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Billing code 93650: AV node ablationMedicare rate & RVUs

Reports catheter ablation of AV node conduction, generally to control a persistently rapid ventricular rate when medication or rhythm-control treatment has not provided adequate control.

CMS RVU26DEffective Oct 1, 2026109 payment localities12.5K Medicare services in 2024

Medicare pays $497.01 for 93650 nationally in a facility.

Medicare rate · 93650

AV node ablation

Work RVUs
9.98
Total RVUs
14.88
Global days
000

National rate · 2026

$497.01

Facility setting, before claim adjustments.

See every locality for 93650 →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 93650 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 93650 covers

An electrophysiologist uses an intracardiac catheter to ablate AV node conduction, intentionally interrupting electrical transmission from the atria to the ventricles. This is commonly performed for rate control in patients with atrial fibrillation or another atrial tachyarrhythmia that continues to cause a rapid ventricular response despite treatment. Because the ventricles can no longer rely on normal atrioventricular conduction, a permanent pacing plan is needed; a pacemaker may be implanted before or during the treatment course.

Report 93650 when the documented target is AV node function, not an atrial or ventricular arrhythmia substrate being ablated for rhythm control. The procedure note should identify the indication, catheter ablation performed, and intended AV conduction outcome. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%. 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 93650 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

93650 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailable$452.29
Alaska*Unavailable$633.97
ArizonaUnavailable$483.06
ArkansasUnavailable$446.93
AtlantaUnavailable$515.15
AustinUnavailable$493.66
BakersfieldUnavailable$480.82
Baltimore/Surr. CntysUnavailable$527.16
BeaumontUnavailable$483.77
BrazoriaUnavailable$481.64

93650 rates by state

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

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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
93650 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 93650 rate is calculated

Each of 93650’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 · 93650

RVUs × geographic indexes × conversion factor

Work9.98

9.98 RVUs× 1.000 GPCI

Practice expense2.55

2.55 RVUs× 1.000 GPCI

Malpractice2.35

2.35 RVUs× 1.000 GPCI

Adjusted RVUs

14.8800

Conversion factor

$33.4009

Medicare rate

$497.01

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 93650

The CMS indicators that decide how 93650 is paid alongside other services.

CMS payment indicators · 93650

AV node ablation

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

93650 without 51 · national facility

$497.01

AV node ablation

93650-51 · Second procedure: 50%

$248.51

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

93650 compared with similar codes

Compare codes · National

5 codes, side by side

  • 93650

    AV node ablation9.98 wRVU

    Not priced

  • 93656

    AF ablation16.58 wRVU

    Not priced

  • 93653

    SVT ablation14.63 wRVU

    Not priced

  • 93654

    VT ablation17.65 wRVU

    Not priced

  • 33208

    Pacemaker implant8.31 wRVU

    Not priced

How to choose

93656AF ablation
Choose 93650 when the intended intervention is AV node ablation for ventricular rate control. Choose 93656 when the ablation targets atrial fibrillation for rhythm control.
93653SVT ablation
93653 is for catheter ablation of a supraventricular tachycardia mechanism. It is not the code for intentionally interrupting AV node conduction.
93654VT ablation
93654 applies when the ablation target is ventricular tachycardia. Code 93650 targets AV node conduction.
33208Pacemaker implant
33208 reports implantation of a dual-chamber permanent pacemaker. It describes a device implantation, not the AV node ablation itself.

Codes related to 93650

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

Codes related to 93650
CodeHow it relatesNational office range
Often billed with
33208Pacemaker implantMay be reported for a separately performed dual-chamber pacemaker implantation.No office rate
Used instead
93656AF ablationTargets atrial fibrillation for rhythm control rather than AV node conduction for rate control.No office rate
93653SVT ablationTreats a supraventricular tachycardia circuit rather than ablating AV node conduction.No office rate
93654VT ablationTargets ventricular tachycardia rather than AV node conduction.No office rate

93650 billing questions

How does 93650 differ from atrial fibrillation ablation?

93650 targets AV node conduction to control ventricular rate. Code 93656 describes catheter ablation directed at atrial fibrillation as a rhythm-control treatment.

Is a pacemaker reported with 93650?

A pacemaker implantation may be reported separately when it is actually performed and documented. Select the device code based on the implantation service and system, rather than assuming every case uses the same pacemaker code.

What documentation supports reporting 93650?

Document the clinical indication, the AV node as the ablation target, and the catheter ablation performed. The record should also support the pacing plan following interruption of AV conduction.

How are other procedures in the same session paid?

Under the CMS multiple-procedure rule, the highest-valued procedure is paid in full and other procedures in that session are paid at 50%. Same-day preoperative and postoperative care is included in the 0-day global period.

Can an assistant, co-surgeon, or surgical team be reported?

Assistant-at-surgery payment requires documentation of medical necessity. CMS does not permit co-surgeon or team-surgery payment for this code.

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 93650PPRRVU2026_Oct_nonQPP.csv, line 12,240 (RVU26D)

Open CMS sourceHow we calculate rates

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