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CPT code 93595: Left heart cath, congenital heart disease2026 Medicare rate & RVUs

Reports diagnostic catheterization of the left heart in congenital heart disease, regardless of whether native cardiac connections are normal or abnormal.

CMS RVU26DEffective Oct 1, 2026109 payment localities15 Medicare services in 2024

Medicare rate · 93595

Left heart cath, congenital heart disease

Office or facility?

Work RVUs
0
Total RVUs
0.00
Global days
000

National rate · 2026

—

Not priced in the facility setting.

See every locality for 93595 →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 93595 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 93595 covers

This service is left-heart catheterization performed to evaluate congenital heart disease, whether native cardiac connections are normal or abnormal. A cardiologist advances a catheter to the left side of the heart to assess pressures and cardiac hemodynamics, typically in a hospital catheterization laboratory. It is distinct from right-heart-only catheterization and from combined right- and left-heart catheterization; the combined codes also distinguish native-connection status.

Medicare assigns physician fee schedule status C: CMS publishes no national payment, and the Medicare Administrative Contractor sets payment for each claim. The service has professional and technical components. Modifier 26 identifies the professional interpretation; modifier TC identifies equipment and staff; billing without either modifier represents the global service. Its 0-day global period includes same-day preoperative and postoperative care.

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 93595 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

93595 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailableUnavailable
AlaskaUnavailableUnavailable
ArizonaUnavailableUnavailable
ArkansasUnavailableUnavailable
Atlanta, GAUnavailableUnavailable
Austin, TXUnavailableUnavailable
Bakersfield, CAUnavailableUnavailable
Baltimore area, MDUnavailableUnavailable
Beaumont, TXUnavailableUnavailable
Brazoria, TXUnavailableUnavailable

93595 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
93595 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 93595 rate is calculated

Each of 93595’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 · 93595

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.00

0.00 RVUs× 1.000 GPCI

Practice expense0.00

0.00 RVUs× 1.000 GPCI

Malpractice0.00

0.00 RVUs× 1.000 GPCI

Adjusted RVUs

0.0000

Conversion factor

$33.4009

Medicare rate

$0.00

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

Payment rules and modifiers for 93595

The CMS indicators that decide how 93595 is paid alongside other services.

CMS payment indicators · 93595

Left heart cath, congenital heart disease

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)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical1Diagnostic test with separate professional (26) and technical (TC) components.

What modifiers do to the payment

Modifier 26 · payment effect

With and without the modifier

93595 without 26 · national facility

$0.00

Left heart cath, congenital heart disease

93595-26 · Professional component

$252.84

Pays only the interpretation and report.

When to use modifier 26

93595 compared with similar codes

Compare codes · National

5 codes, side by side

Office or facility?

  • 93595

    Left heart cath, congenital heart disease0 wRVU

    Not priced

  • 93593

    Right heart cath, normal connections0 wRVU

    Not priced

  • 93594

    Right-heart catheterization, abnormal native connections0 wRVU

    Not priced

  • 93596

    Right and left cath, normal native connections0 wRVU

    Not priced

  • 93597

    Combined heart cath, abnormal native connections0 wRVU

    Not priced

How to choose

93593Right heart cathNormal connections
93593 describes right-heart catheterization with normal native connections. This code describes a left-heart study, regardless of native-connection status.
93594Right-heart catheterizationAbnormal native connections
93594 describes right-heart catheterization with abnormal native connections. This code describes left-heart catheterization without a connection-status distinction.
93596Right and left cathNormal native connections
93596 describes combined right- and left-heart catheterization with normal native connections. Use this code for the left-heart study alone.
93597Combined heart cathAbnormal native connections
93597 describes combined right- and left-heart catheterization with abnormal native connections. This code is for left-heart catheterization without a connection-status distinction.

Codes related to 93595

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

Codes related to 93595
CodeHow it relatesNational office range
Same family
93593Right heart cath, normal connectionsRight-heart catheterization for congenital heart disease with normal native connections.No office rate
93594Right-heart catheterization, abnormal native connectionsRight-heart catheterization for congenital heart disease with abnormal native connections.No office rate
93596Right and left cath, normal native connectionsCombined right- and left-heart catheterization with normal native connections.No office rate
93597Combined heart cath, abnormal native connectionsCombined right- and left-heart catheterization with abnormal native connections.No office rate

93595 billing questions

Does this code distinguish normal from abnormal native connections?

No. It describes left-heart catheterization for congenital heart disease without separating cases by native-connection status.

When is this code used instead of a right-heart catheterization code?

Use this code for a left-heart study. Codes 93593 and 93594 describe right-heart catheterization, with the applicable code depending on native connections.

When should a combined right- and left-heart code be considered?

When both sides of the heart are catheterized, compare the service with 93596 or 93597. Those codes distinguish normal from abnormal native connections.

How are modifiers 26 and TC used?

Modifier 26 identifies the professional interpretation, and modifier TC identifies the technical service, including equipment and staff. Without either modifier, the code represents the global service.

How does Medicare price this code?

Physician fee schedule status C means CMS publishes no national payment. The Medicare Administrative Contractor sets payment for each claim.

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

Open CMS sourceHow we calculate rates

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