Billing code 93456: Cardiac catheterizationMedicare rate & RVUs in Guam
Reports right-sided intracardiac hemodynamic assessment combined with coronary artery imaging during a diagnostic catheterization, without left heart catheterization.
Medicare pays $1,195.43 for 93456 in the office in Guam (Hawaii, Guam). Which amount applies depends on the service address.
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 9 sections
What 93456 covers
A cardiologist typically performs this diagnostic study in a cardiac catheterization laboratory. Catheters are used to measure pressures and hemodynamics in the right heart and pulmonary circulation, while contrast imaging evaluates the coronary arteries. It may be selected when the clinical evaluation needs both right-sided hemodynamic information and anatomic assessment of coronary disease. The service does not include left heart catheterization or bypass graft angiography.
Report 93456 when both the right heart catheterization and coronary angiography are performed; documentation should support the clinical need, right-sided measurements, and coronary imaging and findings. The code has a 0-day global period, so same-day preoperative and postoperative care is included. It may be billed globally or with modifier 26 for interpretation or TC for the technical portion. When other procedures subject to the standard multiple procedure reduction are performed in the same session, the highest-valued procedure is paid in full and the 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.
93456 in Hawaii, Guam
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam | $1,195.43 | Unavailable |
How the 93456 rate is calculated
Each of 93456’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 · 93456
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 5.75Practice expense 25.83Malpractice 1.16
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 93456
The CMS indicators that decide how 93456 is paid alongside other services.
CMS payment indicators · 93456
Cardiac catheterization
| 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 | 1 | Diagnostic test with separate professional (26) and technical (TC) components. |
What modifiers do to the payment
Modifier 26 · payment effect
With and without the modifier
93456 without 26 · national office
$1,093.55
Cardiac catheterization
93456-26 · Professional component
$302.95
Pays only the interpretation and report.
93456 compared with similar codes
Compare codes
93456 vs 93451 vs 93454 vs 93457 vs 93460: national Medicare rates
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How to choose
- 93451Right heart cath
- 93451 covers right heart catheterization alone. Choose 93456 when coronary angiography is also performed in the diagnostic session.
- 93454Coronary angiography
- 93454 covers coronary angiography without right heart catheterization. Choose 93456 when right-sided hemodynamic catheterization is also performed.
- 93457Cardiac catheterization
- 93457 includes bypass graft angiography in addition to the right heart and coronary study. 93456 does not include graft imaging.
- 93460Heart catheterization
- 93460 includes both right and left heart catheterization with coronary angiography. 93456 is the option when the study includes right heart catheterization and coronary angiography without left heart catheterization.
93456 billing questions
When should 93456 be chosen over 93451?
Use 93456 when the same diagnostic session includes right heart catheterization and coronary angiography. Use 93451 when the service is right heart catheterization without the coronary imaging.
How does 93456 differ from 93454?
93456 includes right-sided hemodynamic catheterization along with coronary angiography. 93454 describes coronary angiography without the right heart catheterization.
Can right heart catheterization or coronary angiography be billed separately with 93456?
Both services are represented in 93456 when performed as part of the combined study. Do not separately report the component service for the same work.
Can the professional and technical portions be billed separately?
Yes. Modifier 26 identifies the professional interpretation and modifier TC identifies the technical portion; billing without either modifier represents the global service.
Is modifier 50 appropriate, and how are other same-session procedures handled?
Modifier 50 is inappropriate for this code. When another procedure subject to the standard multiple procedure reduction is performed in the same session, the highest-valued procedure is paid in full and the others at 50%.
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
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