CPT code 93590: Mitral leak closure, paravalvular leak2026 Medicare rate & RVUs in Missouri
Report this service for catheter-based closure of a leak around a mitral valve prosthesis, rather than repair of diseased native valve leaflets.
CMS doesn’t publish an office rate for 93590 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 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 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 | $902.20 |
| Metropolitan St. Louis, MO | Unavailable | $905.58 |
| Rest of Missouri | Unavailable | $890.70 |
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
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
| 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) | 2 | Paid. |
| Co-surgeons (62) | 1 | Permitted with supporting documentation. |
| 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
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%).
93590 compared with similar codes
Compare codes · National
4 codes, side by side
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.
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
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