CPT 93281
Global XXX ActivePm device progr eval multi
CPT 93281 Billing & Documentation Guide
CPT code 93281 (Pm device progr eval multi) is classified under Cardiovascular with a global period indicator of XXX. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 0.83, a non-facility practice expense RVU of 1.61, and a malpractice RVU of 0.04, a total non-facility RVU of 2.48 and facility RVU of 2.48. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $85.56, though rates vary from $74.6 to $109.03 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 93281, 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 93281 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 93281 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 93281
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 0.83 | 0.83 |
| Practice Expense RVU | 1.61 | 1.61 |
| Malpractice RVU | 0.04 | 0.04 |
| Total RVU | 2.48 | 2.48 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 93281
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 | $93.07 | $93.07 | $87.85 - $109.03 | 29 |
| Florida | $84.28 | $84.28 | $81.14 - $87.08 | 3 |
| Georgia | $80.66 | $80.66 | $77.28 - $84.05 | 2 |
| Illinois | $82.34 | $82.34 | $78.91 - $85.51 | 4 |
| Michigan | $80.1 | $80.1 | $78.33 - $81.87 | 2 |
| North Carolina | $78.75 | $78.75 | $78.75 - $78.75 | 1 |
| New York | $90.85 | $90.85 | $79.75 - $95.92 | 5 |
| Ohio | $78.17 | $78.17 | $78.17 - $78.17 | 1 |
| Pennsylvania | $82.07 | $82.07 | $78.35 - $85.8 | 2 |
| Texas | $82.06 | $82.06 | $77.9 - $85.86 | 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 93281
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 93281 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 93281
What does CPT code 93281 mean? +
CPT code 93281 represents: Pm device progr eval multi. It's in the Cardiovascular category with a global period of XXX.
What is the Medicare reimbursement for CPT 93281? +
The 2026 Medicare national average non-facility payment for CPT 93281 is $85.56. Rates range from $74.6 to $109.03 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 93281? +
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 93281? +
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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