Billing code 93285: Device programmingMedicare rate & RVUs in Utah
An in-person evaluation adjusts and tests selected settings on an implantable loop recorder, with review and interpretation by a physician or qualified professional.
Medicare pays $56.87 for 93285 in the office in Utah (Utah). 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 93285 covers
This service is for an in-person programming evaluation of an implantable cardiovascular event recorder, commonly called an implantable loop recorder. A cardiologist, electrophysiologist, or other qualified health care professional assesses selected device functions and iteratively adjusts settings to test them. These recorders may be used to monitor patients with unexplained syncope, suspected intermittent arrhythmias, or other indications for long-term rhythm monitoring. The service may occur in a cardiology office or hospital setting.
Report the code when the encounter includes the programming evaluation and interpretation, rather than only review of stored device data. Documentation should identify the device, the functions and settings evaluated, any adjustments and testing performed, and the clinician’s interpretation. CMS recognizes professional and technical components: modifier 26 identifies the interpretation, modifier TC identifies equipment and staff, and an unmodified claim represents the global service. The cardiovascular diagnostic multiple procedure reduction applies to the technical component.
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.
93285 in Utah
| Payment locality | Office | Facility |
|---|---|---|
| Utah | $56.87 | Unavailable |
How the 93285 rate is calculated
Each of 93285’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 · 93285
RVUs × geographic indexes × conversion factor
Work0.51
0.51 RVUs× 1.000 GPCI
Practice expense1.24
1.24 RVUs× 1.000 GPCI
Malpractice0.03
0.03 RVUs× 1.000 GPCI
Adjusted RVUs
1.7800
Conversion factor
$33.4009
Medicare rate
$59.45
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 93285
The CMS indicators that decide how 93285 is paid alongside other services.
CMS payment indicators · 93285
Device programming
| 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
93285 without 26 · national office
$59.45
Device programming
93285-26 · Professional component
$25.05
Pays only the interpretation and report.
93285 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 93291Loop recorder check
- Both concern an implantable cardiovascular event recorder and are performed in person. Choose 93285 when the service includes iterative programming adjustments and testing; 93291 is for interrogation and evaluation.
- 93298Remote loop recorder check
- 93298 is for remote interrogation and evaluation of an implantable event recorder. This code describes an in-person programming evaluation.
- 93279Pacemaker programming
- 93279 concerns programming evaluation of a pacemaker. This code applies to programming evaluation of an implantable cardiovascular event recorder.
93285 billing questions
When should this code be chosen instead of 93291?
Use this code for an in-person programming evaluation that includes iterative adjustment and testing of selected settings. Code 93291 describes in-person interrogation and evaluation of the recorder without that programming service.
Can the professional and technical components be billed separately?
Yes. Modifier 26 identifies the professional interpretation, and modifier TC identifies the technical service involving equipment and staff. Reporting the code without either modifier represents the global service.
How does the multiple procedure reduction affect this 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.
Is this code appropriate for a remote recorder review?
No. This code describes an in-person programming evaluation; remote interrogation of an implantable event recorder is represented by 93298.
What documentation supports reporting the programming evaluation?
Document the recorder evaluated, the selected functions or settings tested, any iterative adjustments, and the interpreting clinician’s findings.
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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