Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report

CPT 93005 is the billing code for "Electrocardiogram, routine ECG with at least 12 leads; tracing only, without interpretation and report". For routine 12-lead ECG tracing only without interpretation

Medicare pays approximately $6.15 for CPT 93005 (national average). Actual payment varies by geographic location due to GPCI adjustments. Hospital and commercial insurance rates are typically 2-4x higher than Medicare rates.

CPT 93005 has a total RVU of 1.02, broken down as: Work RVU 0.20, Practice Expense RVU 0.80, and Malpractice RVU 0.02. RVUs (Relative Value Units) determine Medicare reimbursement rates.

Key documentation requirements for CPT 93005 include: Indication for ECG; 12-lead ECG tracing obtained; Tracing quality; Technical documentation. Missing or incomplete documentation is a leading cause of claim denials for this code.

Bundling considerations for CPT 93005: Includes tracing only. Interpretation coded separately Use an NCCI bundling checker to verify specific code combinations before billing.

Common modifiers for CPT 93005 include: TC (Technical component only), 59 (Distinct procedural service if performed separately). Modifiers indicate special circumstances and can affect reimbursement or prevent claim denials.

The typical time requirement for CPT 93005 is 3-5 minutes typical procedure time. Time-based codes require documentation of the actual time spent providing the service.