$1,098.80
Choose 93461 when bypass graft angiography is included. Code 93460 includes combined right and left heart catheterization and coronary angiography without graft angiography.
On this page
CMS RVU26D · Effective 2026-10-01
93461 Heart catheterization Medicare reimbursement rates in Kentucky
Reports combined right and left heart catheterization with coronary and bypass graft angiography, typically when evaluating a patient with prior coronary bypass surgery. Compare 93461 office and facility rates across CMS payment localities in Kentucky.
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 93461 in Kentucky?
Kentucky 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
$1211.22
1 of 1 localities have a supported rate.
Payment area: Kentucky
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 93461: Combined heart catheterization with graft angiography
Reports combined right and left heart catheterization with coronary and bypass graft angiography, typically when evaluating a patient with prior coronary bypass surgery.
This service combines right- and left-sided heart catheterization with coronary artery and bypass graft angiography. The cardiologist records pressure and hemodynamic information from both sides of the heart and uses catheter-based contrast imaging to assess native coronary arteries and bypass grafts. Left ventriculography may also be performed. It is typically done in a cardiac catheterization laboratory for patients with known or suspected coronary disease and prior bypass surgery when both heart pressures and coronary or graft anatomy need assessment.
Report the code when the documented service includes right and left heart catheterization plus coronary and bypass graft angiography; document the catheter placements, studies performed, and imaging interpretation. The diagnostic service may be billed globally or as a professional component with modifier 26 or a technical component with modifier TC. It 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 others at 50%. Modifier 50 is inappropriate for this anatomy. Assistant-at-surgery payment requires medical-necessity documentation; co-surgeons and team surgery are not permitted.
CMS billing rules for 93461
- 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 RVU7.65 · 19%
- Practice expense (office) RVU30.58 · 77%
- Malpractice RVU1.56 · 4%
9.2K
Medicare services in 2024 · #1523 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.
93461 compared with similar codes
Office rates for Kentucky, from the same CMS release.
$990.89
93459 includes left heart catheterization with coronary and bypass graft angiography. 93461 also includes right heart catheterization.
$1,086.09
93457 includes right heart catheterization with coronary and bypass graft angiography. 93461 adds the left heart catheterization.
$1,013.83
93453 covers combined right and left heart catheterization with ventriculography but not coronary or bypass graft angiography.
Compare 93461 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
Kentucky →
Office / nonfacility
$1211.22
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 93461 in Kentucky.
PPRRVU2026_Oct_nonQPP.csv
12,121
- Code
- 93461
- Physician work
- 7.65
- Practice expense
- 30.58
- Malpractice
- 1.56
GPCI2026.csv
55
- Locality
- Kentucky
- Physician work
- 1.000
- Practice expense
- 0.889
- Malpractice
- 0.915
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 7.65 | × 1.000 | 7.6500 |
| Practice expense | 30.58 | × 0.889 | 27.1856 |
| Malpractice | 1.56 | × 0.915 | 1.4274 |
| Total RVUs | 36.2630 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Kentucky$1211.22
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 7.65 | 1 |
| Practice expense | 30.58 | 0.889 |
| Malpractice | 1.56 | 0.915 |
(7.65 × 1 + 30.58 × 0.889 + 1.56 × 0.915) × $33.4009 = $1211.22
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.
93461 billing questions
How does 93461 differ from 93460?
93461 includes bypass graft angiography along with coronary angiography and combined right and left heart catheterization. Use 93460 when the service includes coronary angiography but not bypass graft angiography.
Can modifier 26 or TC be reported?
Yes. Modifier 26 identifies the professional interpretation, and modifier TC identifies the technical service; billing without either modifier represents the global service.
Should modifier 50 be appended?
No. The anatomy and service represented by 93461 make modifier 50 inappropriate.
What documentation supports reporting 93461?
Document right- and left-sided catheterization, coronary angiography, and bypass graft angiography, along with the catheter placements and imaging interpretation. Include ventriculography when performed.
How are multiple procedures in the same session paid?
The highest-valued procedure is paid in full, and other procedures in that session are paid at 50% under the standard multiple procedure reduction.
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 service.
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.
12,11893460,,R&l hrt art/ventricle angio,A,,6.92,27.78,,27.78,NA,1.40,36.10,36.10,1,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,11993460,26,R&l hrt art/ventricle angio,A,,6.92,2.63,,2.63,,1.34,10.89,10.89,1,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,12093460,TC,R&l hrt art/ventricle angio,A,,0.00,25.15,,25.15,NA,0.06,25.21,25.21,1,000,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,03,0,99,0.00,0.00,0.00
12,12193461,,R&l hrt art/ventricle angio,A,,7.65,30.58,,30.58,NA,1.56,39.79,39.79,1,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,12293461,26,R&l hrt art/ventricle angio,A,,7.65,2.89,,2.89,,1.49,12.03,12.03,1,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,12393461,TC,R&l hrt art/ventricle angio,A,,0.00,27.69,,27.69,NA,0.07,27.76,27.76,1,000,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,03,0,99,0.00,0.00,0.00
12,12493462,,L hrt cath trnsptl puncture,A,,3.64,1.60,,0.80,,0.86,6.10,5.30,0,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136
5707202,LA,99,REST OF LOUISIANA,1.000,0.885,0.958
5814112,ME,03,SOUTHERN MAINE,1.000,0.991,0.631