Billing code 93591: Leak closureMedicare rate & RVUs in Ohio
Reports catheter-based closure of a leak around an aortic valve, typically to treat clinically significant regurgitation, heart failure, or hemolysis.
CMS doesn’t publish an office rate for 93591 in Ohio.
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 93591 covers
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.
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 in Ohio
| Payment locality | Office | Facility |
|---|---|---|
| Ohio | Unavailable | $741.67 |
How the 93591 rate is calculated
Each of 93591’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 · 93591
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 17.52Practice expense 3.63Malpractice 1.36
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 93591
The CMS indicators that decide how 93591 is paid alongside other services.
CMS payment indicators · 93591
Leak closure
| 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) | 2 | Permitted. |
| Team surgery (66) | 1 | Permitted with supporting documentation. |
| Professional/technical | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
93591 without 51 · national facility
$751.85
Leak closure
93591-51 · Second procedure: 50%
$375.93
When this isn’t the highest-valued procedure in the session, Medicare pays 50% of its fee schedule amount (the highest is paid at 100%).
93591 compared with similar codes
Compare codes
93591 vs 93590 vs 93592 vs 33405: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 93590Mitral leak closure
- Choose 93591 for a leak around the aortic valve and 93590 for a leak around the mitral valve.
- 93592Valve leak closure
- 93591 identifies the aortic valve closure; 93592 reports each additional valve treated and is used as an add-on.
- 33405Aortic valve replacement
- 33405 describes surgical aortic valve replacement. It is a different operative approach from catheter-based closure of an aortic paravalvular leak.
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 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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