CPT 93280
Global XXX ActivePm device progr eval dual
CPT 93280 Billing & Documentation Guide
CPT code 93280 (Pm device progr eval dual) is classified under Cardiovascular with a global period indicator of XXX. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 0.75, a non-facility practice expense RVU of 1.56, and a malpractice RVU of 0.04, a total non-facility RVU of 2.35 and facility RVU of 2.35. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $81.09, though rates vary from $70.5 to $103.66 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 93280, 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 93280 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 93280 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 93280
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 0.75 | 0.75 |
| Practice Expense RVU | 1.56 | 1.56 |
| Malpractice RVU | 0.04 | 0.04 |
| Total RVU | 2.35 | 2.35 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 93280
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 | $88.33 | $88.33 | $83.3 - $103.66 | 29 |
| Florida | $79.93 | $79.93 | $76.87 - $82.67 | 3 |
| Georgia | $76.4 | $76.4 | $73.12 - $79.67 | 2 |
| Illinois | $78.04 | $78.04 | $74.71 - $81.11 | 4 |
| Michigan | $75.85 | $75.85 | $74.13 - $77.58 | 2 |
| North Carolina | $74.52 | $74.52 | $74.52 - $74.52 | 1 |
| New York | $86.18 | $86.18 | $75.49 - $91.09 | 5 |
| Ohio | $73.97 | $73.97 | $73.97 - $73.97 | 1 |
| Pennsylvania | $77.75 | $77.75 | $74.15 - $81.34 | 2 |
| Texas | $77.73 | $77.73 | $73.71 - $81.41 | 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 93280
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 93280 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 |
| 0302T | Column 1 (primary), can be billed with modifier | Yes | CPT Manual or CMS manual coding instruction |
| 0303T | Column 1 (primary), can be billed with modifier | Yes | CPT Manual or CMS manual coding instruction |
| 0304T | Column 1 (primary), can be billed with modifier | Yes | CPT Manual or CMS manual coding instruction |
Frequently Asked Questions, CPT 93280
What does CPT code 93280 mean? +
CPT code 93280 represents: Pm device progr eval dual. It's in the Cardiovascular category with a global period of XXX.
What is the Medicare reimbursement for CPT 93280? +
The 2026 Medicare national average non-facility payment for CPT 93280 is $81.09. Rates range from $70.5 to $103.66 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 93280? +
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 93280? +
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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