CPT 93798
Global 000 ActivePhys/qhp op car rhab w/ecg
CPT 93798 Billing & Documentation Guide
CPT code 93798 (Phys/qhp op car rhab w/ecg) is classified under Cardiovascular with a global period indicator of 000. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 0.28, a non-facility practice expense RVU of 0.48, and a malpractice RVU of 0.02, a total non-facility RVU of 0.78 and facility RVU of 0.36. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $26.85, though rates vary from $23.47 to $33.86 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 93798, 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 93798 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
Endoscopic or minor procedure with related preoperative and postoperative work performed on the same day
MUE Limit (Medically Unlikely Edits)
Submitting more than 2 units of 93798 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 93798
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 0.28 | 0.28 |
| Practice Expense RVU | 0.48 | 0.06 |
| Malpractice RVU | 0.02 | 0.02 |
| Total RVU | 0.78 | 0.36 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 93798
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 | $29.02 | $12.42 | $27.44 - $33.86 | 29 |
| Florida | $26.74 | $12.66 | $25.68 - $27.73 | 3 |
| Georgia | $25.46 | $12.08 | $24.45 - $26.47 | 2 |
| Illinois | $26.15 | $12.6 | $25.03 - $27.07 | 4 |
| Michigan | $25.35 | $12.18 | $24.74 - $25.95 | 2 |
| North Carolina | $24.74 | $11.65 | $24.74 - $24.74 | 1 |
| New York | $28.59 | $12.94 | $25.05 - $30.25 | 5 |
| Ohio | $24.66 | $11.86 | $24.66 - $24.66 | 1 |
| Pennsylvania | $25.86 | $12.11 | $24.7 - $27.01 | 2 |
| Texas | $25.81 | $12 | $24.56 - $26.93 | 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 93798
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 93798 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 | HCPCS/CPT procedure code definition |
| 0179T | Column 1 (primary), can be billed with modifier | Yes | HCPCS/CPT procedure code definition |
| 0180T | Column 1 (primary), can be billed with modifier | Yes | HCPCS/CPT procedure code definition |
| 0596T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0597T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 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 |
| 12001 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 12002 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
Frequently Asked Questions, CPT 93798
What does CPT code 93798 mean? +
CPT code 93798 represents: Phys/qhp op car rhab w/ecg. It's in the Cardiovascular category with a global period of 000.
What is the Medicare reimbursement for CPT 93798? +
The 2026 Medicare national average non-facility payment for CPT 93798 is $26.85. Rates range from $23.47 to $33.86 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 93798? +
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 93798? +
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 2, 2026.
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