Rmvl&rplcmt perm ccm-d pg
Replacing a permanent cardiac device pulse generator costs between $18,814 and $22,446 depending on your facility, with a potential difference of $3,632 making bill verification essential.
About the analyst
Michael Glenn reviews CMS datasets and drug pricing at BillRazor Research. He focuses on NADAC acquisition costs and procedure coding accuracy. Expertise: drug pricing, NADAC data, CPT coding.
This procedure involves surgically removing an existing cardiac contractility modulation device's pulse generator and installing a new one to continue treating heart failure patients with weakened heart muscle contractions. Patients typically receive this replacement when their original device battery depletes or malfunctions after several years of use. Medicare reimbursement for code 0923T varies significantly between inpatient and outpatient settings, with potential billing differences exceeding $4,000 depending on the facility type.
Non-facility rate
$99
Office setting benchmark
Data sources
4
23 data points
Key insights for CPT 0923T
ASC vs hospital outpatient savings
$3,632Having this done at an ambulatory surgery center costs $18,814 vs $22,446 at a hospital outpatient
What this procedure costs across different settings
The same procedure can cost very different amounts depending on where it's performed. These are the Medicare-allowed amounts — what hospitals actually charge can be 3-10x higher.
| Setting | Medicare rate | vs lowest |
|---|---|---|
| Non-facility (office) | $99 | Lowest |
| Outpatient (APC) | $22,446 | +22573% |
| Ambulatory surgery (ASC) | $18,814 | +18904% |
Got a bill with CPT 0923T?
Upload your bill and our AI compares every line item against these exact benchmark rates. Free analysis in 60 seconds — you only pay if we find savings.
About this data
Rates shown are from the 2026 Medicare Physician Fee Schedule, Hospital Outpatient Prospective Payment System (OPPS), Ambulatory Surgery Center Payment System, Clinical Laboratory Fee Schedule, Durable Medical Equipment Fee Schedule, and CMS Inpatient Prospective Payment System (DRG weights). Regional adjustments use CMS Geographic Practice Cost Indices (GPCI). Hospital charges are from CMS Hospital Price Transparency machine-readable files. All data is publicly available under federal law (45 CFR Part 180).
This data is for informational purposes only and does not constitute medical or financial advice. Actual costs depend on insurance coverage, negotiated rates, and individual circumstances.
Data: Medicare Physician Fee Schedule, CMS Inpatient PPS (IPPS), Outpatient PPS (OPPS), ASC Payment System, Clinical Lab Fee Schedule (CLFS), National Average Drug Acquisition Cost (NADAC). FY 2024 data. All publicly available from CMS.
Methodology: Facility rate applies when the procedure is performed in a hospital or ASC. Non-facility rate applies in a physician office. GPCI adjustments reflect regional cost-of-living differences.
This information is for educational purposes only and is not medical, financial, or legal advice. Actual costs depend on your insurance and provider. We recommend verifying costs directly with your provider. Full methodology · Terms of use