CPT code 93597: Combined heart cath, abnormal native connections2026 Medicare rate & RVUs

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

What 93597 covers

This diagnostic catheterization evaluates congenital heart disease when the patient’s native cardiovascular connections are abnormal. A cardiologist performs both right- and left-heart catheterization to assess pressures and hemodynamics in relation to the congenital anatomy. The service is typically performed in a hospital cardiac catheterization laboratory by a cardiologist experienced in congenital heart disease. It describes diagnostic catheterization, rather than a transcatheter defect-closure procedure.

Medicare assigns status C: CMS publishes no national payment, and the Medicare Administrative Contractor sets payment for each claim. Modifier 26 identifies the professional interpretation, modifier TC identifies the technical service, and billing without either modifier represents the global service. The code has a 0-day global period, with same-day preoperative and postoperative care included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Bilateral adjustment does not apply; assistant-at-surgery payment requires documented medical necessity, and 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 93597 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

93597 rates by state

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

How the 93597 rate is calculated

Each of 93597’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.

Payment rules and modifiers for 93597

The CMS indicators that decide how 93597 is paid alongside other services.

What modifiers do to the payment

When to use modifier 26

93597 compared with similar codes

How to choose

93596Right and left cathNormal native connections

Both codes describe combined right- and left-heart catheterization. Choose 93597 for abnormal native connections and 93596 for normal native connections.

93594Right-heart catheterizationAbnormal native connections

93594 describes right-heart catheterization alone for abnormal native connections; 93597 describes both right- and left-heart catheterization for that anatomy.

93595Left heart cathCongenital heart disease

93595 describes left-heart catheterization for congenital disease. 93597 represents combined right- and left-heart catheterization when native connections are abnormal.

Codes related to 93597

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

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