CPT code 93460: Heart catheterization, right and left heart with coronary imaging2026 Medicare rate & RVUs in Iowa
Reports combined right- and left-heart catheterization with coronary angiography when clinicians need coronary anatomy and intracardiac hemodynamics during one diagnostic evaluation.
In Iowa, Medicare pays $1,098.71 for 93460 in the office.
Check a contract rate as a % of Medicare · 93460 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 93460 covers
A cardiologist typically performs this diagnostic catheterization in a cardiac catheterization laboratory to assess coronary anatomy and measure pressures in the right and left sides of the heart. The study can support evaluation of coronary artery disease, valve disease, pulmonary hypertension, or cardiomyopathy. It includes coronary angiographic imaging and left ventriculography when performed; the right- and left-heart measurements provide hemodynamic information that a coronary angiogram alone does not supply.
Select this code when the documented service includes both right- and left-heart catheterization and coronary angiography. The report should support the catheterization performed, the angiographic study, and the physician’s interpretation; bypass graft angiography points to a different code in this family. A 0-day global period includes same-day preoperative and postoperative care. The service may be billed globally or split into professional interpretation (modifier 26) and technical equipment and staff (modifier TC). When multiple procedures occur in one session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 is inappropriate. 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 Iowa compares for 93460
Across 109 of 109 payment localities, the office rate for 93460 runs from $1,052.26 in Arkansas to $1,619.62 in San Benito County, CA. Iowa pays $1,098.71. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Iowa · this page$1,098.71
- Los Angeles, CA · California$1,369.34+$270.63
- Washington, DC area · District of Columbia$1,388.70+$289.99
- Miami, FL · Florida$1,315.31+$216.60
- Chicago, IL · Illinois$1,272.59+$173.88
- Manhattan, NY · New York$1,398.28+$299.57
- Alaska · Alaska$1,360.66+$261.95
Other areas in Iowa first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $1,069.49 | — |
| ArkansasArkansas | $1,052.26 | — |
| ArizonaArizona | $1,170.27 | — |
| Bakersfield, CACalifornia | $1,280.96 | — |
| Chico, CACalifornia | $1,277.08 | — |
| El Centro, CACalifornia | $1,277.31 | — |
| Fresno, CACalifornia | $1,277.08 | — |
| Hanford, CACalifornia | $1,277.08 | — |
| Madera, CACalifornia | $1,277.08 | — |
| Merced, CACalifornia | $1,277.08 | — |
| Modesto, CACalifornia | $1,277.08 | — |
| Napa, CACalifornia | $1,492.39 | — |
| Oxnard, CACalifornia | $1,363.49 | — |
| Redding, CACalifornia | $1,277.08 | — |
| Rest of CaliforniaCalifornia | $1,277.08 | — |
| Riverside, CACalifornia | $1,292.14 | — |
| Sacramento, CACalifornia | $1,343.64 | — |
| Salinas, CACalifornia | $1,338.77 | — |
| San Diego, CACalifornia | $1,373.15 | — |
| Marin County, CACalifornia | $1,582.86 | — |
| San Francisco, CACalifornia | $1,581.27 | — |
| San Benito County, CACalifornia | $1,619.62 | — |
| Santa Clara County, CACalifornia | $1,613.12 | — |
| San Luis Obispo, CACalifornia | $1,316.98 | — |
| Santa Cruz, CACalifornia | $1,388.42 | — |
| Santa Maria, CACalifornia | $1,344.57 | — |
| Santa Rosa, CACalifornia | $1,402.57 | — |
| Stockton, CACalifornia | $1,277.08 | — |
| Vallejo, CACalifornia | $1,490.10 | — |
| Visalia, CACalifornia | $1,277.08 | — |
| Yuba City, CACalifornia | $1,277.08 | — |
| ColoradoColorado | $1,257.69 | — |
| ConnecticutConnecticut | $1,291.66 | — |
| DelawareDelaware | $1,191.07 | — |
| Fort Lauderdale, FLFlorida | $1,255.62 | — |
| Rest of FloridaFlorida | $1,188.47 | — |
| Atlanta, GAGeorgia | $1,230.71 | — |
| Rest of GeorgiaGeorgia | $1,114.54 | — |
| Hawaii, Guam, HIHawaii | $1,313.21 | — |
| IdahoIdaho | $1,106.90 | — |
| East St. Louis, ILIllinois | $1,178.96 | — |
| Rest of IllinoisIllinois | $1,151.37 | — |
| Suburban Chicago, ILIllinois | $1,268.54 | — |
| IndianaIndiana | $1,114.00 | — |
| KansasKansas | $1,093.50 | — |
| KentuckyKentucky | $1,098.80 | — |
| New Orleans, LALouisiana | $1,157.39 | — |
| Rest of LouisianaLouisiana | $1,097.10 | — |
| Metropolitan Boston, MAMassachusetts | $1,390.11 | — |
| Rest of MassachusettsMassachusetts | $1,249.16 | — |
| Baltimore area, MDMaryland | $1,288.29 | — |
| Rest of MarylandMaryland | $1,215.38 | — |
| Rest of MaineMaine | $1,113.87 | — |
| Southern Maine, MEMaine | $1,180.17 | — |
| Detroit, MIMichigan | $1,205.38 | — |
| Rest of MichiganMichigan | $1,131.08 | — |
| MinnesotaMinnesota | $1,199.76 | — |
| Metropolitan Kansas City, MOMissouri | $1,148.10 | — |
| Metropolitan St. Louis, MOMissouri | $1,161.33 | — |
| Rest of MissouriMissouri | $1,076.51 | — |
| MississippiMississippi | $1,064.59 | — |
| MontanaMontana | $1,205.68 | — |
| North CarolinaNorth Carolina | $1,126.72 | — |
| North DakotaNorth Dakota | $1,178.00 | — |
| NebraskaNebraska | $1,105.24 | — |
| New HampshireNew Hampshire | $1,237.97 | — |
| Northern New JerseyNew Jersey | $1,371.97 | — |
| Rest of New JerseyNew Jersey | $1,304.92 | — |
| New MexicoNew Mexico | $1,138.16 | — |
| NevadaNevada | $1,198.89 | — |
| NYC suburbs and Long Island, NYNew York | $1,436.01 | — |
| Poughkeepsie and northern NYC suburbs, NYNew York | $1,314.14 | — |
| Queens, NYNew York | $1,410.11 | — |
| Rest of New YorkNew York | $1,145.49 | — |
| OhioOhio | $1,125.42 | — |
| OklahomaOklahoma | $1,096.06 | — |
| Portland, OROregon | $1,300.49 | — |
| Rest of OregonOregon | $1,188.17 | — |
| Metropolitan Philadelphia, PAPennsylvania | $1,257.00 | — |
| Rest of PennsylvaniaPennsylvania | $1,127.11 | — |
| Puerto RicoPuerto Rico | $1,215.28 | — |
| Rhode IslandRhode Island | $1,235.73 | — |
| South CarolinaSouth Carolina | $1,128.24 | — |
| South DakotaSouth Dakota | $1,174.72 | — |
| TennesseeTennessee | $1,099.69 | — |
| Austin, TXTexas | $1,254.72 | — |
| Beaumont, TXTexas | $1,118.94 | — |
| Brazoria, TXTexas | $1,188.98 | — |
| Dallas, TXTexas | $1,197.50 | — |
| Fort Worth, TXTexas | $1,188.83 | — |
| Galveston, TXTexas | $1,193.08 | — |
| Houston, TXTexas | $1,218.71 | — |
| Rest of TexasTexas | $1,153.91 | — |
| UtahUtah | $1,145.33 | — |
| VirginiaVirginia | $1,176.25 | — |
| Virgin Islands, VIUnited States Virgin Islands | $1,215.28 | — |
| VermontVermont | $1,173.39 | — |
| Rest of WashingtonWashington | $1,246.78 | — |
| King County, WAWashington | $1,419.40 | — |
| WisconsinWisconsin | $1,134.44 | — |
| West VirginiaWest Virginia | $1,104.37 | — |
| WyomingWyoming | $1,193.61 | — |
93460 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.
$1,052.26
$1,448.35
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 | $1,360.66 | 1 |
| AL | $1,069.49 | 1 |
| AR | $1,052.26 | 1 |
| AZ | $1,170.27 | 1 |
| CA | $1,277.08–$1,619.62 | 29 |
| CO | $1,257.69 | 1 |
| CT | $1,291.66 | 1 |
| DC | $1,388.70 | 1 |
| DE | $1,191.07 | 1 |
| FL | $1,188.47–$1,315.31 | 3 |
| GA | $1,114.54–$1,230.71 | 2 |
| GU | $1,313.21 | 1 |
| HI | $1,313.21 | 1 |
| IA | $1,098.71 | 1 |
| ID | $1,106.90 | 1 |
| IL | $1,151.37–$1,272.59 | 4 |
| IN | $1,114.00 | 1 |
| KS | $1,093.50 | 1 |
| KY | $1,098.80 | 1 |
| LA | $1,097.10–$1,157.39 | 2 |
| MA | $1,249.16–$1,390.11 | 2 |
| MD | $1,215.38–$1,388.70 | 3 |
| ME | $1,113.87–$1,180.17 | 2 |
| MI | $1,131.08–$1,205.38 | 2 |
| MN | $1,199.76 | 1 |
| MO | $1,076.51–$1,161.33 | 3 |
| MS | $1,064.59 | 1 |
| MT | $1,205.68 | 1 |
| NC | $1,126.72 | 1 |
| ND | $1,178.00 | 1 |
| NE | $1,105.24 | 1 |
| NH | $1,237.97 | 1 |
| NJ | $1,304.92–$1,371.97 | 2 |
| NM | $1,138.16 | 1 |
| NV | $1,198.89 | 1 |
| NY | $1,145.49–$1,436.01 | 5 |
| OH | $1,125.42 | 1 |
| OK | $1,096.06 | 1 |
| OR | $1,188.17–$1,300.49 | 2 |
| PA | $1,127.11–$1,257.00 | 2 |
| PR | $1,215.28 | 1 |
| RI | $1,235.73 | 1 |
| SC | $1,128.24 | 1 |
| SD | $1,174.72 | 1 |
| TN | $1,099.69 | 1 |
| TX | $1,118.94–$1,254.72 | 8 |
| UT | $1,145.33 | 1 |
| VA | $1,176.25–$1,388.70 | 2 |
| VI | $1,215.28 | 1 |
| VT | $1,173.39 | 1 |
| WA | $1,246.78–$1,419.40 | 2 |
| WI | $1,134.44 | 1 |
| WV | $1,104.37 | 1 |
| WY | $1,193.61 | 1 |
How the 93460 rate is calculated
Each of 93460’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 · 93460
RVUs × geographic indexes × conversion factor
Work6.92
6.92 RVUs× 1.000 GPCI
Practice expense27.78
27.78 RVUs× 1.000 GPCI
Malpractice1.40
1.40 RVUs× 1.000 GPCI
Adjusted RVUs
36.1000
Conversion factor
$33.4009
Medicare rate
$1,205.77
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Iowa inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
12,118
- Code
- 93460
- Physician work
- 6.92
- Practice expense
- 27.78
- Malpractice
- 1.40
GPCI2026.csv
53
- Locality
- Iowa
- Physician work
- 1.000
- Practice expense
- 0.915
- Malpractice
- 0.397
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 6.92 | × 1.000 | 6.9200 |
| Practice expense | 27.78 | × 0.915 | 25.4187 |
| Malpractice | 1.40 | × 0.397 | 0.5558 |
| Total RVUs | 32.8945 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Iowa$1098.71
Office: (6.92 × 1 + 27.78 × 0.915 + 1.4 × 0.397) × $33.4009 = $1098.71
Payment rules and modifiers for 93460
The CMS indicators that decide how 93460 is paid alongside other services.
CMS payment indicators · 93460
Heart catheterization, right and left heart with coronary imaging
| 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
93460 without 26 · national office
$1,205.77
Heart catheterization, right and left heart with coronary imaging
93460-26 · Professional component
$363.74
Pays only the interpretation and report.
How 93460 has changed in Iowa
93460 · Office / nonfacility
$1098.71
Effective 2026-10-01
The base rate is $49.06 higher than on 2025-10-01, moving from $1049.65 to $1098.71 (4.7%).
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
$1049.65changed to$1098.71
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 7.10 changed to 6.92
- Practice expense RVU 27.07 changed to 27.78
- Malpractice RVU 1.39 changed to 1.40
- Practice expense GPCI 0.913 changed to 0.915
- Malpractice GPCI 0.457 changed to 0.397
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$1114.98changed to$1049.65
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 28.21 changed to 27.07
- Malpractice RVU 1.40 changed to 1.39
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$1096.78changed to$1114.98
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$1147.96changed to$1096.78
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 28.77 changed to 28.21
- Malpractice RVU 1.35 changed to 1.40
- Practice expense GPCI 0.910 changed to 0.913
- Malpractice GPCI 0.441 changed to 0.457
January 1, 2023
RVU23A
$1203.83changed to$1147.96
- Conversion factor 34.6062 changed to 33.8872
- Practice expense RVU 29.86 changed to 28.77
- Malpractice RVU 1.42 changed to 1.35
- Practice expense GPCI 0.907 changed to 0.910
- Malpractice GPCI 0.425 changed to 0.441
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$1236.47changed to$1203.83
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 30.59 changed to 29.86
- Malpractice RVU 1.39 changed to 1.42
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$1199.32changed to$1236.47
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 28.18 changed to 30.59
- Malpractice RVU 1.35 changed to 1.39
- Malpractice GPCI 0.424 changed to 0.425
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$1155.64changed to$1199.32
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 26.85 changed to 28.18
- Malpractice RVU 1.45 changed to 1.35
- Malpractice GPCI 0.423 changed to 0.424
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$1120.39changed to$1155.64
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 25.80 changed to 26.85
- Malpractice RVU 1.47 changed to 1.45
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$1106.55changed to$1120.39
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 25.57 changed to 25.80
- Malpractice RVU 1.46 changed to 1.47
- Practice expense GPCI 0.902 changed to 0.907
- Malpractice GPCI 0.458 changed to 0.423
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$1164.69changed to$1106.55
- Conversion factor 35.8043 changed to 35.8887
- Work RVU 7.35 changed to 7.10
- Practice expense RVU 27.26 changed to 25.57
- Malpractice RVU 1.53 changed to 1.46
- Practice expense GPCI 0.896 changed to 0.902
- Malpractice GPCI 0.493 changed to 0.458
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$1168.39changed to$1164.69
- Conversion factor 35.9335 changed to 35.8043
- Practice expense RVU 27.25 changed to 27.26
- Malpractice RVU 1.52 changed to 1.53
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$1162.58changed to$1168.39
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$1150.04changed to$1162.58
- Conversion factor 35.8228 changed to 35.7547
- Practice expense RVU 26.92 changed to 27.25
- Malpractice RVU 1.56 changed to 1.52
- Practice expense GPCI 0.892 changed to 0.896
- Malpractice GPCI 0.475 changed to 0.493
Held through RVU15B.
January 1, 2014
RVU14A
$1170.75changed to$1150.04
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 29.67 changed to 26.92
- Malpractice RVU 1.63 changed to 1.56
- Practice expense GPCI 0.887 changed to 0.892
- Malpractice GPCI 0.456 changed to 0.475
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $1170.75
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $1,098.71 | Not available in this setting | RVU26D |
| 2026-07-01 | $1,098.71 | Not available in this setting | RVU26C |
| 2026-04-01 | $1,098.71 | Not available in this setting | RVU26B |
| 2026-01-01 | $1,098.71 | Not available in this setting | RVU26A |
| 2025-10-01 | $1,049.65 | Not available in this setting | RVU25D |
| 2025-07-01 | $1,049.65 | Not available in this setting | RVU25C |
| 2025-04-01 | $1,049.65 | Not available in this setting | RVU25B |
| 2025-01-01 | $1,049.65 | Not available in this setting | RVU25A |
| 2024-10-01 | $1,114.98 | Not available in this setting | RVU24D |
| 2024-07-01 | $1,114.98 | Not available in this setting | RVU24C |
| 2024-04-01 | $1,114.98 | Not available in this setting | RVU24B |
| 2024-03-09 | $1,114.98 | Not available in this setting | RVU24AR |
| 2024-01-01 | $1,096.78 | Not available in this setting | RVU24A |
| 2023-10-01 | $1,147.96 | Not available in this setting | RVU23D |
| 2023-07-01 | $1,147.96 | Not available in this setting | RVU23C |
| 2023-04-01 | $1,147.96 | Not available in this setting | RVU23B |
| 2023-01-01 | $1,147.96 | Not available in this setting | RVU23A |
| 2022-10-01 | $1,203.83 | Not available in this setting | RVU22D |
| 2022-07-01 | $1,203.83 | Not available in this setting | RVU22C |
| 2022-04-01 | $1,203.83 | Not available in this setting | RVU22B |
| 2022-01-01 | $1,203.83 | Not available in this setting | RVU22A |
| 2021-10-01 | $1,236.47 | Not available in this setting | RVU21D |
| 2021-07-01 | $1,236.47 | Not available in this setting | RVU21C |
| 2021-04-01 | $1,236.47 | Not available in this setting | RVU21B |
| 2021-01-01 | $1,236.47 | Not available in this setting | RVU21A |
| 2020-10-01 | $1,199.32 | Not available in this setting | RVU20D |
| 2020-07-01 | $1,199.32 | Not available in this setting | RVU20C |
| 2020-04-01 | $1,199.32 | Not available in this setting | RVU20B |
| 2020-01-01 | $1,199.32 | Not available in this setting | RVU20A |
| 2019-10-01 | $1,155.64 | Not available in this setting | RVU19D |
| 2019-07-01 | $1,155.64 | Not available in this setting | RVU19C |
| 2019-04-01 | $1,155.64 | Not available in this setting | RVU19B |
| 2019-01-01 | $1,155.64 | Not available in this setting | RVU19A |
| 2018-10-01 | $1,120.39 | Not available in this setting | RVU18D |
| 2018-07-01 | $1,120.39 | Not available in this setting | RVU18C |
| 2018-04-01 | $1,120.39 | Not available in this setting | RVU18B |
| 2018-01-01 | $1,120.39 | Not available in this setting | RVU18AR1 |
| 2017-10-01 | $1,106.55 | Not available in this setting | RVU17D |
| 2017-07-01 | $1,106.55 | Not available in this setting | RVU17C |
| 2017-04-01 | $1,106.55 | Not available in this setting | RVU17B |
| 2017-01-01 | $1,106.55 | Not available in this setting | RVU17A |
| 2016-10-01 | $1,164.69 | Not available in this setting | RVU16D |
| 2016-07-01 | $1,164.69 | Not available in this setting | RVU16C |
| 2016-04-01 | $1,164.69 | Not available in this setting | RVU16B |
| 2016-01-01 | $1,164.69 | Not available in this setting | RVU16A |
| 2015-10-01 | $1,168.39 | Not available in this setting | RVU15D |
| 2015-07-01 | $1,168.39 | Not available in this setting | RVU15C |
| 2015-04-01 | $1,162.58 | Not available in this setting | RVU15B |
| 2015-01-01 | $1,162.58 | Not available in this setting | RVU15A |
| 2014-10-01 | $1,150.04 | Not available in this setting | RVU14D |
| 2014-07-01 | $1,150.04 | Not available in this setting | RVU14C |
| 2014-04-01 | $1,150.04 | Not available in this setting | RVU14B |
| 2014-01-01 | $1,150.04 | Not available in this setting | RVU14A |
| 2013-10-01 | $1,170.75 | Not available in this setting | RVU13D |
| 2013-07-01 | $1,170.75 | Not available in this setting | RVU13C |
| 2013-04-01 | $1,170.75 | Not available in this setting | RVU13B |
| 2013-01-01 | $1,170.75 | Not available in this setting | RVU13AR |
Where the Iowa rate applies
Iowa is a Medicare payment area, not a city. Our Census mapping connects it to 1026 cities and communities in Iowa. Some span more than one payment area; confirm with the service ZIP.
- Ackley
- Ackworth
- Adair
- Adel
- Afton
- Agency
- Ainsworth
- Akron
93460 billing questions
When should this code be selected instead of 93458?
Use 93460 when the service includes right- and left-heart catheterization with coronary angiography. Code 93458 describes the left-heart and coronary study without the right-heart catheterization.
Is left ventriculography required?
The code includes left ventriculography when performed. The record should reflect what was actually done rather than implying a ventriculogram that was not obtained.
Can the professional and technical services be billed separately?
Yes. Modifier 26 identifies the professional interpretation, and modifier TC identifies the technical service; billing without either modifier represents the global service.
Can modifier 50 be used for this service?
No. The anatomy and service definition make bilateral adjustment inappropriate for this code.
How are additional procedures in the same session paid?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and the others at 50%. The 0-day global period includes same-day preoperative and postoperative care.
What supports assistant-at-surgery payment?
The record must document medical necessity for the assistant. 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
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