Billing code 93243: ECG analysisMedicare rate & RVUs in Virginia
Reports technical scanning, analysis, and a report for ambulatory ECG monitoring lasting more than 48 hours but less than seven days.
Medicare pays $240.57–$288.39 for 93243 in the office in Virginia, from Virginia to Dc + Md/Va Suburbs. 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 93243 covers
This code covers the technical processing of ambulatory ECG data collected over more than 48 hours but less than seven days. After the monitoring device is returned or its data are transmitted, technical staff or a monitoring service scan and analyze the recorded rhythm and prepare a report. Extended monitoring can help evaluate intermittent palpitations, fainting, or suspected arrhythmias that may not appear during a brief office ECG. The service is commonly performed through an outpatient cardiology practice or an ECG monitoring vendor.
Report 93243 for the scanning, analysis, and report portion; it does not include the physician’s review and interpretation, which is separately represented by 93244. The complete service may instead be reported with 93241, while 93242 represents recording only. Documentation should support the monitoring duration and the technical analysis and report provided. CMS applies the cardiovascular diagnostic multiple procedure reduction to the technical component, including this code, when the reduction is triggered by multiple procedures.
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 93243 pays more and less in Virginia
| Payment locality | Office | Facility |
|---|---|---|
| Dc + Md/Va Suburbs | $288.39 | Unavailable |
| Virginia | $240.57 | Unavailable |
How the 93243 rate is calculated
Each of 93243’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 · 93243
RVUs × geographic indexes × conversion factor
Work0.00
0.00 RVUs× 1.000 GPCI
Practice expense7.32
7.32 RVUs× 1.000 GPCI
Malpractice0.01
0.01 RVUs× 1.000 GPCI
Adjusted RVUs
7.3300
Conversion factor
$33.4009
Medicare rate
$244.83
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 93243
The CMS indicators that decide how 93243 is paid alongside other services.
CMS payment indicators · 93243
ECG analysis
| 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 | 3 | Technical component only. |
93243 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 93242Ambulatory ECG recording
- Use 93242 for recording only. Use 93243 for technical scanning, analysis, and the report.
- 93244Extended ECG
- 93244 represents the physician’s review and interpretation; 93243 is the technical analysis and report.
- 93241Ambulatory ECG
- 93241 represents the complete extended monitoring service, including recording, technical analysis and report, and physician interpretation. 93243 is only the technical analysis and report portion.
- 93247Extended ECG monitoring
- Both codes represent technical scanning and analysis, but 93247 is for monitoring lasting more than 7 days and less than 15 days.
93243 billing questions
How does 93243 differ from 93242?
93242 represents recording only. 93243 represents the subsequent technical scanning, analysis, and report.
Is physician interpretation included in 93243?
No. The physician review and interpretation are represented separately by 93244.
Can 93243 be reported with 93242 and 93244?
Those codes represent the recording, technical analysis and report, and physician interpretation portions of the extended monitoring service. The complete service may instead be reported with 93241.
Should modifier 26 be used with 93243?
No. 93243 is the technical-component-only code; physician interpretation is reported separately with 93244.
What documentation supports 93243?
Keep documentation of the monitoring duration and the scanning, analysis, and report performed. The recorded period must be more than 48 hours and less than seven days.
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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