CPT 93245
Global XXX ActiveExt ecg>7d<15d rec scan a/r
CPT 93245 Billing & Documentation Guide
CPT code 93245 (Ext ecg>7d<15d rec scan a/r) is classified under Cardiovascular with a global period indicator of XXX. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 0.54, a non-facility practice expense RVU of 8.09, and a malpractice RVU of 0.04, a total non-facility RVU of 8.67 and facility RVU of 8.67. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $301.55, though rates vary from $250.84 to $410.38 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 93245, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 93245 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
No global period (E/M and other non-procedural services)
MUE Limit (Medically Unlikely Edits)
Submitting more than 1 units of 93245 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 93245
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 0.54 | 0.54 |
| Practice Expense RVU | 8.09 | 8.09 |
| Malpractice RVU | 0.04 | 0.04 |
| Total RVU | 8.67 | 8.67 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 93245
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $339.14 | $339.14 | $315.21 - $410.38 | 29 |
| Florida | $291.75 | $291.75 | $278.37 - $302.71 | 3 |
| Georgia | $277.45 | $277.45 | $260.66 - $294.23 | 2 |
| Illinois | $281.75 | $281.75 | $266.83 - $298.04 | 4 |
| Michigan | $273.65 | $273.65 | $266.25 - $281.04 | 2 |
| North Carolina | $271 | $271 | $271 - $271 | 1 |
| New York | $322.16 | $322.16 | $275.68 - $342.96 | 5 |
| Ohio | $266.09 | $266.09 | $266.09 - $266.09 | 1 |
| Pennsylvania | $284.3 | $284.3 | $267.35 - $301.25 | 2 |
| Texas | $285.4 | $285.4 | $265.17 - $305.14 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 93245
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 93245 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 0734T | Column 1 (primary), can be billed with modifier | Yes | HCPCS/CPT procedure code definition |
| 0897T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0903T | Column 1 (primary), can be billed with modifier | Yes | HCPCS/CPT procedure code definition |
| 0904T | Column 1 (primary), can be billed with modifier | Yes | HCPCS/CPT procedure code definition |
| 0905T | Column 1 (primary), can be billed with modifier | Yes | HCPCS/CPT procedure code definition |
| 36591 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 36592 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 93000 | Column 1 (primary), can be billed with modifier | Yes | HCPCS/CPT procedure code definition |
| 93005 | Column 1 (primary), can be billed with modifier | Yes | HCPCS/CPT procedure code definition |
| 93010 | Column 1 (primary), can be billed with modifier | Yes | HCPCS/CPT procedure code definition |
Frequently Asked Questions, CPT 93245
What does CPT code 93245 mean? +
CPT code 93245 represents: Ext ecg>7d<15d rec scan a/r. It's in the Cardiovascular category with a global period of XXX.
What is the Medicare reimbursement for CPT 93245? +
The 2026 Medicare national average non-facility payment for CPT 93245 is $301.55. Rates range from $250.84 to $410.38 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 93245? +
Medicine section spans a wide range: therapy services use GP/GO/GN (PT/OT/SLP plans of care) and KX (above cap with documentation). Drug administration uses JW (waste) and JZ (no waste). Professional/technical split applies to some diagnostic codes.
What bundling edits apply to CPT 93245? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
Get the full PayerReady toolkit
Free access to CPT/ICD-10 lookup, denial appeals, fee comparator, and claim auditing with credentialing enrollment.
Start free →Run this code through our claim audit tool
Check NCCI bundling, MUE limits, and modifier logic before submission.
Try the auditor →Did this page help?
Quick signal so we know what to improve.
If you want a code reference page that doesn't exist yet, email coding@payerready.com.
Tell us what's missing or wrong: coding@payerready.com. We respond within 5 business days.
Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
Powered by 11K CPT · 98K ICD-10 · 860K MPFS rates · 4.5M NCCI edits · 9.5M NPIs. Our data methodology · About our coding team