CPT code 93459: Cardiac catheterization, left heart with bypass grafts2026 Medicare rate & RVUs in North Carolina
Reports diagnostic left-heart catheterization with coronary and bypass-graft angiography, with left ventriculography included when performed during the study.
In North Carolina, Medicare pays $1,015.85 for 93459 in the office.
Check a contract rate as a % of Medicare · 93459 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
What 93459 covers
A cardiologist or other qualified physician performs this invasive diagnostic study, usually in a hospital catheterization laboratory. It combines left-heart catheterization with imaging of the native coronary arteries and bypass grafts, such as saphenous vein or internal mammary artery grafts, in a patient with prior coronary artery bypass surgery. Left ventriculography may be performed as part of the study, but is not required for the code.
Select 93459 when the documented service includes left-heart catheterization, coronary angiography, and bypass-graft angiography; the record should identify the catheterization and the native-vessel and graft imaging performed. The code includes the diagnostic imaging supervision and interpretation. CMS allows global billing or separate professional interpretation (modifier 26) and technical service (modifier TC). It has a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures occur in the same session, the highest-valued procedure is paid in full and others at 50%. 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 North Carolina compares for 93459
Across 109 of 109 payment localities, the office rate for 93459 runs from $948.52 in Arkansas to $1,460.54 in San Benito County, CA. North Carolina pays $1,015.85. The RVUs are the same everywhere; the geographic indexes change the dollars.
- North Carolina · this page$1,015.85
- Los Angeles, CA · California$1,234.83+$218.98
- Washington, DC area · District of Columbia$1,252.68+$236.83
- Miami, FL · Florida$1,187.76+$171.91
- Chicago, IL · Illinois$1,148.97+$133.12
- Manhattan, NY · New York$1,261.72+$245.87
- Alaska · Alaska$1,226.01+$210.16
Other areas in North Carolina first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $964.12 | — |
| ArkansasArkansas | $948.52 | — |
| ArizonaArizona | $1,055.36 | — |
| Bakersfield, CACalifornia | $1,155.03 | — |
| Chico, CACalifornia | $1,151.47 | — |
| El Centro, CACalifornia | $1,151.69 | — |
| Fresno, CACalifornia | $1,151.47 | — |
| Hanford, CACalifornia | $1,151.47 | — |
| Madera, CACalifornia | $1,151.47 | — |
| Merced, CACalifornia | $1,151.47 | — |
| Modesto, CACalifornia | $1,151.47 | — |
| Napa, CACalifornia | $1,345.75 | — |
| Oxnard, CACalifornia | $1,229.54 | — |
| Redding, CACalifornia | $1,151.47 | — |
| Rest of CaliforniaCalifornia | $1,151.47 | — |
| Riverside, CACalifornia | $1,165.34 | — |
| Sacramento, CACalifornia | $1,211.53 | — |
| Salinas, CACalifornia | $1,207.14 | — |
| San Diego, CACalifornia | $1,238.19 | — |
| Marin County, CACalifornia | $1,427.32 | — |
| San Francisco, CACalifornia | $1,425.85 | — |
| San Benito County, CACalifornia | $1,460.54 | — |
| Santa Clara County, CACalifornia | $1,454.56 | — |
| San Luis Obispo, CACalifornia | $1,187.50 | — |
| Santa Cruz, CACalifornia | $1,251.99 | — |
| Santa Maria, CACalifornia | $1,212.39 | — |
| Santa Rosa, CACalifornia | $1,264.74 | — |
| Stockton, CACalifornia | $1,151.47 | — |
| Vallejo, CACalifornia | $1,343.64 | — |
| Visalia, CACalifornia | $1,151.47 | — |
| Yuba City, CACalifornia | $1,151.47 | — |
| ColoradoColorado | $1,134.19 | — |
| ConnecticutConnecticut | $1,165.22 | — |
| DelawareDelaware | $1,074.16 | — |
| Fort Lauderdale, FLFlorida | $1,133.24 | — |
| Rest of FloridaFlorida | $1,072.35 | — |
| Atlanta, GAGeorgia | $1,110.22 | — |
| Rest of GeorgiaGeorgia | $1,005.34 | — |
| Hawaii, Guam, HIHawaii | $1,184.16 | — |
| IowaIowa | $990.35 | — |
| IdahoIdaho | $997.81 | — |
| East St. Louis, ILIllinois | $1,064.21 | — |
| Rest of IllinoisIllinois | $1,038.91 | — |
| Suburban Chicago, ILIllinois | $1,144.86 | — |
| IndianaIndiana | $1,004.23 | — |
| KansasKansas | $985.74 | — |
| KentuckyKentucky | $990.89 | — |
| New Orleans, LALouisiana | $1,043.97 | — |
| Rest of LouisianaLouisiana | $989.39 | — |
| Metropolitan Boston, MAMassachusetts | $1,253.78 | — |
| Rest of MassachusettsMassachusetts | $1,126.49 | — |
| Baltimore area, MDMaryland | $1,162.20 | — |
| Rest of MarylandMaryland | $1,096.12 | — |
| Rest of MaineMaine | $1,004.23 | — |
| Southern Maine, MEMaine | $1,064.09 | — |
| Detroit, MIMichigan | $1,087.77 | — |
| Rest of MichiganMichigan | $1,020.21 | — |
| MinnesotaMinnesota | $1,081.49 | — |
| Metropolitan Kansas City, MOMissouri | $1,035.44 | — |
| Metropolitan St. Louis, MOMissouri | $1,047.41 | — |
| Rest of MissouriMissouri | $970.81 | — |
| MississippiMississippi | $959.85 | — |
| MontanaMontana | $1,087.45 | — |
| North DakotaNorth Dakota | $1,061.94 | — |
| NebraskaNebraska | $996.23 | — |
| New HampshireNew Hampshire | $1,116.49 | — |
| Northern New JerseyNew Jersey | $1,237.52 | — |
| Rest of New JerseyNew Jersey | $1,177.05 | — |
| New MexicoNew Mexico | $1,026.67 | — |
| NevadaNevada | $1,081.18 | — |
| NYC suburbs and Long Island, NYNew York | $1,296.02 | — |
| Poughkeepsie and northern NYC suburbs, NYNew York | $1,185.47 | — |
| Queens, NYNew York | $1,272.27 | — |
| Rest of New YorkNew York | $1,032.85 | — |
| OhioOhio | $1,015.00 | — |
| OklahomaOklahoma | $988.29 | — |
| Portland, OROregon | $1,172.80 | — |
| Rest of OregonOregon | $1,071.39 | — |
| Metropolitan Philadelphia, PAPennsylvania | $1,133.92 | — |
| Rest of PennsylvaniaPennsylvania | $1,016.47 | — |
| Puerto RicoPuerto Rico | $1,096.10 | — |
| Rhode IslandRhode Island | $1,114.45 | — |
| South CarolinaSouth Carolina | $1,017.41 | — |
| South DakotaSouth Dakota | $1,058.92 | — |
| TennesseeTennessee | $991.35 | — |
| Austin, TXTexas | $1,131.62 | — |
| Beaumont, TXTexas | $1,009.08 | — |
| Brazoria, TXTexas | $1,072.17 | — |
| Dallas, TXTexas | $1,079.92 | — |
| Fort Worth, TXTexas | $1,072.11 | — |
| Galveston, TXTexas | $1,075.91 | — |
| Houston, TXTexas | $1,099.52 | — |
| Rest of TexasTexas | $1,040.63 | — |
| UtahUtah | $1,032.88 | — |
| VirginiaVirginia | $1,060.62 | — |
| Virgin Islands, VIUnited States Virgin Islands | $1,096.10 | — |
| VermontVermont | $1,057.87 | — |
| Rest of WashingtonWashington | $1,124.32 | — |
| King County, WAWashington | $1,280.14 | — |
| WisconsinWisconsin | $1,022.53 | — |
| West VirginiaWest Virginia | $996.37 | — |
| WyomingWyoming | $1,076.33 | — |
93459 rates by state
Office rate range in each state. Select a state to see its payment localities.
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.
$948.52
$1,306.01
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $1,226.01 | 1 |
| AL | $964.12 | 1 |
| AR | $948.52 | 1 |
| AZ | $1,055.36 | 1 |
| CA | $1,151.47–$1,460.54 | 29 |
| CO | $1,134.19 | 1 |
| CT | $1,165.22 | 1 |
| DC | $1,252.68 | 1 |
| DE | $1,074.16 | 1 |
| FL | $1,072.35–$1,187.76 | 3 |
| GA | $1,005.34–$1,110.22 | 2 |
| GU | $1,184.16 | 1 |
| HI | $1,184.16 | 1 |
| IA | $990.35 | 1 |
| ID | $997.81 | 1 |
| IL | $1,038.91–$1,148.97 | 4 |
| IN | $1,004.23 | 1 |
| KS | $985.74 | 1 |
| KY | $990.89 | 1 |
| LA | $989.39–$1,043.97 | 2 |
| MA | $1,126.49–$1,253.78 | 2 |
| MD | $1,096.12–$1,252.68 | 3 |
| ME | $1,004.23–$1,064.09 | 2 |
| MI | $1,020.21–$1,087.77 | 2 |
| MN | $1,081.49 | 1 |
| MO | $970.81–$1,047.41 | 3 |
| MS | $959.85 | 1 |
| MT | $1,087.45 | 1 |
| NC | $1,015.85 | 1 |
| ND | $1,061.94 | 1 |
| NE | $996.23 | 1 |
| NH | $1,116.49 | 1 |
| NJ | $1,177.05–$1,237.52 | 2 |
| NM | $1,026.67 | 1 |
| NV | $1,081.18 | 1 |
| NY | $1,032.85–$1,296.02 | 5 |
| OH | $1,015.00 | 1 |
| OK | $988.29 | 1 |
| OR | $1,071.39–$1,172.80 | 2 |
| PA | $1,016.47–$1,133.92 | 2 |
| PR | $1,096.10 | 1 |
| RI | $1,114.45 | 1 |
| SC | $1,017.41 | 1 |
| SD | $1,058.92 | 1 |
| TN | $991.35 | 1 |
| TX | $1,009.08–$1,131.62 | 8 |
| UT | $1,032.88 | 1 |
| VA | $1,060.62–$1,252.68 | 2 |
| VI | $1,096.10 | 1 |
| VT | $1,057.87 | 1 |
| WA | $1,124.32–$1,280.14 | 2 |
| WI | $1,022.53 | 1 |
| WV | $996.37 | 1 |
| WY | $1,076.33 | 1 |
How the 93459 rate is calculated
Each of 93459’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 · 93459
RVUs × geographic indexes × conversion factor
Work6.19
6.19 RVUs× 1.000 GPCI
Practice expense25.08
25.08 RVUs× 1.000 GPCI
Malpractice1.29
1.29 RVUs× 1.000 GPCI
Adjusted RVUs
32.5600
Conversion factor
$33.4009
Medicare rate
$1,087.53
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact North Carolina inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
12,115
- Code
- 93459
- Physician work
- 6.19
- Practice expense
- 25.08
- Malpractice
- 1.29
GPCI2026.csv
83
- Locality
- North Carolina
- Physician work
- 1.000
- Practice expense
- 0.933
- Malpractice
- 0.639
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 6.19 | × 1.000 | 6.1900 |
| Practice expense | 25.08 | × 0.933 | 23.3996 |
| Malpractice | 1.29 | × 0.639 | 0.8243 |
| Total RVUs | 30.4139 | ||
| Conversion factor | × 33.4009 | ||
Office rate, North Carolina$1015.85
Office: (6.19 × 1 + 25.08 × 0.933 + 1.29 × 0.639) × $33.4009 = $1015.85
Payment rules and modifiers for 93459
The CMS indicators that decide how 93459 is paid alongside other services.
CMS payment indicators · 93459
Cardiac catheterization, left heart with bypass grafts
| Rule | CMS value | What it means |
|---|---|---|
| Global period | 000 | Same-day global: pre- and post-op care on the day of the procedure is included. |
| Multiple procedures | 2 | Standard reduction: highest-valued procedure at 100%, others at 50%. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 1 | Diagnostic test with separate professional (26) and technical (TC) components. |
What modifiers do to the payment
Modifier 26 · payment effect
With and without the modifier
93459 without 26 · national office
$1,087.53
Cardiac catheterization, left heart with bypass grafts
93459-26 · Professional component
$325.99
Pays only the interpretation and report.
How 93459 has changed in North Carolina
93459 · Office / nonfacility
$1015.85
Effective 2026-10-01
The base rate is $51.05 higher than on 2025-10-01, moving from $964.80 to $1015.85 (5.3%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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
January 1, 2026
RVU26A
$964.80changed to$1015.85
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 6.35 changed to 6.19
- Practice expense RVU 24.47 changed to 25.08
- Malpractice RVU 1.23 changed to 1.29
- Practice expense GPCI 0.926 changed to 0.933
- Malpractice GPCI 0.665 changed to 0.639
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$1024.58changed to$964.80
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 25.47 changed to 24.47
- Malpractice RVU 1.27 changed to 1.23
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$1007.86changed to$1024.58
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$1060.79changed to$1007.86
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 25.95 changed to 25.47
- Malpractice RVU 1.21 changed to 1.27
- Practice expense GPCI 0.927 changed to 0.926
- Malpractice GPCI 0.742 changed to 0.665
January 1, 2023
RVU23A
$1120.27changed to$1060.79
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 26.92 changed to 25.95
- Malpractice RVU 1.27 changed to 1.21
- Practice expense GPCI 0.928 changed to 0.927
- Malpractice GPCI 0.819 changed to 0.742
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$1151.69changed to$1120.27
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 27.63 changed to 26.92
- Malpractice RVU 1.24 changed to 1.27
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$1119.37changed to$1151.69
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 25.53 changed to 27.63
- Malpractice RVU 1.22 changed to 1.24
- Practice expense GPCI 0.930 changed to 0.928
- Malpractice GPCI 0.757 changed to 0.819
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$1091.75changed to$1119.37
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 24.74 changed to 25.53
- Malpractice RVU 1.31 changed to 1.22
- Practice expense GPCI 0.931 changed to 0.930
- Malpractice GPCI 0.695 changed to 0.757
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$1073.71changed to$1091.75
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 24.23 changed to 24.74
- Malpractice RVU 1.32 changed to 1.31
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$1064.54changed to$1073.71
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 24.01 changed to 24.23
- Malpractice RVU 1.31 changed to 1.32
- Malpractice GPCI 0.732 changed to 0.695
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$1130.35changed to$1064.54
- Conversion factor 35.8043 changed to 35.8887
- Work RVU 6.60 changed to 6.35
- Practice expense RVU 25.71 changed to 24.01
- Malpractice RVU 1.38 changed to 1.31
- Practice expense GPCI 0.930 changed to 0.931
- Malpractice GPCI 0.768 changed to 0.732
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$1132.93changed to$1130.35
- Conversion factor 35.9335 changed to 35.8043
- Practice expense RVU 25.69 changed to 25.71
- Malpractice RVU 1.35 changed to 1.38
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$1127.29changed to$1132.93
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$1118.70changed to$1127.29
- Conversion factor 35.8228 changed to 35.7547
- Practice expense RVU 25.40 changed to 25.69
- Malpractice RVU 1.41 changed to 1.35
- Practice expense GPCI 0.929 changed to 0.930
- Malpractice GPCI 0.732 changed to 0.768
Held through RVU15B.
January 1, 2014
RVU14A
$1142.41changed to$1118.70
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 28.00 changed to 25.40
- Malpractice RVU 1.47 changed to 1.41
- Practice expense GPCI 0.927 changed to 0.929
- Malpractice GPCI 0.695 changed to 0.732
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $1142.41
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $1,015.85 | Not available in this setting | RVU26D |
| 2026-07-01 | $1,015.85 | Not available in this setting | RVU26C |
| 2026-04-01 | $1,015.85 | Not available in this setting | RVU26B |
| 2026-01-01 | $1,015.85 | Not available in this setting | RVU26A |
| 2025-10-01 | $964.80 | Not available in this setting | RVU25D |
| 2025-07-01 | $964.80 | Not available in this setting | RVU25C |
| 2025-04-01 | $964.80 | Not available in this setting | RVU25B |
| 2025-01-01 | $964.80 | Not available in this setting | RVU25A |
| 2024-10-01 | $1,024.58 | Not available in this setting | RVU24D |
| 2024-07-01 | $1,024.58 | Not available in this setting | RVU24C |
| 2024-04-01 | $1,024.58 | Not available in this setting | RVU24B |
| 2024-03-09 | $1,024.58 | Not available in this setting | RVU24AR |
| 2024-01-01 | $1,007.86 | Not available in this setting | RVU24A |
| 2023-10-01 | $1,060.79 | Not available in this setting | RVU23D |
| 2023-07-01 | $1,060.79 | Not available in this setting | RVU23C |
| 2023-04-01 | $1,060.79 | Not available in this setting | RVU23B |
| 2023-01-01 | $1,060.79 | Not available in this setting | RVU23A |
| 2022-10-01 | $1,120.27 | Not available in this setting | RVU22D |
| 2022-07-01 | $1,120.27 | Not available in this setting | RVU22C |
| 2022-04-01 | $1,120.27 | Not available in this setting | RVU22B |
| 2022-01-01 | $1,120.27 | Not available in this setting | RVU22A |
| 2021-10-01 | $1,151.69 | Not available in this setting | RVU21D |
| 2021-07-01 | $1,151.69 | Not available in this setting | RVU21C |
| 2021-04-01 | $1,151.69 | Not available in this setting | RVU21B |
| 2021-01-01 | $1,151.69 | Not available in this setting | RVU21A |
| 2020-10-01 | $1,119.37 | Not available in this setting | RVU20D |
| 2020-07-01 | $1,119.37 | Not available in this setting | RVU20C |
| 2020-04-01 | $1,119.37 | Not available in this setting | RVU20B |
| 2020-01-01 | $1,119.37 | Not available in this setting | RVU20A |
| 2019-10-01 | $1,091.75 | Not available in this setting | RVU19D |
| 2019-07-01 | $1,091.75 | Not available in this setting | RVU19C |
| 2019-04-01 | $1,091.75 | Not available in this setting | RVU19B |
| 2019-01-01 | $1,091.75 | Not available in this setting | RVU19A |
| 2018-10-01 | $1,073.71 | Not available in this setting | RVU18D |
| 2018-07-01 | $1,073.71 | Not available in this setting | RVU18C |
| 2018-04-01 | $1,073.71 | Not available in this setting | RVU18B |
| 2018-01-01 | $1,073.71 | Not available in this setting | RVU18AR1 |
| 2017-10-01 | $1,064.54 | Not available in this setting | RVU17D |
| 2017-07-01 | $1,064.54 | Not available in this setting | RVU17C |
| 2017-04-01 | $1,064.54 | Not available in this setting | RVU17B |
| 2017-01-01 | $1,064.54 | Not available in this setting | RVU17A |
| 2016-10-01 | $1,130.35 | Not available in this setting | RVU16D |
| 2016-07-01 | $1,130.35 | Not available in this setting | RVU16C |
| 2016-04-01 | $1,130.35 | Not available in this setting | RVU16B |
| 2016-01-01 | $1,130.35 | Not available in this setting | RVU16A |
| 2015-10-01 | $1,132.93 | Not available in this setting | RVU15D |
| 2015-07-01 | $1,132.93 | Not available in this setting | RVU15C |
| 2015-04-01 | $1,127.29 | Not available in this setting | RVU15B |
| 2015-01-01 | $1,127.29 | Not available in this setting | RVU15A |
| 2014-10-01 | $1,118.70 | Not available in this setting | RVU14D |
| 2014-07-01 | $1,118.70 | Not available in this setting | RVU14C |
| 2014-04-01 | $1,118.70 | Not available in this setting | RVU14B |
| 2014-01-01 | $1,118.70 | Not available in this setting | RVU14A |
| 2013-10-01 | $1,142.41 | Not available in this setting | RVU13D |
| 2013-07-01 | $1,142.41 | Not available in this setting | RVU13C |
| 2013-04-01 | $1,142.41 | Not available in this setting | RVU13B |
| 2013-01-01 | $1,142.41 | Not available in this setting | RVU13AR |
Where the North Carolina rate applies
North Carolina is a Medicare payment area, not a city. Our Census mapping connects it to 785 cities and communities in North Carolina. Some span more than one payment area; confirm with the service ZIP.
- Aberdeen
- Advance
- Ahoskie
- Alamance
- Albemarle
- Alexis
- Alliance
- Altamahaw
93459 billing questions
When should 93459 be chosen over 93458?
Use 93459 when the left-heart catheterization and coronary angiography include bypass-graft angiography. Use 93458 when graft angiography is not part of the study.
Is left ventriculography required?
No. Left ventriculography may be performed during the study, but it is not required for 93459.
Can coronary or graft angiography be billed separately?
The coronary and bypass-graft imaging and its supervision and interpretation are included in 93459 for the same study. Do not separately report 93455 for that same imaging.
How are the professional and technical services reported?
Report modifier 26 for the professional interpretation or modifier TC for the technical service. Reporting without either modifier represents the global service.
How does the multiple-procedure rule affect payment?
For multiple procedures in the same session, CMS pays the highest-valued procedure in full and pays other procedures at 50%.
What documentation is needed for an assistant at surgery?
Document the medical necessity for the assistant. CMS pays an assistant at surgery for this code only when that necessity is documented.
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
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