CPT code 93581: VSD closure, transcatheter2026 Medicare rate & RVUs in Missouri
Reports catheter-based closure of a ventricular septal defect, typically in a congenital heart catheterization lab when anatomy is suitable for device treatment.
CMS doesn’t publish an office rate for 93581 in Missouri.
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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What 93581 covers
This code represents catheter-based treatment to close a ventricular septal defect, an opening between the heart’s ventricles. A congenital or structural interventional cardiologist typically performs the procedure in a hospital catheterization laboratory, using imaging to guide delivery of a closure device through a catheter. The service is used for a VSD selected for transcatheter closure rather than open surgical repair.
Report it for the VSD closure performed, and document the defect, catheter-based approach, closure method, and procedural findings. The code 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 other procedures are subject to the standard multiple-procedure reduction. Modifier 50 is inappropriate for this code. 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 93581 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.
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | Unavailable | $1,131.45 |
| Metropolitan St. Louis, MO | Unavailable | $1,138.30 |
| Rest of Missouri | Unavailable | $1,118.48 |
How the 93581 rate is calculated
Each of 93581’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 · 93581
RVUs × geographic indexes × conversion factor
Work23.78
23.78 RVUs× 1.000 GPCI
Practice expense4.82
4.82 RVUs× 1.000 GPCI
Malpractice5.70
5.70 RVUs× 1.000 GPCI
Adjusted RVUs
34.3000
Conversion factor
$33.4009
Medicare rate
$1,145.65
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 93581
The CMS indicators that decide how 93581 is paid alongside other services.
CMS payment indicators · 93581
VSD closure, transcatheter
| 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 | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
93581 without 51 · national facility
$1,145.65
VSD closure, transcatheter
93581-51 · Second procedure: 50%
$572.83
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
93581 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 93580ASD closureTranscatheter device closure
- Use 93580 for an atrial septal defect. Use 93581 when the defect being closed is ventricular.
- 93582PDA closureTranscatheter approach
- 93582 is for transcatheter closure of a patent ductus arteriosus, not a ventricular septal defect.
- 93583Septal reductionTranscatheter approach
- 93583 describes transcatheter septal reduction, a treatment for obstructive hypertrophic cardiomyopathy; it is not closure of a ventricular septal defect.
93581 billing questions
How is this different from 93580?
93581 is for transcatheter closure of a ventricular septal defect. 93580 is for closure of an atrial septal defect.
How is this different from 93582?
93581 treats a ventricular septal defect; 93582 treats a patent ductus arteriosus. Select the code for the defect being closed.
Can modifier 50 be reported?
No. The CMS bilateral adjustment does not apply, and modifier 50 is inappropriate for this code.
Can an assistant surgeon be paid?
Assistant-at-surgery payment is available only when medical necessity is documented. Co-surgeons and team surgery are not permitted.
What same-day care is included?
The 0-day global period includes same-day preoperative and postoperative care. Routine care on the procedure date is not separately reported as a separate E/M service.
What happens when another procedure is performed in the same session?
The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction.
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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