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CPT code 93458: Coronary catheterization, left heart, native coronaries2026 Medicare rate & RVUs in Vermont

Reports left heart catheterization with imaging of the native coronary arteries, with left ventriculography included when performed during the study.

CMS RVU26DEffective Oct 1, 2026One payment locality391.7K Medicare services in 2024

In Vermont, Medicare pays $983.50 for 93458 in the office.

$983.50Office (non-facility)
Not available in this settingHospital or facility
−2.6%vs the national office rate ($1,010.04)

Check a contract rate as a % of Medicare · 93458 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 93458 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Vermont
  2. What 93458 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 93458 covers

An interventional cardiologist typically performs this diagnostic study in a cardiac catheterization laboratory. Catheters are advanced to the left side of the heart and into the coronary arteries to obtain hemodynamic information and images of the native vessels. Contrast imaging of the left ventricle may also be performed as part of the study. This code is used for the combined left-heart and coronary evaluation, rather than coronary imaging alone or a study that also includes right-heart catheterization.

Report the code when both left heart catheterization and coronary angiography are performed; document the catheterization, vessels imaged, and any ventriculography performed. The global service includes the professional interpretation and the technical resources; modifier 26 identifies the professional interpretation, and modifier TC identifies equipment and staff. Same-day preoperative and postoperative care is included in its 0-day global period. In a same-session multiple-procedure claim, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is not appropriate for this left-sided study. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

How Vermont compares for 93458

Across 109 of 109 payment localities, the office rate for 93458 runs from $880.36 in Arkansas to $1,361.74 in San Benito County, CA. Vermont pays $983.50. The RVUs are the same everywhere; the geographic indexes change the dollars.

93458 in Vermont vs other payment areas
  1. Vermont · this page$983.50
  2. Los Angeles, CA · California$1,149.40+$165.90
  3. Washington, DC area · District of Columbia$1,164.76+$181.26
  4. Miami, FL · Florida$1,100.14+$116.64
  5. Chicago, IL · Illinois$1,064.15+$80.65
  6. Manhattan, NY · New York$1,171.80+$188.30
  7. Alaska · Alaska$1,135.63+$152.13

Other areas in Vermont first, then benchmark localities. Bars start at $0.

Every other payment area

93458 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$894.92—
ArkansasArkansas$880.36—
ArizonaArizona$980.12—
Bakersfield, CACalifornia$1,074.58—
Chico, CACalifornia$1,071.46—
El Centro, CACalifornia$1,071.65—
Fresno, CACalifornia$1,071.46—
Hanford, CACalifornia$1,071.46—

93458 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$880.36

$1,216.60

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
93458 office rate range by state
State / territoryOffice rate rangeLocalities
AK$1,135.631
AL$894.921
AR$880.361
AZ$980.121
CA$1,071.46–$1,361.7429
CO$1,054.521
CT$1,082.441
DC$1,164.761
DE$997.661
FL$994.27–$1,100.143
GA$931.98–$1,030.822
GU$1,102.371
HI$1,102.371
IA$920.141
ID$926.961
IL$962.57–$1,064.154
IN$932.981
KS$915.491
KY$919.151
LA$917.62–$968.572
MA$1,047.17–$1,166.622
MD$1,018.25–$1,164.763
ME$932.58–$989.012
MI$946.19–$1,008.292
MN$1,006.381
MO$900.05–$972.203
MS$890.391
MT$1,009.971
NC$943.491
ND$987.621
NE$925.741
NH$1,037.711
NJ$1,093.67–$1,150.492
NM$952.071
NV$1,004.531
NY$959.34–$1,203.365
OH$941.621
OK$917.101
OR$995.67–$1,090.982
PA$943.19–$1,053.002
PR$1,018.171
RI$1,035.501
SC$944.351
SD$984.981
TN$920.681
TX$936.27–$1,051.928
UT$958.801
VA$985.52–$1,164.762
VI$1,018.171
VT$983.501
WA$1,045.26–$1,191.572
WI$950.751
WV$922.831
WY$1,000.231

See 93458 in every payment locality

How the 93458 rate is calculated

Each of 93458’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 93458

RVUs × geographic indexes × conversion factor

Office or facility?

Work5.46

5.46 RVUs× 1.000 GPCI

Practice expense23.65

23.65 RVUs× 1.000 GPCI

Malpractice1.13

1.13 RVUs× 1.000 GPCI

Adjusted RVUs

30.2400

Conversion factor

$33.4009

Medicare rate

$1,010.04

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Vermont inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

12,112

Code
93458
Physician work
5.46
Practice expense
23.65
Malpractice
1.13

GPCI2026.csv

105

Locality
Vermont
Physician work
1.000
Practice expense
0.990
Malpractice
0.506
Office calculation for 93458 in Vermont
ComponentRVULocality factorAdjusted
Physician work5.46× 1.0005.4600
Practice expense23.65× 0.99023.4135
Malpractice1.13× 0.5060.5718
Total RVUs29.4453
Conversion factor× 33.4009

Office rate, Vermont$983.50

Office: (5.46 × 1 + 23.65 × 0.99 + 1.13 × 0.506) × $33.4009 = $983.50

Open 93458 in the RVU calculator

Payment rules and modifiers for 93458

The CMS indicators that decide how 93458 is paid alongside other services.

CMS payment indicators · 93458

Coronary catheterization, left heart, native coronaries

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical1Diagnostic test with separate professional (26) and technical (TC) components.

What modifiers do to the payment

Modifier 26 · payment effect

With and without the modifier

93458 without 26 · national office

$1,010.04

Coronary catheterization, left heart, native coronaries

93458-26 · Professional component

$287.25

Pays only the interpretation and report.

When to use modifier 26

Codes related to 93458

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 93458
CodeHow it relatesOffice range, Vermont
Used instead
93452Left heart cath, left-sided studyLeft heart catheterization with ventriculography, without the coronary angiography included in 93458.$854.26
93454Coronary angiography, without graft or left-heart catheterizationCoronary angiography without the left heart catheterization component.$855.60
93459Cardiac catheterization, left heart with bypass graftsUse when the study also includes imaging of coronary bypass grafts.$1,057.87
Same family
93460Heart catheterization, right and left heart with coronary imagingAdds right heart catheterization to the left-heart and coronary evaluation.$1,173.39

How 93458 has changed in Vermont

93458 · Office / nonfacility

$983.50

Effective 2026-10-01

The base rate is $42.76 higher than on 2025-10-01, moving from $940.74 to $983.50 (4.5%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $940.74changed to$983.50

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 5.60 changed to 5.46
    • Practice expense RVU 23.08 changed to 23.65
    • Malpractice RVU 1.09 changed to 1.13
    • Practice expense GPCI 0.993 changed to 0.990
    • Malpractice GPCI 0.518 changed to 0.506

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $1000.35changed to$940.74

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 24.04 changed to 23.08
    • Malpractice RVU 1.12 changed to 1.09

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $984.02changed to$1000.35

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $1036.53changed to$984.02

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 24.48 changed to 24.04
    • Malpractice RVU 1.07 changed to 1.12
    • Practice expense GPCI 0.997 changed to 0.993
    • Malpractice GPCI 0.543 changed to 0.518

  5. January 1, 2023

    RVU23A

    $1095.73changed to$1036.53

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 25.40 changed to 24.48
    • Malpractice RVU 1.12 changed to 1.07
    • Practice expense GPCI 1.001 changed to 0.997
    • Malpractice GPCI 0.569 changed to 0.543

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $1121.28changed to$1095.73

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 25.90 changed to 25.40
    • Malpractice RVU 1.07 changed to 1.12

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $1088.04changed to$1121.28

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 23.73 changed to 25.90
    • Malpractice RVU 1.08 changed to 1.07
    • Practice expense GPCI 1.008 changed to 1.001
    • Malpractice GPCI 0.582 changed to 0.569

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $1058.52changed to$1088.04

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 22.74 changed to 23.73
    • Malpractice RVU 1.16 changed to 1.08
    • Practice expense GPCI 1.015 changed to 1.008
    • Malpractice GPCI 0.595 changed to 0.582

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $1031.20changed to$1058.52

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 22.03 changed to 22.74
    • Malpractice RVU 1.15 changed to 1.16

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $1018.14changed to$1031.20

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 21.81 changed to 22.03
    • Malpractice RVU 1.16 changed to 1.15
    • Practice expense GPCI 1.010 changed to 1.015
    • Malpractice GPCI 0.639 changed to 0.595

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $1081.02changed to$1018.14

    • Conversion factor 35.8043 changed to 35.8887
    • Work RVU 5.85 changed to 5.60
    • Practice expense RVU 23.41 changed to 21.81
    • Malpractice RVU 1.23 changed to 1.16
    • Practice expense GPCI 1.004 changed to 1.010
    • Malpractice GPCI 0.682 changed to 0.639

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $1083.83changed to$1081.02

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 23.40 changed to 23.41
    • Malpractice RVU 1.20 changed to 1.23

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $1078.43changed to$1083.83

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $1071.23changed to$1078.43

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 23.13 changed to 23.40
    • Malpractice RVU 1.27 changed to 1.20
    • Practice expense GPCI 1.006 changed to 1.004
    • Malpractice GPCI 0.618 changed to 0.682

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    No ratechanged to$1071.23

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$983.50Not available in this settingRVU26D
2026-07-01$983.50Not available in this settingRVU26C
2026-04-01$983.50Not available in this settingRVU26B
2026-01-01$983.50Not available in this settingRVU26A
2025-10-01$940.74Not available in this settingRVU25D
2025-07-01$940.74Not available in this settingRVU25C
2025-04-01$940.74Not available in this settingRVU25B
2025-01-01$940.74Not available in this settingRVU25A
2024-10-01$1,000.35Not available in this settingRVU24D
2024-07-01$1,000.35Not available in this settingRVU24C
2024-04-01$1,000.35Not available in this settingRVU24B
2024-03-09$1,000.35Not available in this settingRVU24AR
2024-01-01$984.02Not available in this settingRVU24A
2023-10-01$1,036.53Not available in this settingRVU23D
2023-07-01$1,036.53Not available in this settingRVU23C
2023-04-01$1,036.53Not available in this settingRVU23B
2023-01-01$1,036.53Not available in this settingRVU23A
2022-10-01$1,095.73Not available in this settingRVU22D
2022-07-01$1,095.73Not available in this settingRVU22C
2022-04-01$1,095.73Not available in this settingRVU22B
2022-01-01$1,095.73Not available in this settingRVU22A
2021-10-01$1,121.28Not available in this settingRVU21D
2021-07-01$1,121.28Not available in this settingRVU21C
2021-04-01$1,121.28Not available in this settingRVU21B
2021-01-01$1,121.28Not available in this settingRVU21A
2020-10-01$1,088.04Not available in this settingRVU20D
2020-07-01$1,088.04Not available in this settingRVU20C
2020-04-01$1,088.04Not available in this settingRVU20B
2020-01-01$1,088.04Not available in this settingRVU20A
2019-10-01$1,058.52Not available in this settingRVU19D
2019-07-01$1,058.52Not available in this settingRVU19C
2019-04-01$1,058.52Not available in this settingRVU19B
2019-01-01$1,058.52Not available in this settingRVU19A
2018-10-01$1,031.20Not available in this settingRVU18D
2018-07-01$1,031.20Not available in this settingRVU18C
2018-04-01$1,031.20Not available in this settingRVU18B
2018-01-01$1,031.20Not available in this settingRVU18AR1
2017-10-01$1,018.14Not available in this settingRVU17D
2017-07-01$1,018.14Not available in this settingRVU17C
2017-04-01$1,018.14Not available in this settingRVU17B
2017-01-01$1,018.14Not available in this settingRVU17A
2016-10-01$1,081.02Not available in this settingRVU16D
2016-07-01$1,081.02Not available in this settingRVU16C
2016-04-01$1,081.02Not available in this settingRVU16B
2016-01-01$1,081.02Not available in this settingRVU16A
2015-10-01$1,083.83Not available in this settingRVU15D
2015-07-01$1,083.83Not available in this settingRVU15C
2015-04-01$1,078.43Not available in this settingRVU15B
2015-01-01$1,078.43Not available in this settingRVU15A
2014-10-01$1,071.23Not available in this settingRVU14D
2014-07-01$1,071.23Not available in this settingRVU14C
2014-04-01$1,071.23Not available in this settingRVU14B
2014-01-01$1,071.23Not available in this settingRVU14A
2013-10-01Rate data unavailableNot available in this settingRVU13D
2013-07-01Rate data unavailableNot available in this settingRVU13C
2013-04-01Rate data unavailableNot available in this settingRVU13B
2013-01-01Rate data unavailableNot available in this settingRVU13AR

Price 93458 for an earlier date of service

Where the Vermont rate applies

Vermont is a Medicare payment area, not a city. Our Census mapping connects it to 180 cities and communities in Vermont. Some span more than one payment area; confirm with the service ZIP.

Browse all communities in Vermont

93458 billing questions

When should 93458 be chosen instead of 93454?

Use 93458 when the service includes both left heart catheterization and coronary angiography. Code 93454 describes coronary angiography without the left heart catheterization component.

Is left ventriculography required to report 93458?

No. The code includes left ventriculography when performed, but the study may be reported when left ventriculography is not performed.

Can the professional and technical services be billed separately?

Yes. Modifier 26 identifies the professional interpretation, and modifier TC identifies the technical service. Without either modifier, the claim represents the global service.

Should modifier 50 be appended when both coronary arteries are imaged?

No. Report 93458 once for the described study; modifier 50 is inappropriate for this code.

How are other procedures in the same session affected?

The highest-valued procedure is paid in full, and other procedures in the same session are subject to the standard multiple-procedure reduction. The code has a 0-day global period, which includes same-day preoperative and postoperative care.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment requires documentation of medical necessity. Co-surgeons and team surgery are not permitted for this code.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 93458PPRRVU2026_Oct_nonQPP.csv, line 12,112 (RVU26D)
Geographic factors for VermontGPCI2026.csv, line 105 (RVU26D)

Open CMS sourceHow we calculate rates

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