FeeBase
Log inGet started
Menu

Billing code 93581: VSD closureMedicare rate & RVUs

Reports catheter-based closure of a ventricular septal defect, typically in a congenital heart catheterization lab when anatomy is suitable for device treatment.

CMS RVU26DEffective Oct 1, 2026109 payment localities55 Medicare services in 2024

Medicare pays $1,145.65 for 93581 nationally in a facility.

Medicare rate · 93581

VSD closure

Swap in your local Medicare rate.

Work RVUs
23.78
Total RVUs
34.30
Global days
000

National rate · 2026

$1,145.65

Facility setting, before claim adjustments.

See every locality for 93581 → · Billed by an NP, PA or therapist? →

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

On this page 10 sections
  1. Medicare rate
  2. What 93581 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 93581 covers

This code represents catheter-based treatment to close a ventricular septal defect, an opening between the heart’s ventricles. A congenital or structural interventional cardiologist typically performs the procedure in a hospital catheterization laboratory, using imaging to guide delivery of a closure device through a catheter. The service is used for a VSD selected for transcatheter closure rather than open surgical repair.

Report it for the VSD closure performed, and document the defect, catheter-based approach, closure method, and procedural findings. The code has a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures are performed in one session, the highest-valued procedure is paid in full and other procedures are subject to the standard multiple-procedure reduction. Modifier 50 is inappropriate for this code. 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 93581 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

93581 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$1,042.90
Alaska*Unavailable$1,467.77
ArizonaUnavailable$1,113.24
ArkansasUnavailable$1,030.61
AtlantaUnavailable$1,188.88
AustinUnavailable$1,134.87
BakersfieldUnavailable$1,101.76
Baltimore/Surr. CntysUnavailable$1,215.23
BeaumontUnavailable$1,117.64
BrazoriaUnavailable$1,108.67

93581 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
93581 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 93581 rate is calculated

Each of 93581’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 · 93581

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 23.78Practice expense 4.82Malpractice 5.70

34.3000 adjusted RVUs×$33.4009 conversion factor=$1,145.65

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 93581

The CMS indicators that decide how 93581 is paid alongside other services.

CMS payment indicators · 93581

VSD closure

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

93581 without 51 · national facility

$1,145.65

VSD closure

93581-51 · Second procedure: 50%

$572.83

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%).

When to use modifier 51

93581 compared with similar codes

Compare codes

93581 vs 93580 vs 93582 vs 93583: national Medicare rates

Swap in your local Medicare rate.

  • 93581
    VSD closure · 23.78 wRVU
    —
  • 93580
    ASD closure · 17.52 wRVU
    —
  • 93582
    PDA closure · 12 wRVU
    —
  • 93583
    Septal reduction · 13.41 wRVU
    —

How to choose

93580ASD closure
Use 93580 for an atrial septal defect. Use 93581 when the defect being closed is ventricular.
93582PDA closure
93582 is for transcatheter closure of a patent ductus arteriosus, not a ventricular septal defect.
93583Septal reduction
93583 describes transcatheter septal reduction, a treatment for obstructive hypertrophic cardiomyopathy; it is not closure of a ventricular septal defect.

Codes related to 93581

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

Codes related to 93581
CodeHow it relatesNational office range
Same family
93580ASD closureTranscatheter closure of an atrial septal defect; a related congenital defect closure code.No office rate
93582PDA closureTranscatheter closure of a patent ductus arteriosus; a related congenital defect closure code.No office rate

93581 billing questions

How is this different from 93580?

93581 is for transcatheter closure of a ventricular septal defect. 93580 is for closure of an atrial septal defect.

How is this different from 93582?

93581 treats a ventricular septal defect; 93582 treats a patent ductus arteriosus. Select the code for the defect being closed.

Can modifier 50 be reported?

No. The CMS bilateral adjustment does not apply, and modifier 50 is inappropriate for this code.

Can an assistant surgeon be paid?

Assistant-at-surgery payment is available only when medical necessity is documented. Co-surgeons and team surgery are not permitted.

What same-day care is included?

The 0-day global period includes same-day preoperative and postoperative care. Routine care on the procedure date is not separately reported as a separate E/M service.

What happens when another procedure is performed in the same session?

The highest-valued procedure is paid in full, and other procedures are subject to the standard multiple-procedure reduction.

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

Show the CMS file lines behind this rate
RVUs for 93581PPRRVU2026_Oct_nonQPP.csv, line 12,150 (RVU26D)

Open CMS sourceHow we calculate rates

Did this answer your question about what 93581 pays?

Tell us what you were actually trying to work out. We’ll answer you directly, or build the page that does.

Fee sheets

Put 93581 and the rest of your codes on one sheet

Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.

Build my fee sheetOr price your code list free →