CPT code 93654: VT ablation, comprehensive EP evaluation2026 Medicare rate & RVUs in Missouri
Reports a comprehensive electrophysiology study with catheter ablation to treat ventricular tachycardia, including evaluation and treatment during the same procedure.
CMS doesn’t publish an office rate for 93654 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 93654 covers
An electrophysiologist performs this procedure in an electrophysiology lab, typically in a hospital or other facility, to evaluate and ablate ventricular tachycardia. The work includes placing and positioning intracardiac electrode catheters, recording and pacing the heart, inducing or attempting to induce the arrhythmia, and using catheter ablation to treat the ventricular tachycardia. A common clinical setting is treatment of scar-related VT in a patient with structural heart disease.
Select 93654 when the procedure includes comprehensive EP evaluation and catheter ablation for VT; an EP study without ablation or ablation for another arrhythmia type points to a different code. The operative report should support the arrhythmia treated, evaluation and mapping performed, and ablation delivered. The same-day preoperative and postoperative care is included in the 0-day global period. For multiple procedures in one session, CMS pays the highest-valued procedure in full and reduces the others to 50%. Modifier 50 is inappropriate. Assistant-at-surgery payment requires documentation of medical necessity; 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 93654 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 | $846.33 |
| Metropolitan St. Louis, MO | Unavailable | $851.47 |
| Rest of Missouri | Unavailable | $835.96 |
How the 93654 rate is calculated
Each of 93654’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 · 93654
RVUs × geographic indexes × conversion factor
Work17.65
17.65 RVUs× 1.000 GPCI
Practice expense3.87
3.87 RVUs× 1.000 GPCI
Malpractice4.15
4.15 RVUs× 1.000 GPCI
Adjusted RVUs
25.6700
Conversion factor
$33.4009
Medicare rate
$857.40
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 93654
The CMS indicators that decide how 93654 is paid alongside other services.
CMS payment indicators · 93654
VT ablation, comprehensive EP evaluation
| 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 | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
93654 without 51 · national facility
$857.40
VT ablation, comprehensive EP evaluation
93654-51 · Second procedure: 50%
$428.70
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%).
93654 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 93653SVT ablationComprehensive EP evaluation
- Choose 93653 when the ablation treats supraventricular tachycardia; choose 93654 when it treats ventricular tachycardia.
- 93656AF ablationPulmonary vein isolation
- 93656 describes comprehensive EP evaluation and ablation for atrial fibrillation, not VT.
- 93655Catheter ablationSeparate arrhythmia mechanism
- 93655 is an add-on for a distinct additional arrhythmia mechanism treated during a primary ablation procedure; it does not replace 93654 for VT ablation.
- 93619EP evaluationWithout arrhythmia induction
- 93619 represents comprehensive EP evaluation without the VT ablation included in 93654.
93654 billing questions
How does 93654 differ from 93653?
93654 is for catheter ablation treating ventricular tachycardia. Use 93653 for comprehensive EP evaluation and ablation treating supraventricular tachycardia.
Can 93654 be reported with 93613?
93613 may be reported when intracardiac three-dimensional electroanatomic mapping is performed and documented. The record should support the mapping service in addition to the VT ablation.
Can 93655 be added to 93654?
93655 is an add-on for ablation of an additional, distinct arrhythmia mechanism. It is not for additional lesions used to treat the same VT mechanism.
Should modifier 50 be used for VT ablation?
No. CMS identifies bilateral adjustment as inappropriate for this code, so modifier 50 is not appropriate.
What documentation supports 93654?
The procedure report should identify VT as the arrhythmia treated and describe the comprehensive EP evaluation, catheter mapping or localization, and ablation performed. Assistant-at-surgery payment requires documentation of medical necessity.
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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