No office rate
Choose 93591 for a leak around the aortic valve and 93590 for a leak around the mitral valve.
On this page
CMS RVU26D · Effective 2026-10-01
93591 in Modesto
Office / nonfacility
Not available in this setting
Base rate per service
Facility setting
$752.36
Base rate per service
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
Cardiac intervention
About 93591: Transcatheter aortic paravalvular leak closure
Reports catheter-based closure of a leak around an aortic valve, typically to treat clinically significant regurgitation, heart failure, or hemolysis.
An interventional cardiologist uses a catheter to deliver a closure device to a paravalvular leak around an aortic valve, often a prosthetic valve. The procedure is generally performed in a hospital catheterization or hybrid laboratory, with imaging used to guide device placement. Patients may have symptoms or complications such as heart failure or hemolysis related to the leak.
Select this code when the treated leak is around the aortic valve; a mitral paravalvular leak is reported with 93590. Document the valve involved, leak location and clinical indication, and the catheter-based closure performed. 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 50% multiple-procedure reduction. Modifier 50 is inappropriate. Assistant-at-surgery payment requires medical-necessity documentation; co-surgeons are permitted, and team surgery requires supporting documentation.
CMS billing rules for 93591
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is included.
- Multiple procedures
- Standard multiple procedure reduction: the highest-valued procedure is paid in full and others at 50% when performed in the same session.
- Bilateral procedures
- Bilateral adjustment does not apply; the descriptor or anatomy makes modifier 50 inappropriate.
- Assistant at surgery
- Assistant at surgery is paid only with documentation of medical necessity.
- Co-surgeons
- Co-surgeons permitted.
- Team surgery
- Team surgery paid only with supporting documentation.
Where the value comes from
- Work RVU17.52 · 78%
- Practice expense (office) RVU3.63 · 16%
- Malpractice RVU1.36 · 6%
152
Medicare services in 2024 · #4557 by national volume
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.
93591 compared with similar codes
Office rates for Modesto, from the same CMS release.
No office rate
93591 identifies the aortic valve closure; 93592 reports each additional valve treated and is used as an add-on.
No office rate
33405 describes surgical aortic valve replacement. It is a different operative approach from catheter-based closure of an aortic paravalvular leak.
The same code, a different location
How does Modesto compare?
93591 across payment areas
Same release and payment basis · bars start at $0
Modesto · This locality
Unavailable
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
Unavailable
No comparable rate is available in this setting.
No comparable rate is available in this setting.
Other payment areas listed in California appear first, followed by selected cross-country examples. The chart compares amounts, not distance.
The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.
Compare all 108 other payment areas
Madera
California · 93591
Office
Unavailable
Facility
$752.36
No comparable office rate is available.
Merced
California · 93591
Office
Unavailable
Facility
$752.36
No comparable office rate is available.
Napa
California · 93591
Office
Unavailable
Facility
$804.93
No comparable office rate is available.
Oxnard-Thousand Oaks-Ventura
California · 93591
Office
Unavailable
Facility
$773.18
No comparable office rate is available.
Redding
California · 93591
Office
Unavailable
Facility
$752.36
No comparable office rate is available.
Rest Of California
California · 93591
Office
Unavailable
Facility
$752.36
No comparable office rate is available.
Riverside-San Bernardino-Ontario
California · 93591
Office
Unavailable
Facility
$767.35
No comparable office rate is available.
Sacramento-Roseville-Folsom
California · 93591
Office
Unavailable
Facility
$771.61
No comparable office rate is available.
Salinas
California · 93591
Office
Unavailable
Facility
$768.20
No comparable office rate is available.
San Diego-Chula Vista-Carlsbad
California · 93591
Office
Unavailable
Facility
$772.37
No comparable office rate is available.
San Francisco-Oakland-Berkeley (Marin Cnty)
California · 93591
Office
Unavailable
Facility
$832.58
No comparable office rate is available.
San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)
California · 93591
Office
Unavailable
Facility
$831.04
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
California · 93591
Office
Unavailable
Facility
$848.74
No comparable office rate is available.
San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)
California · 93591
Office
Unavailable
Facility
$842.42
No comparable office rate is available.
San Luis Obispo-Paso Robles
California · 93591
Office
Unavailable
Facility
$757.58
No comparable office rate is available.
Santa Cruz-Watsonville
California · 93591
Office
Unavailable
Facility
$769.13
No comparable office rate is available.
Santa Maria-Santa Barbara
California · 93591
Office
Unavailable
Facility
$767.29
No comparable office rate is available.
Santa Rosa-Petaluma
California · 93591
Office
Unavailable
Facility
$775.98
No comparable office rate is available.
Stockton
California · 93591
Office
Unavailable
Facility
$752.36
No comparable office rate is available.
Vallejo
California · 93591
Office
Unavailable
Facility
$802.70
No comparable office rate is available.
Visalia
California · 93591
Office
Unavailable
Facility
$752.36
No comparable office rate is available.
Yuba City
California · 93591
Office
Unavailable
Facility
$752.36
No comparable office rate is available.
Dc + Md/Va Suburbs
District of Columbia · 93591
Office
Unavailable
Facility
$810.17
No comparable office rate is available.
Miami
Florida · 93591
Office
Unavailable
Facility
$826.28
No comparable office rate is available.
Chicago
Illinois · 93591
Office
Unavailable
Facility
$815.38
No comparable office rate is available.
Manhattan
New York · 93591
Office
Unavailable
Facility
$835.57
No comparable office rate is available.
Alaska*
Alaska · 93591
Office
Unavailable
Facility
$1031.93
No comparable office rate is available.
Alabama
Alabama · 93591
Office
Unavailable
Facility
$716.98
No comparable office rate is available.
Arkansas
Arkansas · 93591
Office
Unavailable
Facility
$712.73
No comparable office rate is available.
Arizona
Arizona · 93591
Office
Unavailable
Facility
$741.55
No comparable office rate is available.
Colorado
Colorado · 93591
Office
Unavailable
Facility
$756.69
No comparable office rate is available.
Connecticut
Connecticut · 93591
Office
Unavailable
Facility
$782.43
No comparable office rate is available.
Delaware
Delaware · 93591
Office
Unavailable
Facility
$748.74
No comparable office rate is available.
Fort Lauderdale
Florida · 93591
Office
Unavailable
Facility
$790.13
No comparable office rate is available.
Rest Of Florida
Florida · 93591
Office
Unavailable
Facility
$769.37
No comparable office rate is available.
Atlanta
Georgia · 93591
Office
Unavailable
Facility
$764.68
No comparable office rate is available.
Rest Of Georgia
Georgia · 93591
Office
Unavailable
Facility
$747.48
No comparable office rate is available.
Hawaii, Guam
Hawaii · 93591
Office
Unavailable
Facility
$749.34
No comparable office rate is available.
Iowa
Iowa · 93591
Office
Unavailable
Facility
$714.16
No comparable office rate is available.
Idaho
Idaho · 93591
Office
Unavailable
Facility
$718.22
No comparable office rate is available.
East St. Louis
Illinois · 93591
Office
Unavailable
Facility
$788.22
No comparable office rate is available.
Rest Of Illinois
Illinois · 93591
Office
Unavailable
Facility
$766.88
No comparable office rate is available.
Suburban Chicago
Illinois · 93591
Office
Unavailable
Facility
$794.29
No comparable office rate is available.
Indiana
Indiana · 93591
Office
Unavailable
Facility
$719.65
No comparable office rate is available.
Kansas
Kansas · 93591
Office
Unavailable
Facility
$717.68
No comparable office rate is available.
Kentucky
Kentucky · 93591
Office
Unavailable
Facility
$734.53
No comparable office rate is available.
New Orleans
Louisiana · 93591
Office
Unavailable
Facility
$750.88
No comparable office rate is available.
Rest Of Louisiana
Louisiana · 93591
Office
Unavailable
Facility
$736.00
No comparable office rate is available.
Metropolitan Boston
Massachusetts · 93591
Office
Unavailable
Facility
$794.37
No comparable office rate is available.
Rest Of Massachusetts
Massachusetts · 93591
Office
Unavailable
Facility
$758.42
No comparable office rate is available.
Baltimore/Surr. Cntys
Maryland · 93591
Office
Unavailable
Facility
$780.83
No comparable office rate is available.
Rest Of Maryland
Maryland · 93591
Office
Unavailable
Facility
$755.44
No comparable office rate is available.
Rest Of Maine
Maine · 93591
Office
Unavailable
Facility
$724.98
No comparable office rate is available.
Southern Maine
Maine · 93591
Office
Unavailable
Facility
$734.00
No comparable office rate is available.
Detroit
Michigan · 93591
Office
Unavailable
Facility
$778.77
No comparable office rate is available.
Rest Of Michigan
Michigan · 93591
Office
Unavailable
Facility
$747.17
No comparable office rate is available.
Minnesota
Minnesota · 93591
Office
Unavailable
Facility
$723.39
No comparable office rate is available.
Metropolitan Kansas City
Missouri · 93591
Office
Unavailable
Facility
$743.41
No comparable office rate is available.
Metropolitan St. Louis
Missouri · 93591
Office
Unavailable
Facility
$746.13
No comparable office rate is available.
Rest Of Missouri
Missouri · 93591
Office
Unavailable
Facility
$733.94
No comparable office rate is available.
Mississippi
Mississippi · 93591
Office
Unavailable
Facility
$723.15
No comparable office rate is available.
Montana**
Montana · 93591
Office
Unavailable
Facility
$751.76
No comparable office rate is available.
North Carolina
North Carolina · 93591
Office
Unavailable
Facility
$727.33
No comparable office rate is available.
North Dakota**
North Dakota · 93591
Office
Unavailable
Facility
$724.87
No comparable office rate is available.
Nebraska
Nebraska · 93591
Office
Unavailable
Facility
$714.26
No comparable office rate is available.
New Hampshire
New Hampshire · 93591
Office
Unavailable
Facility
$751.15
No comparable office rate is available.
Northern Nj
New Jersey · 93591
Office
Unavailable
Facility
$811.21
No comparable office rate is available.
Rest Of New Jersey
New Jersey · 93591
Office
Unavailable
Facility
$790.82
No comparable office rate is available.
New Mexico
New Mexico · 93591
Office
Unavailable
Facility
$750.92
No comparable office rate is available.
Nevada**
Nevada · 93591
Office
Unavailable
Facility
$744.39
No comparable office rate is available.
Nyc Suburbs/Long Island
New York · 93591
Office
Unavailable
Facility
$851.15
No comparable office rate is available.
Poughkpsie/N Nyc Suburbs
New York · 93591
Office
Unavailable
Facility
$799.25
No comparable office rate is available.
Queens
New York · 93591
Office
Unavailable
Facility
$831.45
No comparable office rate is available.
Rest Of New York
New York · 93591
Office
Unavailable
Facility
$732.30
No comparable office rate is available.
Ohio
Ohio · 93591
Office
Unavailable
Facility
$741.67
No comparable office rate is available.
Oklahoma
Oklahoma · 93591
Office
Unavailable
Facility
$728.75
No comparable office rate is available.
Portland
Oregon · 93591
Office
Unavailable
Facility
$763.05
No comparable office rate is available.
Rest Of Oregon
Oregon · 93591
Office
Unavailable
Facility
$737.88
No comparable office rate is available.
Metropolitan Philadelphia
Pennsylvania · 93591
Office
Unavailable
Facility
$776.13
No comparable office rate is available.
Rest Of Pennsylvania
Pennsylvania · 93591
Office
Unavailable
Facility
$739.41
No comparable office rate is available.
Puerto Rico
Puerto Rico · 93591
Office
Unavailable
Facility
$752.51
No comparable office rate is available.
Rhode Island
Rhode Island · 93591
Office
Unavailable
Facility
$762.07
No comparable office rate is available.
South Carolina
South Carolina · 93591
Office
Unavailable
Facility
$735.83
No comparable office rate is available.
South Dakota**
South Dakota · 93591
Office
Unavailable
Facility
$721.69
No comparable office rate is available.
Tennessee
Tennessee · 93591
Office
Unavailable
Facility
$719.79
No comparable office rate is available.
Austin
Texas · 93591
Office
Unavailable
Facility
$754.88
No comparable office rate is available.
Beaumont
Texas · 93591
Office
Unavailable
Facility
$737.72
No comparable office rate is available.
Brazoria
Texas · 93591
Office
Unavailable
Facility
$745.45
No comparable office rate is available.
Dallas
Texas · 93591
Office
Unavailable
Facility
$750.19
No comparable office rate is available.
Fort Worth
Texas · 93591
Office
Unavailable
Facility
$749.56
No comparable office rate is available.
Galveston
Texas · 93591
Office
Unavailable
Facility
$747.87
No comparable office rate is available.
Houston
Texas · 93591
Office
Unavailable
Facility
$772.77
No comparable office rate is available.
Rest Of Texas
Texas · 93591
Office
Unavailable
Facility
$741.26
No comparable office rate is available.
Utah
Utah · 93591
Office
Unavailable
Facility
$739.95
No comparable office rate is available.
Virginia
Virginia · 93591
Office
Unavailable
Facility
$736.44
No comparable office rate is available.
Virgin Islands
United States Virgin Islands · 93591
Office
Unavailable
Facility
$752.51
No comparable office rate is available.
Vermont
Vermont · 93591
Office
Unavailable
Facility
$728.20
No comparable office rate is available.
Rest Of Washington
Washington · 93591
Office
Unavailable
Facility
$755.03
No comparable office rate is available.
Seattle (King Cnty)
Washington · 93591
Office
Unavailable
Facility
$800.32
No comparable office rate is available.
Wisconsin
Wisconsin · 93591
Office
Unavailable
Facility
$715.33
No comparable office rate is available.
West Virginia
West Virginia · 93591
Office
Unavailable
Facility
$755.55
No comparable office rate is available.
Wyoming**
Wyoming · 93591
Office
Unavailable
Facility
$740.04
No comparable office rate is available.
See how rates vary across the country
93591 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.
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 all state and territory rates as a table
| State / territory | Rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
Where does this rate apply?
Modesto is a Medicare payment area. Our Census mapping connects it to 33 cities and communities in California, including the examples shown here.
Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.
Use this rate
What is a percentage of Medicare worth?
Turn a percentage into dollars for 93591 in Modesto. This uses the base rate on this page, so the locality and release stay consistent.
Reference amount per service
$827.60
$752.36 × 110% = $827.60
A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.
Working with a whole code list?
Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.
How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 93591 in Modesto.
PPRRVU2026_Oct_nonQPP.csv
12,159
- Code
- 93591
- Physician work
- 17.52
- Practice expense
- 3.63
- Malpractice
- 1.36
GPCI2026.csv
16
- Locality
- Modesto
- Physician work
- 1.017
- Practice expense
- 1.096
- Malpractice
- 0.536
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 17.52 | × 1.017 | 17.8178 |
| Practice expense | 3.63 | × 1.096 | 3.9785 |
| Malpractice | 1.36 | × 0.536 | 0.7290 |
| Total RVUs | 22.5253 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Modesto$752.36
Open 93591 in the RVU calculator →
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 17.52 | 1.017 |
| Practice expense | 3.63 | 1.096 |
| Malpractice | 1.36 | 0.536 |
(17.52 × 1.017 + 3.63 × 1.096 + 1.36 × 0.536) × $33.4009 = $752.36
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
How this rate has changed
93591 · Office / nonfacility
Rate unavailable
Effective 2026-10-01
A rate is unavailable in one of these releases, so a change cannot be calculated.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
Explore release dates and calculate this code in an earlier period →
Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.
Inspect every release and its CMS source
| Effective from | Office / nonfacility | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Not available in this setting | $752.36 | RVU26D |
| 2026-07-01 | Not available in this setting | $752.36 | RVU26C |
| 2026-04-01 | Not available in this setting | $752.36 | RVU26B |
| 2026-01-01 | Not available in this setting | $752.36 | RVU26A |
| 2025-10-01 | Not available in this setting | $846.73 | RVU25D |
| 2025-07-01 | Not available in this setting | $846.73 | RVU25C |
| 2025-04-01 | Not available in this setting | $846.73 | RVU25B |
| 2025-01-01 | Not available in this setting | $846.73 | RVU25A |
93591 billing questions
How does 93591 differ from 93590?
93591 is for closure of a paravalvular leak around the aortic valve. Use 93590 when the leak is around the mitral valve.
When is 93592 reported with 93591?
93592 is the add-on code for each additional valve treated for a paravalvular leak. Report it with the primary closure code when another valve is treated during the procedure.
What documentation supports 93591?
Document the aortic valve leak, its clinical significance, and the catheter-based closure performed. The record should identify any additional valve treated.
Can modifier 50 be used for bilateral closure?
No. The descriptor and anatomy make modifier 50 inappropriate for this code.
How are same-day care and multiple procedures handled?
The 0-day global period includes same-day preoperative and postoperative care. For multiple procedures in one session, the highest-valued procedure is paid in full and the others are subject to the standard 50% reduction.
When may an assistant or co-surgeon be reported?
Assistant-at-surgery payment requires documentation of medical necessity. Co-surgeons are permitted, while team surgery requires supporting documentation.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
12,15693587,,Vngrph chd vnvn cltrl at/abv,A,,2.06,0.38,NA,0.38,,0.15,2.59,2.59,0,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,15793588,,Vngrph chd vnvn cltrl below,A,,2.08,0.38,NA,0.38,,0.15,2.61,2.61,0,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,15893590,,Perq transcath cls mitral,A,,21.16,4.40,NA,4.40,,1.76,27.32,27.32,0,000,0.00,0.00,0.00,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,15993591,,Perq transcath cls aortic,A,,17.52,3.63,NA,3.63,,1.36,22.51,22.51,0,000,0.00,0.00,0.00,2,0,0,2,1,9,,33.4009,09,0,99,0.00,0.00,0.00
12,16093592,,Perq transcath closure each,A,,7.80,1.45,NA,1.45,,0.54,9.79,9.79,0,ZZZ,0.00,0.00,0.00,0,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,16193593,,R hrt cath chd nml nt cnj,C,,0.00,0.00,,0.00,NA,0.00,0.00,0.00,1,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,16293593,26,R hrt cath chd nml nt cnj,A,,3.89,1.53,,1.53,,0.15,5.57,5.57,1,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
1301182,CA,18,LOS ANGELES-LONG BEACH-ANAHEIM (LOS ANGELES/ORANGE CNTY),1.041,1.183,0.664
1401112,CA,58,MADERA,1.017,1.096,0.536
1501112,CA,59,MERCED,1.017,1.096,0.536
1601112,CA,60,MODESTO,1.017,1.096,0.536
1701112,CA,51,NAPA,1.063,1.318,0.508
1801182,CA,17,OXNARD-THOUSAND OAKS-VENTURA,1.028,1.182,0.623
1901112,CA,61,REDDING,1.017,1.096,0.536