93280 Pacemaker programming check Medicare reimbursement rates in Missouri

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.