$71.62–$74.78
Both involve an implanted subcutaneous defibrillator. Choose 93261 for an in-person interrogation; choose 93260 when the evaluation involves programming adjustments.
On this page
CMS RVU26D · Effective 2026-10-01
93261 Defibrillator check Medicare reimbursement rates in Michigan
Report an in-person interrogation of an implanted subcutaneous defibrillator when its stored data and device function are reviewed without programming changes. Compare 93261 office and facility rates across CMS payment localities in Michigan.
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 93261 in Michigan?
Michigan has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
$66.12–$69.17
2 of 2 localities have a supported rate.
Facility setting
No supported rate
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 device evaluation
About 93261: In-person subcutaneous defibrillator interrogation
Report an in-person interrogation of an implanted subcutaneous defibrillator when its stored data and device function are reviewed without programming changes.
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.
CMS billing rules for 93261
- 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 RVU0.72 · 34%
- Practice expense (office) RVU1.33 · 64%
- Malpractice RVU0.04 · 2%
2.2K
Medicare services in 2024 · #2400 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.
93261 compared with similar codes
Office rates for Michigan, from the same CMS release.
$67.36–$70.47
Both describe in-person defibrillator interrogation. Code 93261 identifies a subcutaneous system, while 93289 identifies a conventional implanted defibrillator system.
$51.99–$54.48
Use 93288 for in-person interrogation of a pacemaker. Code 93261 is specific to an implanted subcutaneous defibrillator.
Compare 93261 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.
2 of 2 payment localities
Detroit →
Office / nonfacility
$69.17
Facility
Unavailable
Rest Of Michigan →
Office / nonfacility
$66.12
Facility
Unavailable
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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 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.
11,97293260,,Prgrmg dev eval impltbl sys,A,,0.83,1.39,,1.39,NA,0.04,2.26,2.26,1,XXX,0.00,0.00,0.00,6,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,97393260,26,Prgrmg dev eval impltbl sys,A,,0.83,0.36,,0.36,,0.03,1.22,1.22,1,XXX,0.00,0.00,0.00,6,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,97493260,TC,Prgrmg dev eval impltbl sys,A,,0.00,1.03,,1.03,NA,0.01,1.04,1.04,1,XXX,0.00,0.00,0.00,6,0,0,0,0,9,,33.4009,02,0,99,0.00,0.00,0.00
11,97593261,,Interrogate subq defib,A,,0.72,1.33,,1.33,NA,0.04,2.09,2.09,1,XXX,0.00,0.00,0.00,6,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,97693261,26,Interrogate subq defib,A,,0.72,0.31,,0.31,,0.03,1.06,1.06,1,XXX,0.00,0.00,0.00,6,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
11,97793261,TC,Interrogate subq defib,A,,0.00,1.02,,1.02,NA,0.01,1.03,1.03,1,XXX,0.00,0.00,0.00,6,0,0,0,0,9,,33.4009,02,0,99,0.00,0.00,0.00
11,97893264,,Rem mntr wrls p-art prs snr,A,,0.68,0.85,,0.16,,0.05,1.58,0.89,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00