93242 Ext ecg>48hr<7d recording
What 93242 is
CMS fee schedule short descriptor: Ext ecg>48hr<7d recording.
Full CPT long descriptions are licensed by the American Medical Association and are not published on this site; the short descriptor above is the one CMS prints in its own fee schedule file. See About CPT.
Medicare payment for 93242 (CY2026)
| Work RVU | Practice expense RVU | Malpractice RVU | Total | Medicare rate | |
|---|---|---|---|---|---|
| Non-facility (office) | 0.00 | 0.34 | 0.01 | 0.35 | $11.69 |
| Facility (hospital, ASC) | 0.00 | 0.34 | 0.01 | 0.35 | $11.69 |
National rates: total RVUs x the CY2026 conversion factor of 33.4009 (non-QP), before geographic adjustment. Actual Medicare payment is 80% of the rate shown after the deductible; the patient or secondary payer owes the 20% coinsurance.
Status: Active - payable under the Physician Fee Schedule. Global period: Global concept does not apply.
Medically Unlikely Edit (MUE)
Medicare caps 93242 at 1 unit per date of service for practitioner claims (MAI 2 - date of service edit (absolute): units above the MUE never pay), rationale: Code Descriptor / CPT Instruction. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.
Billed with 93242? These codes are bundled into it
93242 is a Column 1 code in 19 active NCCI PTP edits. When one of these Column 2 codes is reported on the same date of service, it is denied as bundled - unless the edit's modifier indicator is 1 and documentation supports a distinct service with an NCCI-associated modifier.
| Column 2 code | Short description | Modifier indicator | |
|---|---|---|---|
0897T | N-invas augmnt arrhyt alys | 1 - modifier may bypass | Check pair |
0903T | Ecg alg 12 lead reduced i&r | 1 - modifier may bypass | Check pair |
0904T | Ecg alg 12 ld rdcd trcg only | 1 - modifier may bypass | Check pair |
0905T | Ecg alg 12 ld rdcd i&r only | 1 - modifier may bypass | Check pair |
0929T | Rem interrog dev ccm-d tech | 1 - modifier may bypass | Check pair |
36591 | Draw blood off venous device | 0 - no modifier bypass | Check pair |
36592 | Collect blood from picc | 0 - no modifier bypass | Check pair |
93000 | Electrocardiogram complete | 1 - modifier may bypass | Check pair |
93005 | Electrocardiogram tracing | 1 - modifier may bypass | Check pair |
93010 | Electrocardiogram report | 1 - modifier may bypass | Check pair |
93040 | Rhythm ecg with report | 1 - modifier may bypass | Check pair |
93041 | Rhythm ecg tracing | 1 - modifier may bypass | Check pair |
93042 | Rhythm ecg report | 1 - modifier may bypass | Check pair |
94774 | Ped home apnea mntr evnt rec | 1 - modifier may bypass | Check pair |
94775 | Ped home apnea mntr att only | 1 - modifier may bypass | Check pair |
94776 | Ped home apnea mntr dl&alys | 1 - modifier may bypass | Check pair |
94777 | Ped home apnea mntr rvw i&r | 1 - modifier may bypass | Check pair |
96523 | Irrig drug delivery device | 0 - no modifier bypass | Check pair |
99473 | Self-meas bp pt educaj/train | 0 - no modifier bypass | Check pair |
93242 is bundled into these codes
93242 appears as a Column 2 code in 92 active edits. Reported with one of these Column 1 codes on the same date of service, 93242 is the code that denies.
| Column 1 code | Short description | Modifier indicator | |
|---|---|---|---|
0417T | Prgrmg eval cardiac modulj | 1 | Check pair |
0418T | Interro eval cardiac modulj | 1 | Check pair |
0521T | Interrog dev eval wcs ip | 1 | Check pair |
0522T | Prgrmg dev eval wcs ip | 1 | Check pair |
0525T | Insj/rplcmt compl iims | 1 | Check pair |
0526T | Insj/rplcmt iims eltrd only | 1 | Check pair |
0527T | Insj/rplcmt iims implt mntr | 1 | Check pair |
0528T | Prgrmg dev eval iims ip | 1 | Check pair |
0575T | Prgrmg dev eval icds ss ip | 1 | Check pair |
0576T | Interrog dev eval icds ss ip | 1 | Check pair |
0578T | Rem interrog dev icds phys | 1 | Check pair |
0579T | Rem interrog dev icds tech | 1 | Check pair |
0650T | Prgrmg dev eval scrms remote | 1 | Check pair |
0659T | Tcat intra-c nfs supersat o2 | 1 | Check pair |
0696T | Bdy surf mapg pm/cvdfb f/up | 1 | Check pair |
Data: CMS CY2026 Physician Fee Schedule RVU file (October release, RVU26D) and Medicare NCCI PTP practitioner edits v32.3 (2026 Q4). Verify against the official files before billing or contracting decisions.