Rhythm ECG, 1-3 leads; with interpretation and report

CPT 93040 is the billing code for "Rhythm ECG, 1-3 leads; with interpretation and report". For rhythm ECG with 1-3 leads with interpretation and report

Medicare pays approximately $12.94 for CPT 93040 (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 93040 has a total RVU of 1.28, broken down as: Work RVU 0.35, Practice Expense RVU 0.90, and Malpractice RVU 0.03. RVUs (Relative Value Units) determine Medicare reimbursement rates.

Key documentation requirements for CPT 93040 include: Indication for rhythm ECG; Number of leads used; Rhythm interpretation; Heart rate and rhythm. Missing or incomplete documentation is a leading cause of claim denials for this code.

Bundling considerations for CPT 93040: Includes 1-3 lead rhythm ECG. Includes interpretation and report Use an NCCI bundling checker to verify specific code combinations before billing.

Common modifiers for CPT 93040 include: 26 (Professional component only (interpretation)), TC (Technical component only (equipment/staff)), 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 93040 is 3-5 minutes typical procedure time. Time-based codes require documentation of the actual time spent providing the service.