CPT 93279
Global XXX ActivePrgrmg dev eval pm/ldls pm
CPT 93279 Billing & Documentation Guide
CPT code 93279 (Prgrmg dev eval pm/ldls pm) is classified under Cardiovascular with a global period indicator of XXX. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 0.63, a non-facility practice expense RVU of 1.34, and a malpractice RVU of 0.03, a total non-facility RVU of 2 and facility RVU of 2. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $69.04, though rates vary from $60.01 to $88.43 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 93279, 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 93279 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 93279 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 93279
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 0.63 | 0.63 |
| Practice Expense RVU | 1.34 | 1.34 |
| Malpractice RVU | 0.03 | 0.03 |
| Total RVU | 2 | 2 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 93279
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 | $75.3 | $75.3 | $70.99 - $88.43 | 29 |
| Florida | $67.9 | $67.9 | $65.34 - $70.17 | 3 |
| Georgia | $64.97 | $64.97 | $62.16 - $67.78 | 2 |
| Illinois | $66.28 | $66.28 | $63.47 - $68.93 | 4 |
| Michigan | $64.48 | $64.48 | $63.04 - $65.92 | 2 |
| North Carolina | $63.44 | $63.44 | $63.44 - $63.44 | 1 |
| New York | $73.34 | $73.34 | $64.27 - $77.47 | 5 |
| Ohio | $62.92 | $62.92 | $62.92 - $62.92 | 1 |
| Pennsylvania | $66.15 | $66.15 | $63.08 - $69.21 | 2 |
| Texas | $66.15 | $66.15 | $62.7 - $69.33 | 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 93279
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 93279 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 0178T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0179T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0180T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0295T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0296T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0297T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0298T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0389T | Column 1 (primary), can be billed with modifier | Yes | Mutually exclusive procedures |
| 0390T | Column 1 (primary), can be billed with modifier | Yes | CPT Manual or CMS manual coding instruction |
| 0391T | Column 1 (primary), can be billed with modifier | Yes | CPT Manual or CMS manual coding instruction |
Frequently Asked Questions, CPT 93279
What does CPT code 93279 mean? +
CPT code 93279 represents: Prgrmg dev eval pm/ldls pm. It's in the Cardiovascular category with a global period of XXX.
What is the Medicare reimbursement for CPT 93279? +
The 2026 Medicare national average non-facility payment for CPT 93279 is $69.04. Rates range from $60.01 to $88.43 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 93279? +
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 93279? +
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 June 1, 2026.
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