Billing code 93280: Pacemaker programming checkMedicare rate & RVUs in Florida
In-person iterative testing of a dual-lead pacemaker’s settings, reported when programming is evaluated to select optimal permanent settings.
Medicare pays $76.87–$82.67 for 93280 in the office in Florida, from Rest Of Florida to Miami. Which amount applies depends on the service address.
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 9 sections
What 93280 covers
This in-person evaluation tests a dual-lead pacemaker, typically with atrial and ventricular leads. A programmer measures battery status, lead impedance, sensing, and capture thresholds and reviews stored episodes and pacing data. Settings such as output, rate limits, AV delay, or pacing mode are adjusted iteratively to test performance and select optimal permanent values; the original settings may be retained. The service is performed in cardiology or electrophysiology clinics and hospitals. A technician or manufacturer representative may assist, while a physician or other qualified health care professional analyzes and reports the findings.
Select 93280 for iterative programming of an implanted dual-lead pacemaker, rather than interrogation alone. Document the implanted leads, measurements, settings tested, final programmed values, and the practitioner's analysis, review, and report. Medicare recognizes a professional component (modifier 26) for interpretation and a technical component (modifier TC) for equipment and staff; billing without either modifier represents the global service. Hospital-based physicians generally bill the professional component because the hospital supplies technical resources; offices providing both components may bill globally. When multiple eligible cardiovascular diagnostic services are furnished on the same date, CMS reduces the technical component under its cardiovascular multiple-procedure policy.
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 93280 pays more and less in Florida
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
3 payment localities
$76.87 to $82.67
| Payment locality | Office | Facility |
|---|---|---|
| Fort Lauderdale | $80.25 | Unavailable |
| Miami | $82.67 | Unavailable |
| Rest Of Florida | $76.87 | Unavailable |
How the 93280 rate is calculated
Each of 93280’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 · 93280
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 0.75Practice expense 1.56Malpractice 0.04
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 93280
The CMS indicators that decide how 93280 is paid alongside other services.
CMS payment indicators · 93280
Pacemaker programming 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
93280 without 26 · national office
$78.49
Pacemaker programming check
93280-26 · Professional component
$36.74
Pays only the interpretation and report.
93280 compared with similar codes
Compare codes
93280 vs 93288 vs 93279 vs 93281 vs 93283: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 93288Pacemaker interrogation
- 93288 covers in-person interrogation and review. Choose 93280 when settings are iteratively adjusted to test device function and select optimal values, even if the original settings are retained.
- 93279Pacemaker programming
- 93279 applies to single-lead or leadless pacemakers; 93280 applies when the pacemaker system has two leads, typically atrial and ventricular.
- 93281Pacemaker evaluation
- 93281 is for pacemaker systems with multiple leads, such as cardiac resynchronization pacemakers; 93280 is for dual-lead systems.
- 93283ICD evaluation
- 93283 covers a dual-lead implantable cardioverter-defibrillator; 93280 covers a dual-lead pacemaker without defibrillation capability.
93280 billing questions
When is this code chosen over 93288?
Use 93280 when dual-lead pacemaker settings are iteratively adjusted to test function and select optimal values, even if the original settings are retained. Use 93288 for in-person interrogation and review without iterative programming; do not report both for the same session.
Does lead count determine the code even if only one lead is adjusted?
Yes. Code selection follows the implanted system: a dual-lead pacemaker uses 93280 regardless of how many leads are adjusted. Single-lead or leadless pacemakers use 93279, and multiple-lead systems use 93281.
Which modifier is used when the evaluation happens in a hospital outpatient department?
The physician typically appends modifier 26 for the analysis and report when the hospital supplies the equipment and staff. The hospital submits its facility claim separately.
Can a manufacturer representative assist with the programming?
A representative may operate the programmer, but the billing practitioner must analyze, review, and report the evaluation. The representative's work alone does not support the professional component.
What documentation supports this code?
Record the implanted lead configuration, device and lead measurements, settings tested through iterative adjustment, final programmed values, and the practitioner's signed analysis and report.
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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