table
State / territoryRate rangeLocalities
AK$91.771
AL$69.101
AR$68.291
AZ$73.851
CA$79.79–$98.4429
CO$78.501
CT$79.901
DC$85.401
DE$74.931
FL$74.12–$79.433
GA$70.73–$76.582
GU$81.281
HI$81.281
IA$70.731
ID$71.071
IL$72.20–$77.974
IN$71.411
KS$70.371
KY$70.221
LA$70.09–$72.932
MA$78.12–$85.482
MD$76.21–$85.403
ME$71.27–$74.582
MI$71.62–$74.782
MN$75.891
MO$69.04–$73.263
MS$68.681
MT$75.481
NC$71.891
ND$74.691
NE$71.081
NH$77.221
NJ$81.00–$84.752
NM$71.901
NV$75.311
NY$72.77–$87.185
OH$71.461
OK$70.221
OR$74.90–$80.742
PA$71.61–$78.152
PR$75.981
RI$77.401
SC$71.761
SD$74.601
TN$70.641
TX$71.21–$78.088
UT$72.561
VA$74.30–$85.402
VI$75.981
VT$74.361
WA$77.99–$87.172
WI$72.611
WV$69.981
WY$75.141

Explore 93260 on the national rate map →

Where does this rate apply?

Delaware is a Medicare payment area. Our Census mapping connects it to 79 cities and communities in Delaware, including the examples shown here.

Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.

Browse all communities in Delaware →

Use this rate

What is a percentage of Medicare worth?

Turn a percentage into dollars for 93260 in Delaware. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$82.42

$74.93 × 110% = $82.42

A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.

Working with a whole code list?

Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.

Compare your contract offer →

How this local rate is calculated

Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 93260 in Delaware.

PPRRVU2026_Oct_nonQPP.csv

11,972

Code
93260
Physician work
0.83
Practice expense
1.39
Malpractice
0.04

GPCI2026.csv

40

Locality
Delaware
Physician work
1.005
Practice expense
0.988
Malpractice
0.899
Office / nonfacility calculation for 93260 in Delaware
ComponentRVULocality factorAdjusted
Physician work0.83× 1.0050.8341
Practice expense1.39× 0.9881.3733
Malpractice0.04× 0.8990.0360
Total RVUs2.2434
Conversion factor× 33.4009

Office / nonfacility rate, Delaware$74.93

Open 93260 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work0.831.005
Practice expense1.390.988
Malpractice0.040.899

(0.83 × 1.005 + 1.39 × 0.988 + 0.04 × 0.899) × $33.4009 = $74.93

The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.

How this rate has changed

93260 · Office / nonfacility

$74.93

Effective 2026-10-01

The base rate is $2.00 higher than on 2025-10-01, moving from $72.93 to $74.93 (2.7%).

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

    $72.93changed to$74.93

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 0.85 changed to 0.83
    • Practice expense RVU 1.37 changed to 1.39
    • Work GPCI 1.009 changed to 1.005
    • Practice expense GPCI 0.992 changed to 0.988
    • Malpractice GPCI 0.949 changed to 0.899

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: $72.93

    Held through RVU25B, RVU25C, RVU25D.

Explore release dates and calculate this code in an earlier period →

Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.

Inspect every release and its CMS source
Effective fromOffice / nonfacilityFacilityCMS release
2026-10-01$74.93Not available in this settingRVU26D
2026-07-01$74.93Not available in this settingRVU26C
2026-04-01$74.93Not available in this settingRVU26B
2026-01-01$74.93Not available in this settingRVU26A
2025-10-01$72.93Not available in this settingRVU25D
2025-07-01$72.93Not available in this settingRVU25C
2025-04-01$72.93Not available in this settingRVU25B
2025-01-01$72.93Not available in this settingRVU25A

93260 billing questions

How does 93260 differ from 93261?

93260 is for an in-person programming evaluation of a subcutaneous ICD. Use 93261 for interrogation of that system when the service is review without programming.

Which modifiers identify the components?

Modifier 26 identifies the professional interpretation, and modifier TC identifies the technical service, including equipment and staff. Billing without either modifier 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 under the CMS facts for this code.

What documentation supports 93260?

Document that the device is a subcutaneous ICD, the in-person evaluation performed, the settings reviewed or changed, and the interpretation and report.

Can 93260 be used for a transvenous ICD?

No. The 93260 service is for a subcutaneous ICD; programming evaluations for transvenous ICD systems are selected according to the system configuration.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.

Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.

RVUs for 93260PPRRVU2026_Oct_nonQPP.csv, line 11,972 (RVU26D)
Geographic factors for DelawareGPCI2026.csv, line 40 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet