CPT code 93596: Right and left cath, normal native connections2026 Medicare rate & RVUs in Florida
Reports combined right- and left-heart catheterization to evaluate congenital heart disease when the heart’s native connections are normal.
CMS doesn’t publish an office rate for 93596 in Florida.
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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On this page 9 sections
What 93596 covers
This code reports diagnostic catheterization of both the right and left sides of the heart for congenital heart disease when native connections are normal. A cardiologist performs the study in a cardiac catheterization laboratory. It can evaluate intracardiac pressures, oxygen levels, blood flow, and cardiac anatomy in the setting of congenital heart disease. The normal-native-connection distinction separates this service from the combined catheterization code for abnormal native connections.
Medicare assigns physician fee schedule status C (carrier priced): 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 interpretation, modifier TC identifies equipment and staff, and reporting without either modifier represents the global service. The global period is zero days, and same-day preoperative and postoperative care are included. The standard multiple-procedure reduction applies when multiple procedures are performed in the same session.
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 93596 pays more and less in Florida
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Fort Lauderdale, FL | Unavailable | Unavailable |
| Miami, FL | Unavailable | Unavailable |
| Rest of Florida | Unavailable | Unavailable |
How the 93596 rate is calculated
Each of 93596’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 · 93596
RVUs × geographic indexes × conversion factor
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 93596
The CMS indicators that decide how 93596 is paid alongside other services.
CMS payment indicators · 93596
Right and left cath, normal native connections
| 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
93596 without 26 · national facility
$0.00
Right and left cath, normal native connections
93596-26 · Professional component
$315.64
Pays only the interpretation and report.
93596 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 93593Right heart cathNormal connections
- 93593 is for right-heart catheterization alone with normal native connections. 93596 represents catheterization of both the right and left sides.
- 93595Left heart cathCongenital heart disease
- 93595 represents left-heart catheterization for congenital heart disease; 93596 includes both right- and left-heart catheterization.
- 93597Combined heart cathAbnormal native connections
- Both codes represent right- and left-heart catheterization. Choose 93596 for normal native connections and 93597 for abnormal native connections.
93596 billing questions
How does this differ from 93593?
93593 describes right-heart catheterization only for congenital heart disease with normal native connections. Use 93596 when both the right and left sides are catheterized.
When should 93597 be considered instead?
93597 describes combined right- and left-heart catheterization for congenital heart disease with abnormal native connections. The native connection anatomy distinguishes it from 93596.
Which modifiers identify the components?
Modifier 26 identifies the professional interpretation, and modifier TC identifies the technical service. Without either modifier, the code represents the global service.
How many units are reported?
The code represents the combined right- and left-heart catheterization; the two sides are reported together under 93596, not as separate units of this code.
How does Medicare price this service?
Medicare assigns physician fee schedule status C. The Medicare Administrative Contractor sets payment for each claim rather than CMS publishing a national payment amount.
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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