No office rate
Use 93580 for an atrial septal defect. Use 93581 when the defect being closed is ventricular.
On this page
CMS RVU26D · Effective 2026-10-01
93581 VSD closure Medicare reimbursement rates in Delaware
Reports catheter-based closure of a ventricular septal defect, typically in a congenital heart catheterization lab when anatomy is suitable for device treatment. Compare 93581 office and facility rates across CMS payment localities in Delaware.
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.
What does Medicare pay for 93581 in Delaware?
Delaware has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
No supported rate
Facility setting
$1128.46
1 of 1 localities have a supported rate.
Payment area: Delaware
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Structural heart procedure
About 93581: Transcatheter ventricular septal defect closure
Reports catheter-based closure of a ventricular septal defect, typically in a congenital heart catheterization lab when anatomy is suitable for device treatment.
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.
CMS billing rules for 93581
- 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 not permitted.
- Team surgery
- Team surgery not permitted.
Where the value comes from
- Work RVU23.78 · 69%
- Practice expense (office) RVU4.82 · 14%
- Malpractice RVU5.70 · 17%
55
Medicare services in 2024 · #5308 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.
93581 compared with similar codes
Office rates for Delaware, from the same CMS release.
No office rate
93582 is for transcatheter closure of a patent ductus arteriosus, not a ventricular septal defect.
No office rate
93583 describes transcatheter septal reduction, a treatment for obstructive hypertrophic cardiomyopathy; it is not closure of a ventricular septal defect.
Compare 93581 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Delaware →
Office / nonfacility
Unavailable
Facility
$1128.46
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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 93581 in Delaware.
PPRRVU2026_Oct_nonQPP.csv
12,150
- Code
- 93581
- Physician work
- 23.78
- Practice expense
- 4.82
- Malpractice
- 5.70
GPCI2026.csv
40
- Locality
- Delaware
- Physician work
- 1.005
- Practice expense
- 0.988
- Malpractice
- 0.899
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 23.78 | × 1.005 | 23.8989 |
| Practice expense | 4.82 | × 0.988 | 4.7622 |
| Malpractice | 5.70 | × 0.899 | 5.1243 |
| Total RVUs | 33.7854 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Delaware$1128.46
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 23.78 | 1.005 |
| Practice expense | 4.82 | 0.988 |
| Malpractice | 5.7 | 0.899 |
(23.78 × 1.005 + 4.82 × 0.988 + 5.7 × 0.899) × $33.4009 = $1128.46
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.
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 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.
12,14793574,,Njx cath slct pulm vn angrph,A,,1.40,0.52,,0.27,,0.09,2.01,1.76,0,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,14893575,,Njx cath slct p angrph mapca,A,,1.87,0.70,,0.35,,0.13,2.70,2.35,0,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,14993580,,Transcath closure of asd,A,,17.52,3.69,NA,3.69,,4.06,25.27,25.27,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,15093581,,Transcath closure of vsd,A,,23.78,4.82,NA,4.82,,5.70,34.30,34.30,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,15193582,,Perq transcath closure pda,A,,12.00,2.24,NA,2.24,,2.87,17.11,17.11,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,15293583,,Perq transcath septal reduxn,A,,13.41,2.58,NA,2.58,,3.20,19.19,19.19,0,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,15393584,,Vngrph chd anom/persist svc,A,,1.17,0.22,NA,0.22,,0.07,1.46,1.46,0,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3704112,CO,01,COLORADO,1.012,1.064,0.781
3813102,CT,00,CONNECTICUT,1.020,1.077,1.210
3912202,DC,01,DC + MD/VA SUBURBS,1.054,1.178,1.113
4012102,DE,01,DELAWARE,1.005,0.988,0.899
4109102,FL,03,FORT LAUDERDALE,1.000,1.013,1.808
4209102,FL,04,MIAMI,1.000,1.041,2.529
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503