Phys/qhp op car rhab wo ecg
Cardiac rehabilitation sessions without heart monitoring range from $7.72 at Medicare rates to $125.91 in hospital outpatient settings, making bill verification essential given this 16.3x pricing variation.
About the analyst
Priya Iyengar leads the billing code review team at BillRazor Research. She analyzes NCCI bundling edits, DRG coding, and regional rate variation. Expertise: NCCI bundling, DRG analysis, regional pricing.
Cardiac rehabilitation without electrocardiogram monitoring involves supervised exercise sessions and education for patients recovering from heart attacks, heart surgery, or other cardiac conditions. This outpatient service typically serves patients who have progressed beyond initial recovery phases and no longer require continuous heart rhythm monitoring during exercise. The Medicare benchmark for this service is approximately $89 per session, though facility charges can vary significantly across different outpatient settings.
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Facility rate
$8
National Medicare benchmark
Non-facility rate
$99
Office setting benchmark
Data sources
3
23 data points
Key insights for CPT 93797
Facility vs office setting
$91 differenceFacility setting is less expensive for this procedure
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 |
|---|---|---|
| Facility (physician office) | $8 | Lowest |
| Non-facility (office) | $99 | +1182% |
| Outpatient (APC) | $126 | +1531% |
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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.
Related procedures
Related pricing data
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