Routine Electrocardiogram (ecg) Using At Least 12 Leads With Tracing
What Medicare pays for 93005, what providers bill, and how the price varies across 54 states, drawn from CMS 2023 claims data.
93005 · the short answer
For routine electrocardiogram (ecg) using at least 12 leads with tracing, Medicare pays about $4.39 on average across 54 states. This is a low-payment administrative or drug code, so the billed-to-paid ratio is not a meaningful "markup."
- Medicare pays
- $4.39
- Providers bill
- $52.93
- States with data
- 54
Medicare amounts are CMS-published; markup = average submitted charge ÷ average Medicare payment.
Price Range Across States
What You Might Pay
Estimated using RAND 2024 commercial-to-Medicare ratios. Actual prices vary by insurer, plan, and facility.
How we estimate these prices
These estimates are based on the RAND Hospital Price Transparency Study (4th Edition, 2024), which found that commercial insurance prices average 224% of Medicare rates nationally. We apply category-specific ratios: Cardiac Testing procedures average 2.24x Medicare rates. Cash/self-pay estimates blend typical cash discounts (55% of billed charges) with Medicare-based estimates (150% of allowed amounts). These are statistical estimates, not quotes. Contact your insurer or provider for actual costs.
Prices by State
| State | Medicare Payment | Billed Charge |
|---|---|---|
| New York | $5.49 | $74.06 |
| California | $5.10 | $46.50 |
| Guam | $5.05 | $7.64 |
| New Jersey | $4.99 | $49.67 |
| Hawaii | $4.97 | $64.31 |
| District of Columbia | $4.83 | $47.05 |
| Connecticut | $4.81 | $32.78 |
| Rhode Island | $4.77 | $35.02 |
| Washington | $4.70 | $58.29 |
| Colorado | $4.66 | $25.82 |
| Massachusetts | $4.66 | $49.65 |
| Delaware | $4.57 | $41.27 |
| Maryland | $4.51 | $17.63 |
| Illinois | $4.45 | $85.51 |
| Florida | $4.44 | $40.19 |
| Nevada | $4.43 | $40.91 |
| Ohio | $4.43 | $42.32 |
| Alaska | $4.40 | $95.71 |
| Arizona | $4.37 | $29.29 |
| Wyoming | $4.35 | $81.57 |
| Minnesota | $4.33 | $43.60 |
| Texas | $4.33 | $39.76 |
| Virginia | $4.33 | $37.33 |
| Oregon | $4.29 | $71.40 |
| U.S. Virgin Islands | $4.24 | $93.56 |
| New Hampshire | $4.23 | $64.27 |
| Montana | $4.20 | $61.29 |
| Kansas | $4.18 | $52.83 |
| Georgia | $4.15 | $36.23 |
| North Carolina | $4.13 | $37.84 |
| Utah | $4.12 | $21.86 |
| Pennsylvania | $4.11 | $52.41 |
| South Dakota | $4.10 | $48.78 |
| Louisiana | $4.08 | $69.78 |
| North Dakota | $4.08 | $60.90 |
| Michigan | $4.07 | $36.59 |
| Nebraska | $4.06 | $23.35 |
| Indiana | $4.06 | $63.85 |
| Puerto Rico | $4.02 | $9.54 |
| Iowa | $4.02 | $46.57 |
| Missouri | $3.99 | $43.58 |
| Wisconsin | $3.92 | $106.89 |
| Tennessee | $3.91 | $29.80 |
| South Carolina | $3.84 | $42.88 |
| Mississippi | $3.84 | $51.60 |
| Vermont | $3.80 | $34.65 |
| Oklahoma | $3.77 | $30.30 |
| Arkansas | $3.74 | $157.42 |
| Kentucky | $3.71 | $33.73 |
| New Mexico | $3.70 | $36.91 |
| Idaho | $3.64 | $28.93 |
| Alabama | $3.63 | $31.58 |
| Maine | $3.57 | $44.88 |
| West Virginia | $3.47 | $106.95 |
What the Data Says About Routine Electrocardiogram (ecg) Using At Least 12 Leads With Tracing
Across 54 states with reporting providers, CPT code 93005 (Routine Electrocardiogram (ecg) Using At Least 12 Leads With Tracing) shows a national average Medicare payment of $4.39 against an average billed charge of $52.93. That gap, a 12.1x markup, or 1106% above the Medicare allowed amount, is not a meaningful ratio for this low-payment code, so treat the billed figure as a chargemaster reference point rather than a real-world price.
Cardiac Testing procedures like this one saw 422.3K services billed to Medicare in 2023 by 34.4K distinct providers, serving 368.3K unique beneficiaries. State-level variation is significant: West Virginia reports the lowest average payment at $3.47, while New York reports the highest at $5.49. A 58% spread this wide is typically a GPCI story: practice-expense and malpractice-premium components of the fee formula diverge sharply by locality even though the procedure code never changes.
Applying RAND 2024 commercial-to-Medicare ratios specific to the Cardiac Testing category (2.24x), the estimated commercial insurance price lands near $13.94, with self-pay cash discounts commonly bringing the figure closer to $19.22. Within Cardiac Testing, Routine Electrocardiogram (ecg) Using At Least 12 Leads With Tracing ranks #36 of 36 tracked procedures by national average Medicare payment.
What to do with this
If you may have routine electrocardiogram (ecg) using at least 12 leads with tracing done, these steps turn the numbers above into a real-world cost estimate.
- Request a Good Faith Estimate from your provider at least 3 business days before a scheduled procedure, under the No Surprises Act it is an enforceable written price.
- Compare routine electrocardiogram (ecg) using at least 12 leads with tracing costs in your state, Medicare rates vary by locality. Browse states
- Check a hospital’s published cash price, which is often far below the billed charge. Price transparency
- Understand why billed charges run several times the Medicare rate before you negotiate. Read the guide
Figures here are averages and estimates, not a quote. Confirm coverage and out-of-pocket costs with your insurer and provider.
Frequently Asked Questions
How much does Routine Electrocardiogram (ecg) Using At Least 12 Leads With Tracing cost?
Medicare's national average payment for Routine Electrocardiogram (ecg) Using At Least 12 Leads With Tracing (CPT 93005) is $4.39, with providers billing $52.93 on average; state rates run from $3.47 to $5.49, a meaningful but not extreme spread.
Why do providers charge more than Medicare pays?
Providers set their own chargemaster rates (billed charges), which are typically much higher than what any insurer pays. Medicare pays a fixed rate based on the procedure code and geographic location. The billed charge is relevant mainly for uninsured patients, who may face prices closer to the submitted charge.
How much does Routine Electrocardiogram (ecg) Using At Least 12 Leads With Tracing cost with insurance?
With commercial insurance, routine electrocardiogram (ecg) using at least 12 leads with tracing costs an estimated $13.94 on average (range: $9.76-$19.51), a moderate premium over Medicare's $4.39. Without insurance, the estimated cash price is $19.22.
Which state has the lowest cost for Routine Electrocardiogram (ecg) Using At Least 12 Leads With Tracing?
West Virginia has the lowest average Medicare payment for Routine Electrocardiogram (ecg) Using At Least 12 Leads With Tracing at $3.47, while New York has the highest at $5.49 - a meaningful $2.03 spread.
How many providers perform Routine Electrocardiogram (ecg) Using At Least 12 Leads With Tracing?
Routine Electrocardiogram (ecg) Using At Least 12 Leads With Tracing is a widely-performed procedure: 34.4K providers billed Medicare for it in 2023 across 54 states, together handling 422.3K services for 368.3K beneficiaries.
What is the billed-to-Medicare markup for Routine Electrocardiogram (ecg) Using At Least 12 Leads With Tracing?
Providers bill 12.1x what Medicare pays for Routine Electrocardiogram (ecg) Using At Least 12 Leads With Tracing - a markup within the typical range at 1106% above the Medicare rate.
Related Guides
Tips to reduce out-of-pocket costs
Your right to upfront pricing
How Medicare payments work
Decode charges and codes
Why bills exceed actual costs
Geographic pricing factors
Data from CMS Medicare Physician & Other Practitioners (2023).
Read our methodology - how this data is sourced, computed, and verified.
Related
Every figure on PlainProcedure is rendered directly from CMS Medicare Physician & Other Practitioners data, no number is typed in by an editor. This page draws directly on CMS Medicare Physician & Other Practitioners data, no figure is typed in by an editor. See our editorial standards & corrections policy, the methodology behind these numbers, or report a data error.