CPT 93268
Global XXX ActiveEcg record/review
CPT 93268 Billing & Documentation Guide
CPT code 93268 (Ecg record/review) is classified under Cardiovascular with a global period indicator of XXX. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 0.51, a non-facility practice expense RVU of 4.53, and a malpractice RVU of 0.04, a total non-facility RVU of 5.08 and facility RVU of 5.08. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $176.43, though rates vary from $147.69 to $237.81 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 93268, 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 93268 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 93268 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 93268
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 0.51 | 0.51 |
| Practice Expense RVU | 4.53 | 4.53 |
| Malpractice RVU | 0.04 | 0.04 |
| Total RVU | 5.08 | 5.08 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 93268
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 | $197.41 | $197.41 | $183.87 - $237.81 | 29 |
| Florida | $171.44 | $171.44 | $163.69 - $177.92 | 3 |
| Georgia | $163.01 | $163.01 | $153.59 - $172.42 | 2 |
| Illinois | $165.85 | $165.85 | $157.27 - $174.91 | 4 |
| Michigan | $161 | $161 | $156.69 - $165.3 | 2 |
| North Carolina | $159.06 | $159.06 | $159.06 - $159.06 | 1 |
| New York | $188.46 | $188.46 | $161.71 - $200.51 | 5 |
| Ohio | $156.52 | $156.52 | $156.52 - $156.52 | 1 |
| Pennsylvania | $166.82 | $166.82 | $157.2 - $176.44 | 2 |
| Texas | $167.33 | $167.33 | $155.96 - $178.33 | 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 93268
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 93268 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 0295T | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 0296T | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 0297T | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 0298T | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 0497T | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 0498T | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 0571T | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 0572T | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 0573T | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 0574T | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
Frequently Asked Questions, CPT 93268
What does CPT code 93268 mean? +
CPT code 93268 represents: Ecg record/review. It's in the Cardiovascular category with a global period of XXX.
What is the Medicare reimbursement for CPT 93268? +
The 2026 Medicare national average non-facility payment for CPT 93268 is $176.43. Rates range from $147.69 to $237.81 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 93268? +
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 93268? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
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