93286 Peri-px eval pm/ldls pm ip
What 93286 is
CMS fee schedule short descriptor: Peri-px eval pm/ldls pm ip.
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 93286 (CY2026)
| Work RVU | Practice expense RVU | Malpractice RVU | Total | Medicare rate | |
|---|---|---|---|---|---|
| Non-facility (office) | 0.29 | 1.02 | 0.02 | 1.33 | $44.42 |
| Facility (hospital, ASC) | 0.29 | 1.02 | 0.02 | 1.33 | $44.42 |
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 93286 at 2 units per date of service for practitioner claims (MAI 3 - date of service edit (clinical): units above the MUE may pay with documentation on appeal), rationale: Nature of Service/Procedure. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.
Billed with 93286? These codes are bundled into it
93286 is a Column 1 code in 57 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 | |
|---|---|---|---|
0571T | Insj/rplcmt icds ss eltrd | 0 - no modifier bypass | Check pair |
0572T | Insertion ss dfb electrode | 0 - no modifier bypass | Check pair |
0573T | Removal ss dfb electrode | 0 - no modifier bypass | Check pair |
0574T | Repos prev ss impl dfb eltrd | 0 - no modifier bypass | Check pair |
0575T | Prgrmg dev eval icds ss ip | 0 - no modifier bypass | Check pair |
0576T | Interrog dev eval icds ss ip | 0 - no modifier bypass | Check pair |
0577T | Ephys eval icds ss | 0 - no modifier bypass | Check pair |
0578T | Rem interrog dev icds phys | 0 - no modifier bypass | Check pair |
0579T | Rem interrog dev icds tech | 0 - no modifier bypass | Check pair |
0580T | Rmvl ss impl dfb pg only | 0 - no modifier bypass | Check pair |
0734T | Rem r-t mtn nrehab tx mgmt | 0 - no modifier 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 |
0937T | Xtrnl ecg rec>15d<30d | 1 - modifier may bypass | Check pair |
0938T | Xtrnl ecg rec>15d<30d rec | 1 - modifier may bypass | Check pair |
0939T | Xtrnl ecg rec>15d<30d scan | 1 - modifier may bypass | Check pair |
0940T | Xtrnl ecg rec>15d<30d r&i | 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 |
93224 | Xtrnl ecg rec up to 48 hrs | 1 - modifier may bypass | Check pair |
93225 | Xtrnl ecg rec<48 hrs rec | 1 - modifier may bypass | Check pair |
93226 | Xtrnl ecg rec<48 hr scan a/r | 1 - modifier may bypass | Check pair |
93227 | Xtrnl ecg rec<48 hr r&i | 1 - modifier may bypass | Check pair |
Showing 30 of 57 column 2 codes. Use the pair checker for any specific combination.
93286 is bundled into these codes
93286 appears as a Column 2 code in 98 active edits. Reported with one of these Column 1 codes on the same date of service, 93286 is the code that denies.
| Column 1 code | Short description | Modifier indicator | |
|---|---|---|---|
0408T | Insj/rplc cardiac modulj sys | 0 | Check pair |
0409T | Insj/rplc car modulj pls gn | 0 | Check pair |
0410T | Insj/rplc car modulj atr elt | 0 | Check pair |
0411T | Insj/rplc car modulj vnt elt | 0 | Check pair |
0414T | Rmvl & rpl car modulj pls gn | 0 | Check pair |
0415T | Repos car modulj tranvns elt | 0 | Check pair |
0515T | Insj wcs lv compl sys | 1 | Check pair |
0516T | Insj wcs lv eltrd only | 1 | Check pair |
0517T | Insj wcs lv both compnt pg | 1 | Check pair |
0518T | Rmvl pg wcs lv battery only | 1 | Check pair |
0519T | Rmv&rplcmt pg wcs lv both | 1 | Check pair |
0520T | Rmv&rplcmt pg wcs lv battery | 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 |
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.