FeeBase
Log inGet started
Menu

CPT code 93590: Mitral leak closure, paravalvular leak2026 Medicare rate & RVUs

Report this service for catheter-based closure of a leak around a mitral valve prosthesis, rather than repair of diseased native valve leaflets.

CMS RVU26DEffective Oct 1, 2026109 payment localities210 Medicare services in 2024

Medicare pays $912.51 for 93590 nationally in a facility.

Medicare rate · 93590

Mitral leak closure, paravalvular leak

Office or facility?

Work RVUs
21.16
Total RVUs
27.32
Global days
000

National rate · 2026

$912.51

Facility setting, before claim adjustments.

See every locality for 93590 →Billed by an NP, PA or therapist? →

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

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 93590 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 93590 covers

An interventional cardiologist uses a catheter-delivered closure device to seal a paravalvular leak around a mitral valve prosthesis. The procedure is performed in a hospital catheterization or hybrid laboratory, typically with imaging guidance to position the device and assess the leak. It addresses leakage around the edge of a previously implanted valve, not a defect in the native valve leaflets or a congenital septal opening.

Report the code when the documented procedure closes a leak associated with a mitral prosthesis; the operative report should identify the valve, leak, access and closure work. This is a minor procedure with a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures are performed in the same session, Medicare pays the highest-valued procedure in full and reduces the others to 50%. Modifier 50 is inappropriate. Assistant-at-surgery payment may be made; co-surgeon payment requires supporting documentation, and team surgery is 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 93590 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

93590 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$868.63
AlaskaUnavailable$1,249.05
ArizonaUnavailable$899.49
ArkansasUnavailable$863.28
Atlanta, GAUnavailable$928.80
Austin, TXUnavailable$915.75
Bakersfield, CAUnavailable$917.06
Baltimore area, MDUnavailable$948.48
Beaumont, TXUnavailable$895.11
Brazoria, TXUnavailable$903.91

93590 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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.

View every state and territory as a table
93590 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 93590 rate is calculated

Each of 93590’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 · 93590

RVUs × geographic indexes × conversion factor

Office or facility?

Work21.16

21.16 RVUs× 1.000 GPCI

Practice expense4.40

4.40 RVUs× 1.000 GPCI

Malpractice1.76

1.76 RVUs× 1.000 GPCI

Adjusted RVUs

27.3200

Conversion factor

$33.4009

Medicare rate

$912.51

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 93590

The CMS indicators that decide how 93590 is paid alongside other services.

CMS payment indicators · 93590

Mitral leak closure, paravalvular leak

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)2Paid.
Co-surgeons (62)1Permitted with supporting documentation.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

93590 without 51 · national facility

$912.51

Mitral leak closure, paravalvular leak

93590-51 · Second procedure: 50%

$456.26

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%).

When to use modifier 51

93590 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 93590

    Mitral leak closure, paravalvular leak21.16 wRVU

    Not priced

  • 93591

    Leak closure, aortic valve17.52 wRVU

    Not priced

  • 93592

    Valve leak closure, each additional valve7.8 wRVU

    Not priced

  • 33418

    Mitral valve repair, percutaneous, initial prosthesis31.44 wRVU

    Not priced

How to choose

93591Leak closureAortic valve
Choose 93590 for a leak around a mitral prosthesis and 93591 for one around an aortic prosthesis.
93592Valve leak closureEach additional valve
93592 addresses an additional paravalvular leak; 93590 identifies the mitral valve leak closure.
33418Mitral valve repairPercutaneous, initial prosthesis
33418 is used for transcatheter repair of mitral valve disease, not for sealing a leak around a mitral prosthesis.

Codes related to 93590

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 93590
CodeHow it relatesNational office range
Same family
93591Leak closure, aortic valveCorresponding catheter-based paravalvular leak closure code for the aortic valve.No office rate
Often billed with
93592Valve leak closure, each additional valveUsed for closure of an additional paravalvular leak when the procedure includes one.No office rate
Used instead
33418Mitral valve repair, percutaneous, initial prosthesisAddresses mitral valve disease with transcatheter repair rather than closure of a prosthetic valve leak.No office rate

93590 billing questions

How does this differ from mitral valve repair?

This code is for sealing a leak around a mitral prosthesis. Mitral valve repair codes such as 33418 address a different problem involving the valve itself.

Is same-day preoperative or postoperative care separately reported?

No. The 0-day global period includes same-day preoperative and postoperative care.

Can modifier 50 be reported?

No. The bilateral adjustment is inappropriate for this code.

How are multiple procedures in the same session paid?

Medicare pays the highest-valued procedure in full and reduces the other procedures to 50% when performed in the same session.

Can an assistant or co-surgeon be reported?

Assistant-at-surgery payment may be made. Co-surgeon payment requires supporting documentation; team surgery is not permitted.

What documentation supports reporting this code?

Document that the leak is around a mitral prosthesis and describe the catheter-based closure performed. The record should distinguish a paravalvular leak from native leaflet disease.

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
RVUs for 93590PPRRVU2026_Oct_nonQPP.csv, line 12,158 (RVU26D)

Open CMS sourceHow we calculate rates

Did this answer your question about what 93590 pays?

Tell us what you were actually trying to work out. We’ll answer you directly, or build the page that does.

Fee sheets · Coming soon

Put 93590 and the rest of your codes on one sheet

Your codes at your locality, with payer contracts beside Medicare.

Join the waitlist