CPT code 93505: Heart biopsy, endomyocardial tissue sampling2026 Medicare rate & RVUs in Missouri
Reports catheter-based sampling of heart muscle, commonly to evaluate suspected transplant rejection, myocarditis, or another myocardial disorder.
Medicare pays $579.42–$624.74 for 93505 in the office in Missouri, from Rest of Missouri to Metropolitan St. Louis, MO. 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.
Your location
On this page 9 sections
What 93505 covers
A cardiologist obtains small samples of heart muscle by advancing a biopsy catheter through vascular access into the heart, usually to sample the right ventricle. The specimens are sent for laboratory examination. A common indication is surveillance for rejection after heart transplantation; clinicians may also request tissue evaluation for suspected myocarditis or other myocardial disease. The service is typically performed in a cardiac catheterization laboratory or hospital procedure setting.
Report 93505 for the biopsy procedure, supported by documentation of the clinical indication and tissue sampling. When the diagnostic service is divided, modifier 26 identifies the professional interpretation and modifier TC identifies the technical service; without either modifier, the claim represents the global service. The 0-day global period includes same-day preoperative and postoperative care. When other procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple procedure reduction. 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.
Where 93505 pays more and less in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
3 payment localities
$579.42 to $624.74
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | $617.87 | Unavailable |
| Metropolitan St. Louis, MO | $624.74 | Unavailable |
| Rest of Missouri | $579.42 | Unavailable |
How the 93505 rate is calculated
Each of 93505’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 · 93505
RVUs × geographic indexes × conversion factor
Work4.02
4.02 RVUs× 1.000 GPCI
Practice expense14.93
14.93 RVUs× 1.000 GPCI
Malpractice0.47
0.47 RVUs× 1.000 GPCI
Adjusted RVUs
19.4200
Conversion factor
$33.4009
Medicare rate
$648.65
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 93505
The CMS indicators that decide how 93505 is paid alongside other services.
CMS payment indicators · 93505
Heart biopsy, endomyocardial tissue sampling
| 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
93505 without 26 · national office
$648.65
Heart biopsy, endomyocardial tissue sampling
93505-26 · Professional component
$218.78
Pays only the interpretation and report.
93505 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 93451Right heart cathHemodynamic measurements
- 93451 reports right heart catheterization and hemodynamic measurements. Use 93505 for myocardial tissue sampling; both may be reported when each service is performed and supported.
- 93503Heart catheterMonitoring catheter placement
- 93503 concerns placement of a flow-directed heart catheter, not tissue sampling. It does not describe an endomyocardial biopsy.
- 88307Tissue pathology examLevel V specimen
- 88307 represents a surgical pathology examination of tissue. It is not the catheter-based collection of the myocardial specimen reported with 93505.
93505 billing questions
How is a heart biopsy different from right heart catheterization?
93505 reports sampling of heart muscle. A right heart catheterization such as 93451 reports hemodynamic catheter measurements; it may be performed during the same encounter when separately supported.
Can pathology be billed separately?
Yes. The biopsy procedure and the pathologist’s examination of the submitted tissue are distinct services; the pathology claim should reflect the examination actually performed.
When should modifier 26 or TC be used?
Use modifier 26 for the professional interpretation or TC for the technical service when those components are billed separately. Billing without either modifier represents the global service.
Does 93505 have a global period?
It has a 0-day global period, so same-day preoperative and postoperative care is included.
How are other same-session procedures paid?
Under the standard multiple procedure reduction, the highest-valued procedure is paid in full and other procedures performed in that session are reduced.
Can modifier 50 or an assistant surgeon be reported?
Modifier 50 is inappropriate for this code. Assistant-at-surgery payment requires documentation of medical necessity.
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
Fee sheets
Put 93505 and the rest of your codes on one sheet
Your codes at your locality, with payer contracts beside Medicare.
Build my fee sheet