CPT (Current Procedural Terminology) codes are five-digit numbers that describe every medical service or procedure. Your doctor, hospital, and insurance company use them to communicate exactly what was done. Every line on your medical bill has a CPT code, and knowing the code lets you look up what Medicare pays for that same service.

Why do providers charge so much more than Medicare pays?

Providers set their own "chargemaster" prices, which are essentially list prices. Medicare pays a fixed rate based on the resources each service actually requires (the RVU system for procedures, or the Clinical Lab Fee Schedule for lab tests). Commercial insurers typically pay 150% to 250% of Medicare rates. Uninsured patients are often billed the full chargemaster price, which can be 2x to 30x what Medicare pays.

Can I use Medicare rates to negotiate my bill?

Yes. Medicare rates are the closest thing to a "fair price" benchmark in U.S. healthcare. When negotiating, ask the provider what they accept from Medicare for the same CPT code. Most providers will accept 150% to 200% of Medicare for cash-pay patients, which is still far less than their chargemaster price. Many hospital financial assistance policies also use a multiple of Medicare as their discount floor.

How are Medicare rates calculated?

For most procedures, Medicare uses the Resource-Based Relative Value Scale (RBRVS). Each CPT code gets three RVU components: Work (physician time and skill), Practice Expense (overhead), and Malpractice. These are multiplied by geographic adjustment factors (GPCIs) and a conversion factor ($33.4009 in 2026). Lab tests (80000-89999 range) use a separate Clinical Laboratory Fee Schedule with flat national rates.

CPT 93010

EKG Interpretation and Report Only

CPT 93010 is the "interpretation only" EKG code. It means a physician read the EKG tracing but did not perform or supervise the actual test. This code is common in hospital settings where the facility performs the EKG (billing 93005) and a cardiologist separately interprets it (billing 93010). Providers charge an average of $35.04 for this reading, but Medicare pays only $8.35 (4.2x markup). Understanding this split-billing structure can help you spot double-billing errors on hospital EKG charges.

Updated May 2026Source: CMS Physician Fee Schedule

CPT 93010 at a Glance

Average provider charge: $35.04
Medicare rate (office and facility): $8.35
Typical markup: 4.2x over Medicare
Global EKG code (93000) Medicare rate: $32.40

Service type: Professional component only
Technical component: 93005 (billed separately)
Common setting: Hospitals, cardiology
Beneficiaries (2023): 730,626

How the Medicare Rate Is Calculated

Medicare values every procedure using Relative Value Units (RVUs) across three components, then multiplies by a national conversion factor of $33.4009 (2026). Because 93010 is interpretation only (no equipment, no staff to perform the test), the practice expense RVU is extremely low:

Component	What It Covers	Office (Non-Facility)	Hospital (Facility)
Work RVU	Physician time, skill, and judgment	0.17	0.17
Practice Expense RVU	Rent, staff, equipment, supplies	0.03	0.03
Malpractice RVU	Professional liability insurance	0.02	0.02
Total RVU		0.22	0.22
x $33.4009	2026 conversion factor	$8.35	$8.35

How EKG Split Billing Works

A complete EKG service can be billed as one global code or split into two components. Understanding this is essential for spotting billing errors:

Code	Description	Medicare Rate	Who Bills It
93000	Complete EKG (tracing + interpretation)	$32.40	One provider does both
93005	Tracing only (technical component)	$24.05	Hospital or facility
93010	Interpretation only (professional component)	$8.35	Cardiologist or reading physician

Key billing rule: You cannot bill 93000 (global) AND 93010 (interpretation) for the same EKG. They are mutually exclusive. If you see both on the same bill for the same date, that is double-billing. Either the provider billed the global code (93000) OR the split codes (93005 + 93010), never both. The combined Medicare payment for the split ($24.05 + $8.35 = $32.40) equals the global code, but the combined provider charges are often higher.

Medicare Rate by State

Medicare adjusts the national rate by location using Geographic Practice Cost Indices (GPCIs). Because 93010 has such a low base rate ($8.35) with minimal practice expense, geographic variation is very small in dollar terms.

Medicare Rate by State (2026)

Medicare adjusts payments by location using Geographic Practice Cost Indices (GPCIs). Select your state to see the adjusted rate.

Sample State Rates

State	Medicare Pays	Avg. Charge	Markup
Texas (Austin)	$7.24	$35.04	4.8x
California (Los Angeles)	$7.34	$35.04	4.8x
New York (Manhattan)	$7.52	$35.04	4.7x
Florida (Fort Lauderdale)	$7.13	$35.04	4.9x
Ohio	$6.90	$35.04	5.1x
Mississippi	$6.71	$35.04	5.2x
Arkansas	$6.69	$35.04	5.2x
Alaska	$7.71	$35.04	4.5x

Rates shown use 2026 GPCIs and the $33.4009 conversion factor. The average provider charge of $35.04 is the 2023 national average from CMS utilization data. Actual charges vary by provider.

Common Billing Problems with 93010

Double-billing: 93000 AND 93010 on the same date

The most clear-cut error is seeing both CPT 93000 (global/complete EKG) and CPT 93010 (interpretation only) on the same bill for the same date of service. The global code already includes the interpretation. If you see this combination, contact the billing department immediately. This is a definitive coding error and should result in a refund.

Computer-read EKGs billed as physician interpretation

Modern EKG machines generate automated computer readings (such as "Normal sinus rhythm" or "Left axis deviation"). Some practices bill 93010 when the physician simply signs off on the computer's reading without performing an independent interpretation. A legitimate physician interpretation should include an individualized assessment of rhythm, rate, intervals, axis, ST changes, and clinical correlation. If your EKG report only shows the machine-generated text with a signature, the 93010 charge may not be justified.

Split billing inflating total charges

When an EKG is split into 93005 (tracing, charged at $50 to $100 by facilities) and 93010 (interpretation, charged at $35), the combined charges can reach $85 to $135. An independent office billing 93000 globally might charge $60 to $90 total. The Medicare payments are identical ($32.40 either way), but the commercial charges are often higher when split. If you have a choice between a hospital-based and independent cardiology practice, the independent office may be cheaper for EKGs.

Multiple EKG interpretations on the same date

In rare cases, you may see 93010 billed more than once on the same date. This is only appropriate if multiple separate EKGs were performed (for example, before and after a procedure). If you had only one EKG, only one interpretation should be billed. Check your records for the number of EKG tracings performed.

Frequently Asked Questions

What is CPT 93010 and how is it different from 93000?

CPT 93010 is the interpretation-only component of an EKG, meaning a physician read the tracing but did not perform or supervise the actual test. CPT 93000 is the global (complete) EKG code that includes both performing the test and interpreting it. In hospitals, the service is often split: the facility bills 93005 (tracing only) and the cardiologist bills 93010 (interpretation only). If you see both 93000 AND 93010 on the same bill for the same date, that is double-billing.

How much does an EKG interpretation (93010) cost?

Providers charge an average of $35.04 for CPT 93010 (EKG interpretation only). Medicare pays $8.35 for this service (4.2x markup). This is just the physician reading fee. The total EKG cost also includes the technical component (93005, average charge $50 to $100) or is billed as a complete service (93000, Medicare rate $32.40). Without insurance, the interpretation alone typically costs $25 to $50.

Can I be billed for both 93000 and 93010?

No. CPT 93000 is the global code that includes both the tracing (technical) and interpretation (professional) components. If 93000 is billed, neither 93005 nor 93010 should appear separately for the same EKG on the same date. If you see both 93000 and 93010 on the same bill, this is double-billing and you should dispute it with the billing department.

Does a computer-generated EKG reading count as physician interpretation?

No. Modern EKG machines generate automated readings, but these are not the same as a physician interpretation. To bill 93010, a physician must personally review the tracing, provide a written interpretation, and sign off on it. Some practices bill 93010 when the physician merely confirms the computer reading with a signature. A legitimate interpretation should include the physician's own assessment of rhythm, intervals, axis, and any abnormalities, not just the machine's automated text.

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