CPT code 93656: AF ablation, pulmonary vein isolation2026 Medicare rate & RVUs in Missouri
Reports catheter-based electrophysiologic evaluation and ablation for atrial fibrillation, typically isolating pulmonary veins during an electrophysiology lab procedure.
CMS doesn’t publish an office rate for 93656 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 93656 covers
An electrophysiologist uses intracardiac catheters to evaluate the heart’s electrical activity and ablate tissue to treat atrial fibrillation, commonly by electrically isolating the pulmonary veins in the left atrium. The procedure is generally performed in a hospital electrophysiology laboratory, with catheter access and transseptal access used as clinically needed to reach the left atrium. The comprehensive electrophysiologic evaluation is part of the service.
Report 93656 for the atrial fibrillation ablation session, supported by documentation of the arrhythmia, the evaluation and ablation performed, and the treatment target. Code 93657 may be reported as an add-on when additional atrial ablation is performed for atrial fibrillation after pulmonary vein isolation. The code has a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures in the same session are subject to the standard reduction, the highest-valued is paid in full and others at 50%. Modifier 50 is inappropriate. Assistant-at-surgery payment requires documented 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 93656 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 | $796.17 |
| Metropolitan St. Louis, MO | Unavailable | $801.03 |
| Rest of Missouri | Unavailable | $786.37 |
How the 93656 rate is calculated
Each of 93656’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 · 93656
RVUs × geographic indexes × conversion factor
Work16.58
16.58 RVUs× 1.000 GPCI
Practice expense3.66
3.66 RVUs× 1.000 GPCI
Malpractice3.91
3.91 RVUs× 1.000 GPCI
Adjusted RVUs
24.1500
Conversion factor
$33.4009
Medicare rate
$806.63
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 93656
The CMS indicators that decide how 93656 is paid alongside other services.
CMS payment indicators · 93656
AF ablation, pulmonary vein isolation
| 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
93656 without 51 · national facility
$806.63
AF ablation, pulmonary vein isolation
93656-51 · Second procedure: 50%
$403.32
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%).
93656 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 93653SVT ablationComprehensive EP evaluation
- 93653 is for catheter ablation treating supraventricular tachycardia. Choose 93656 when the ablation treats atrial fibrillation, typically through pulmonary vein isolation.
- 93654VT ablationComprehensive EP evaluation
- 93654 addresses catheter ablation for ventricular tachycardia. 93656 is the atrial fibrillation ablation service.
- 93657AF ablationAdditional atrial lesions
- 93657 is an add-on for additional atrial ablation after pulmonary vein isolation; it does not replace primary code 93656.
- 93619EP evaluationWithout arrhythmia induction
- 93619 reports a comprehensive diagnostic electrophysiologic evaluation. Use 93656 when the session includes catheter ablation to treat atrial fibrillation.
93656 billing questions
When is 93656 selected instead of 93653 or 93654?
Use 93656 for catheter ablation treating atrial fibrillation, typically with pulmonary vein isolation. Codes 93653 and 93654 address ablation for supraventricular tachycardia and ventricular tachycardia, respectively.
Can 93657 be reported with 93656?
Yes. 93657 is an add-on for additional atrial ablation performed for atrial fibrillation after pulmonary vein isolation; document the additional treatment.
Is the diagnostic electrophysiologic evaluation separately reported?
The comprehensive electrophysiologic evaluation is included in 93656. A separate diagnostic study code should not be used to report that same evaluation.
Should modifier 50 be appended for pulmonary vein treatment on both sides?
No. CMS identifies bilateral adjustment as inappropriate for 93656, so do not use modifier 50 to represent treatment of pulmonary veins on both sides.
What does the 0-day global period mean for same-day care?
Same-day preoperative and postoperative care is included in the procedure. The CMS global period is 0 days.
What documentation supports reporting 93656?
Document atrial fibrillation as the treatment indication and describe the electrophysiologic evaluation and catheter ablation performed, including the targeted treatment and pulmonary vein isolation when 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
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