$24.29
Both describe outpatient cardiac rehabilitation sessions; 93797 is for a session without ECG monitoring, while 93798 is for one with monitoring.
On this page
CMS RVU26D · Effective 2026-10-01
93797 Cardiac rehab Medicare reimbursement rates in Iowa
Report this service for a physician- or qualified-health-care-professional-directed outpatient cardiac rehabilitation session conducted without ECG monitoring. Compare 93797 office and facility rates across CMS payment localities in Iowa.
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.
What does Medicare pay for 93797 in Iowa?
Iowa has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$16.54
1 of 1 localities have a supported rate.
Payment area: Iowa
One mapped payment locality.
Facility setting
$7.37
1 of 1 localities have a supported rate.
Payment area: Iowa
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Cardiac rehabilitation
About 93797: Outpatient cardiac rehabilitation without ECG
Report this service for a physician- or qualified-health-care-professional-directed outpatient cardiac rehabilitation session conducted without ECG monitoring.
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.
CMS billing rules for 93797
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is included.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Assistant at surgery is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU0.18 · 34%
- Practice expense (office) RVU0.34 · 64%
- Malpractice RVU0.01 · 2%
12.5K
Medicare services in 2024 · #1361 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.
93797 compared with similar codes
Office rates for Iowa, from the same CMS release.
$124.16
G0422 describes intensive cardiac rehabilitation with exercise. Use it for that program rather than a conventional session reported with 93797.
$124.16
G0423 describes intensive cardiac rehabilitation without exercise. It is distinct from a conventional cardiac rehabilitation session reported with 93797.
Compare 93797 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Iowa →
Office / nonfacility
$16.54
Facility
$7.37
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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 93797 in Iowa.
PPRRVU2026_Oct_nonQPP.csv
12,270
- Code
- 93797
- Physician work
- 0.18
- Practice expense
- 0.34
- Malpractice
- 0.01
GPCI2026.csv
53
- Locality
- Iowa
- Physician work
- 1.000
- Practice expense
- 0.915
- Malpractice
- 0.397
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.18 | × 1.000 | 0.1800 |
| Practice expense | 0.34 | × 0.915 | 0.3111 |
| Malpractice | 0.01 | × 0.397 | 0.0040 |
| Total RVUs | 0.4951 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Iowa$16.54
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.18 | 1 |
| Practice expense | 0.34 | 0.915 |
| Malpractice | 0.01 | 0.397 |
(0.18 × 1 + 0.34 × 0.915 + 0.01 × 0.397) × $33.4009 = $16.54
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.18 | 1 |
| Practice expense | 0.04 | 0.915 |
| Malpractice | 0.01 | 0.397 |
(0.18 × 1 + 0.04 × 0.915 + 0.01 × 0.397) × $33.4009 = $7.37
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.
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 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.
12,26793790,,Ambl bp mntr w/sw i&r,A,,0.37,0.16,,0.16,,0.01,0.54,0.54,2,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,26893792,,Pt/caregiver traing home inr,A,,0.00,2.14,,2.14,NA,0.03,2.17,2.17,3,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,01,0,99,0.00,0.00,0.00
12,26993793,,Anticoag mgmt pt warfarin,A,,0.18,0.16,,0.16,NA,0.01,0.35,0.35,2,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,27093797,,Phys/qhp op car rhab wo ecg,A,,0.18,0.34,,0.04,,0.01,0.53,0.23,0,000,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,27193798,,Phys/qhp op car rhab w/ecg,A,,0.28,0.48,,0.06,,0.02,0.78,0.36,0,000,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,27293799,,Unlisted cv svc/procedure,C,,0.00,0.00,,0.00,NA,0.00,0.00,0.00,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,27393799,26,Unlisted cv svc/procedure,C,,0.00,0.00,,0.00,,0.00,0.00,0.00,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5006102,IL,15,SUBURBAN CHICAGO,1.007,1.027,1.772
5106102,IL,99,REST OF ILLINOIS,1.000,0.913,1.563
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136