CPT 93279 Reimbursement & Benchmarks | OpenPayer

Summary & Overview

CPT 93279: Single-Chamber Pacemaker Reprogramming and Testing

CPT code 93279 captures in-person evaluation and iterative reprogramming/testing of an already implanted single-lead or leadless single-chamber pacemaker, including analysis and a documented report. This code represents both professional and technical components of device interrogation and adjustment, a critical element of ongoing cardiac rhythm management for patients with single-chamber pacemakers. Nationally, appropriate coding for device reprogramming affects clinical follow-up pathways, device clinic workflow, and accurate capture of resource use for payers and providers. Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will learn the clinical scope and typical settings for services billed with CPT code 93279, how the code is positioned relative to device follow-up care, and what to expect in terms of who covers this service. The publication provides benchmarks for service classification, explains the professional and technical component inclusion, and summarizes clinical context relevant to cardiology and device clinics. Data not available in the input is noted where specific payer policy details, associated taxonomies, and ICD-10 linkage would otherwise be presented.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare93279CPTPacemakerDevice ReprogrammingCardiologyDevice ClinicDevice InterrogationOutpatient

Billing Code Overview

CPT code 93279 describes a face-to-face evaluation during which the provider repeatedly adjusts and tests the existing parameters of an already implanted single-lead or leadless pacemaker that senses and regulates the heartbeat in a single chamber. The service includes analysis of device function, iterative reprogramming and testing of pacing and sensing parameters, and preparation of a report documenting findings and changes.

Service type: Device interrogation with reprogramming and testing of a single-chamber pacemaker (professional and technical components included)
Typical site of service: Cardiology clinic, device clinic, or hospital outpatient setting where implanted cardiac device follow-up and programming are performed

Clinical & Coding Specifications

Clinical Context

A 72-year-old patient with an existing single‑chamber ventricular pacemaker (single lead or leadless) presents for a scheduled device evaluation and reprogramming due to symptomatic bradycardia and reported syncope. The patient arrives to an outpatient electrophysiology clinic or cardiac device clinic located in an ambulatory surgical center or hospital outpatient department. A board‑certified electrophysiologist or cardiologist performs a face‑to‑face interrogation of the implanted pacemaker using a programmer. The clinician repeatedly adjusts sensing and pacing parameters (for example, pacing output, sensitivity, rate response, AV timing if applicable in a single‑chamber context) and performs testing to confirm appropriate capture and sensing. Device telemetry and lead integrity are assessed; threshold and impedance testing are documented. The clinician interprets the data, documents adjustments and testing results, and prepares a formal report. The service includes both the professional interpretation and the technical programming, consistent with the description of 93279 for single‑chamber systems. Typical workflow includes check‑in, device interrogation and testing, parameter adjustments with repeated testing, clinical assessment of symptoms and ECG correlation as indicated, documentation and patient counseling, and scheduling of follow‑up care or urgent device revision if abnormalities are identified. Typical sites of service are outpatient electrophysiology/device clinics, hospital outpatient departments, or ambulatory surgery centers when device management requires on‑site monitoring and testing.

Coding Specifications

Modifier	Description	When to Use

CPT 93282: Single-Lead ICD Parameter Evaluation and Adjustment

CPT-93285-SUBCUTANEOUS-CARDIAC-RHYTHM-MONITOR-PROGRAMMING-AND-REPORTING

CPT 93285: Subcutaneous Cardiac Rhythm Monitor Programming and Reporting

CPT-93280-DUAL-CHAMBER-PACEMAKER-PROGRAMMING-AND-OPTIMIZATION

CPT 93280: Dual-Chamber Pacemaker Programming and Optimization

CPT-93283-IMPLANTABLE-CARDIOVERTER-DEFIBRILLATOR-DUAL-LEAD-PROGRAMMING

CPT 93283: Dual-Lead ICD Evaluation and Reprogramming

CPT-93281-MULTI-CHAMBER-PACEMAKER-REPROGRAMMING-AND-EVALUATION

CPT 93281: Multi-Chamber Pacemaker Evaluation and Reprogramming

CPT-93284-MULTICHAMBER-DEFIBRILLATOR-REPROGRAMMING

CPT 93284: Multichamber Defibrillator Evaluation and Reprogramming

Taxonomy Code	Specialty	Notes
207RH0000X	Cardiology	Physicians who diagnose and manage cardiac rhythm disorders and perform device management.
207RT0005X	Cardiac Electrophysiology	Subspecialists who commonly perform device interrogations, programming, and complex testing.
208D00000X	Internal Medicine	Hospitalists or outpatient internists who may manage routine device checks in clinic.
283Q00000X	Registered Nurse Practitioner/Adult Health	Advanced practice clinicians who frequently perform device interrogations under scope of practice.
363LP0200X	Physician Assistant	PAs often perform device checks and programming in collaboration with supervising physician.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`I49.5`	Sick sinus syndrome	Common indication for single‑chamber ventricular pacing when sinus node dysfunction leads to symptomatic bradycardia.
`I49.01`	Ventricular fibrillation	Though severe, device interrogation may be performed after arrhythmic events to assess device function and therapies.
`I44.2`	Atrioventricular block, complete	Complete heart block frequently requires pacemaker therapy; single‑chamber ventricular pacing may be used depending on clinical context.
`I45.6`	Pre‑excitation syndrome (including Wolff‑Parkinson‑White)	Patients with conduction abnormalities may have devices evaluated if bradyarrhythmia or device interactions occur.
`R00.1`	Bradycardia, unspecified	Symptomatic bradycardia is a common reason for reprogramming and testing of an implanted pacemaker.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`93279`	Programming and testing of an existing single‑lead or leadless single‑chamber pacemaker system; face‑to‑face evaluation with repeated adjustments and report (professional and technical components).	Primary code for face‑to‑face reprogramming and testing of an implanted single‑chamber pacemaker.
`93280`	Interrogation device evaluation (remote or in‑person), review and report only; single‑lead or leadless single‑chamber system.	Used when only non‑face‑to‑face interrogation and report are performed without direct programming adjustments.
`93286`	Programming and testing of an existing dual‑lead or dual‑chamber pacemaker system; face‑to‑face evaluation with repeated adjustments and report.	Performed for dual‑chamber systems when both atrial and ventricular leads require adjustments; not appropriate to bill with `93279`.
`93288`	Interrogation device evaluation, remote or in‑person, dual‑lead or dual‑chamber system.	Related for remote monitoring or in‑office interrogation of dual‑chamber devices without programming.
`93294`	Transvenous lead revision (extraction) or related complex device revision codes typically performed when interrogation identifies lead failure requiring procedural intervention.	May follow `93279` if testing demonstrates lead malfunction necessitating extraction or revision; represents a separate operative service.

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