CPT code 93597: Combined heart cath, abnormal native connections2026 Medicare rate & RVUs in Washington, DC area

CMS doesn’t publish a rate for 93597 in Washington, DC area.

Check a contract rate as a % of Medicare · 93597 nationwide

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.

How Washington, DC area compares for 93597

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93597 rates by state

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

See 93597 in every payment locality

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

Codes related to 93597

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

How 93597 has changed in Washington, DC area

Price 93597 for an earlier date of service

Where the Washington, DC area rate applies

Washington, DC area is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in District of Columbia. Some span more than one payment area; confirm with the service ZIP.

• Washington

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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