Billing code 93650: AV node ablationMedicare rate & RVUs in Oregon
Reports catheter ablation of AV node conduction, generally to control a persistently rapid ventricular rate when medication or rhythm-control treatment has not provided adequate control.
CMS doesn’t publish an office rate for 93650 in Oregon.
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 93650 covers
An electrophysiologist uses an intracardiac catheter to ablate AV node conduction, intentionally interrupting electrical transmission from the atria to the ventricles. This is commonly performed for rate control in patients with atrial fibrillation or another atrial tachyarrhythmia that continues to cause a rapid ventricular response despite treatment. Because the ventricles can no longer rely on normal atrioventricular conduction, a permanent pacing plan is needed; a pacemaker may be implanted before or during the treatment course.
Report 93650 when the documented target is AV node function, not an atrial or ventricular arrhythmia substrate being ablated for rhythm control. The procedure note should identify the indication, catheter ablation performed, and intended AV conduction outcome. CMS assigns a 0-day global period, so same-day preoperative and postoperative care is included. When multiple procedures are performed in the same session, the highest-valued procedure is paid in full and the others at 50%. 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.
Where 93650 pays more and less in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland | Unavailable | $491.70 |
| Rest Of Oregon | Unavailable | $473.35 |
How the 93650 rate is calculated
Each of 93650’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 · 93650
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 9.98Practice expense 2.55Malpractice 2.35
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 93650
The CMS indicators that decide how 93650 is paid alongside other services.
CMS payment indicators · 93650
AV node ablation
| 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 | 0 | Physician service: no professional/technical split. |
What modifiers do to the payment
Modifier 51 · payment effect
With and without the modifier
93650 without 51 · national facility
$497.01
AV node ablation
93650-51 · Second procedure: 50%
$248.51
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%).
93650 compared with similar codes
Compare codes
93650 vs 93656 vs 93653 vs 93654 vs 33208: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 93656AF ablation
- Choose 93650 when the intended intervention is AV node ablation for ventricular rate control. Choose 93656 when the ablation targets atrial fibrillation for rhythm control.
- 93653SVT ablation
- 93653 is for catheter ablation of a supraventricular tachycardia mechanism. It is not the code for intentionally interrupting AV node conduction.
- 93654VT ablation
- 93654 applies when the ablation target is ventricular tachycardia. Code 93650 targets AV node conduction.
- 33208Pacemaker implant
- 33208 reports implantation of a dual-chamber permanent pacemaker. It describes a device implantation, not the AV node ablation itself.
93650 billing questions
How does 93650 differ from atrial fibrillation ablation?
93650 targets AV node conduction to control ventricular rate. Code 93656 describes catheter ablation directed at atrial fibrillation as a rhythm-control treatment.
Is a pacemaker reported with 93650?
A pacemaker implantation may be reported separately when it is actually performed and documented. Select the device code based on the implantation service and system, rather than assuming every case uses the same pacemaker code.
What documentation supports reporting 93650?
Document the clinical indication, the AV node as the ablation target, and the catheter ablation performed. The record should also support the pacing plan following interruption of AV conduction.
How are other procedures in the same session paid?
Under the CMS multiple-procedure rule, the highest-valued procedure is paid in full and other procedures in that session are paid at 50%. Same-day preoperative and postoperative care is included in the 0-day global period.
Can an assistant, co-surgeon, or surgical team be reported?
Assistant-at-surgery payment requires documentation of medical necessity. CMS does not permit co-surgeon or team-surgery payment 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 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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