$959.27
93452 covers left heart catheterization with ventriculography but not coronary angiography. Choose 93458 when coronary arteries are also imaged.
On this page
CMS RVU26D · Effective 2026-10-01
93458 Coronary catheterization Medicare reimbursement rates in Guam
Reports left heart catheterization with imaging of the native coronary arteries, with left ventriculography included when performed during the study. Compare 93458 office and facility rates across CMS payment localities in Guam.
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 93458 in Guam?
Guam 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
$1102.37
1 of 1 localities have a supported rate.
Payment area: Hawaii, Guam
One mapped payment locality.
Facility setting
No supported rate
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.
Cardiac catheterization
About 93458: Left heart catheterization with coronary angiography
Reports left heart catheterization with imaging of the native coronary arteries, with left ventriculography included when performed during the study.
An interventional cardiologist typically performs this diagnostic study in a cardiac catheterization laboratory. Catheters are advanced to the left side of the heart and into the coronary arteries to obtain hemodynamic information and images of the native vessels. Contrast imaging of the left ventricle may also be performed as part of the study. This code is used for the combined left-heart and coronary evaluation, rather than coronary imaging alone or a study that also includes right-heart catheterization.
Report the code when both left heart catheterization and coronary angiography are performed; document the catheterization, vessels imaged, and any ventriculography performed. The global service includes the professional interpretation and the technical resources; modifier 26 identifies the professional interpretation, and modifier TC identifies equipment and staff. Same-day preoperative and postoperative care is included in its 0-day global period. In a same-session multiple-procedure claim, the highest-valued procedure is paid in full and other procedures are subject to the standard 50% reduction. Modifier 50 is not appropriate for this left-sided study. Assistant-at-surgery payment requires documented medical necessity; co-surgeons and team surgery are not permitted.
CMS billing rules for 93458
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is included.
- Professional and technical components
- Diagnostic test with a professional component (modifier 26, interpretation) and a technical component (modifier TC, equipment and staff); billing without a modifier is the global service.
- 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 RVU5.46 · 18%
- Practice expense (office) RVU23.65 · 78%
- Malpractice RVU1.13 · 4%
391.7K
Medicare services in 2024 · #262 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.
93458 compared with similar codes
Office rates for Guam, from the same CMS release.
$960.61
93454 covers coronary angiography without left heart catheterization. Choose 93458 when both services are performed.
$1,184.16
93459 includes bypass graft angiography in addition to the left-heart and coronary evaluation. Choose 93458 when graft angiography is not part of the study.
$1,313.21
93460 includes right heart catheterization as well as the left-heart and coronary evaluation. Choose 93458 when right heart catheterization is not performed.
Compare 93458 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
Hawaii, Guam →
Office / nonfacility
$1102.37
Facility
Unavailable
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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 93458 in Hawaii, Guam.
PPRRVU2026_Oct_nonQPP.csv
12,112
- Code
- 93458
- Physician work
- 5.46
- Practice expense
- 23.65
- Malpractice
- 1.13
GPCI2026.csv
46
- Locality
- Hawaii, Guam
- Physician work
- 1.000
- Practice expense
- 1.137
- Malpractice
- 0.579
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 5.46 | × 1.000 | 5.4600 |
| Practice expense | 23.65 | × 1.137 | 26.8900 |
| Malpractice | 1.13 | × 0.579 | 0.6543 |
| Total RVUs | 33.0043 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Hawaii, Guam$1102.37
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 5.46 | 1 |
| Practice expense | 23.65 | 1.137 |
| Malpractice | 1.13 | 0.579 |
(5.46 × 1 + 23.65 × 1.137 + 1.13 × 0.579) × $33.4009 = $1102.37
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.
93458 billing questions
When should 93458 be chosen instead of 93454?
Use 93458 when the service includes both left heart catheterization and coronary angiography. Code 93454 describes coronary angiography without the left heart catheterization component.
Is left ventriculography required to report 93458?
No. The code includes left ventriculography when performed, but the study may be reported when left ventriculography is not performed.
Can the professional and technical services be billed separately?
Yes. Modifier 26 identifies the professional interpretation, and modifier TC identifies the technical service. Without either modifier, the claim represents the global service.
Should modifier 50 be appended when both coronary arteries are imaged?
No. Report 93458 once for the described study; modifier 50 is inappropriate for this code.
How are other procedures in the same session affected?
The highest-valued procedure is paid in full, and other procedures in the same session are subject to the standard multiple-procedure reduction. The code has a 0-day global period, which includes same-day preoperative and postoperative care.
Can an assistant or co-surgeon be reported?
Assistant-at-surgery payment requires documentation of medical necessity. Co-surgeons and team surgery are not permitted 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 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.
12,10993457,,R hrt art/grft angio,A,,6.47,27.93,,27.93,NA,1.33,35.73,35.73,1,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,11093457,26,R hrt art/grft angio,A,,6.47,2.47,,2.47,,1.27,10.21,10.21,1,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,11193457,TC,R hrt art/grft angio,A,,0.00,25.46,,25.46,NA,0.06,25.52,25.52,1,000,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,03,0,99,0.00,0.00,0.00
12,11293458,,L hrt artery/ventricle angio,A,,5.46,23.65,,23.65,NA,1.13,30.24,30.24,1,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,11393458,26,L hrt artery/ventricle angio,A,,5.46,2.06,,2.06,,1.08,8.60,8.60,1,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,11493458,TC,L hrt artery/ventricle angio,A,,0.00,21.59,,21.59,NA,0.05,21.64,21.64,1,000,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,03,0,99,0.00,0.00,0.00
12,11593459,,L hrt art/grft angio,A,,6.19,25.08,,25.08,NA,1.29,32.56,32.56,1,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503
4410212,GA,01,ATLANTA,1.003,1.016,1.201
4510212,GA,99,REST OF GEORGIA,1.000,0.892,1.192
4601212,HI,01,"HAWAII, GUAM",1.000,1.137,0.579
4702202,ID,00,IDAHO,1.000,0.920,0.473
4806102,IL,16,CHICAGO,1.007,1.005,2.295
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014