CPT code 93461: Heart catheterization, bilateral heart and graft imaging2026 Medicare rate & RVUs in California
Reports combined right and left heart catheterization with coronary and bypass graft angiography, typically when evaluating a patient with prior coronary bypass surgery.
Medicare pays $1,407.24–$1,784.41 for 93461 in the office in California, from Chico, CA to San Benito County, CA. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
What 93461 covers
This service combines right- and left-sided heart catheterization with coronary artery and bypass graft angiography. The cardiologist records pressure and hemodynamic information from both sides of the heart and uses catheter-based contrast imaging to assess native coronary arteries and bypass grafts. Left ventriculography may also be performed. It is typically done in a cardiac catheterization laboratory for patients with known or suspected coronary disease and prior bypass surgery when both heart pressures and coronary or graft anatomy need assessment.
Report the code when the documented service includes right and left heart catheterization plus coronary and bypass graft angiography; document the catheter placements, studies performed, and imaging interpretation. The diagnostic service may be billed globally or as a professional component with modifier 26 or a technical component with modifier TC. It has a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and others at 50%. Modifier 50 is inappropriate for this anatomy. Assistant-at-surgery payment requires medical-necessity documentation; 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.
Where 93461 pays more and less in California
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
29 payment localities
$1407.24 to $1784.41
29 of 29 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield, CA | $1,411.56 | Unavailable |
| Chico, CA | $1,407.24 | Unavailable |
| El Centro, CA | $1,407.50 | Unavailable |
| Fresno, CA | $1,407.24 | Unavailable |
| Hanford, CA | $1,407.24 | Unavailable |
| Los Angeles, CA | $1,508.91 | Unavailable |
| Madera, CA | $1,407.24 | Unavailable |
| Marin County, CA | $1,743.88 | Unavailable |
| Merced, CA | $1,407.24 | Unavailable |
| Modesto, CA | $1,407.24 | Unavailable |
| Napa, CA | $1,644.29 | Unavailable |
| Oxnard, CA | $1,502.43 | Unavailable |
| Redding, CA | $1,407.24 | Unavailable |
| Rest of California | $1,407.24 | Unavailable |
| Riverside, CA | $1,424.02 | Unavailable |
| Sacramento, CA | $1,480.53 | Unavailable |
| Salinas, CA | $1,475.17 | Unavailable |
| San Benito County, CA | $1,784.41 | Unavailable |
| San Diego, CA | $1,513.02 | Unavailable |
| San Francisco, CA | $1,742.11 | Unavailable |
| San Luis Obispo, CA | $1,451.16 | Unavailable |
| Santa Clara County, CA | $1,777.17 | Unavailable |
| Santa Cruz, CA | $1,529.81 | Unavailable |
| Santa Maria, CA | $1,481.55 | Unavailable |
| Santa Rosa, CA | $1,545.39 | Unavailable |
| Stockton, CA | $1,407.24 | Unavailable |
| Vallejo, CA | $1,641.74 | Unavailable |
| Visalia, CA | $1,407.24 | Unavailable |
| Yuba City, CA | $1,407.24 | Unavailable |
How the 93461 rate is calculated
Each of 93461’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 · 93461
RVUs × geographic indexes × conversion factor
Work7.65
7.65 RVUs× 1.000 GPCI
Practice expense30.58
30.58 RVUs× 1.000 GPCI
Malpractice1.56
1.56 RVUs× 1.000 GPCI
Adjusted RVUs
39.7900
Conversion factor
$33.4009
Medicare rate
$1,329.02
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 93461
The CMS indicators that decide how 93461 is paid alongside other services.
CMS payment indicators · 93461
Heart catheterization, bilateral heart and graft 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
93461 without 26 · national office
$1,329.02
Heart catheterization, bilateral heart and graft imaging
93461-26 · Professional component
$401.81
Pays only the interpretation and report.
93461 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 93460Heart catheterizationRight and left heart with coronary imaging
- Choose 93461 when bypass graft angiography is included. Code 93460 includes combined right and left heart catheterization and coronary angiography without graft angiography.
- 93459Cardiac catheterizationLeft heart with bypass grafts
- 93459 includes left heart catheterization with coronary and bypass graft angiography. 93461 also includes right heart catheterization.
- 93457Cardiac catheterizationRight heart, coronaries, bypass grafts
- 93457 includes right heart catheterization with coronary and bypass graft angiography. 93461 adds the left heart catheterization.
- 93453Heart catheterizationRight and left with ventriculography
- 93453 covers combined right and left heart catheterization with ventriculography but not coronary or bypass graft angiography.
93461 billing questions
How does 93461 differ from 93460?
93461 includes bypass graft angiography along with coronary angiography and combined right and left heart catheterization. Use 93460 when the service includes coronary angiography but not bypass graft angiography.
Can modifier 26 or TC be reported?
Yes. Modifier 26 identifies the professional interpretation, and modifier TC identifies the technical service; billing without either modifier represents the global service.
Should modifier 50 be appended?
No. The anatomy and service represented by 93461 make modifier 50 inappropriate.
What documentation supports reporting 93461?
Document right- and left-sided catheterization, coronary angiography, and bypass graft angiography, along with the catheter placements and imaging interpretation. Include ventriculography when performed.
How are multiple procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures in that session are paid at 50% under the standard multiple procedure reduction.
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 service.
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
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