No office rate
Choose 93591 for a leak around the aortic valve and 93590 for a leak around the mitral valve.
On this page
CMS RVU26D · Effective 2026-10-01
93591 Leak closure Medicare reimbursement rates in Rhode Island
Reports catheter-based closure of a leak around an aortic valve, typically to treat clinically significant regurgitation, heart failure, or hemolysis. Compare 93591 office and facility rates across CMS payment localities in Rhode Island.
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 93591 in Rhode Island?
Rhode Island 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
No supported rate
Facility setting
$762.07
1 of 1 localities have a supported rate.
Payment area: Rhode Island
One mapped payment locality.
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 intervention
About 93591: Transcatheter aortic paravalvular leak closure
Reports catheter-based closure of a leak around an aortic valve, typically to treat clinically significant regurgitation, heart failure, or hemolysis.
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.
CMS billing rules for 93591
- Global period
- Minor procedure with a 0-day global period: same-day preoperative and postoperative care is included.
- 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 permitted.
- Team surgery
- Team surgery paid only with supporting documentation.
Where the value comes from
- Work RVU17.52 · 78%
- Practice expense (office) RVU3.63 · 16%
- Malpractice RVU1.36 · 6%
152
Medicare services in 2024 · #4557 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.
93591 compared with similar codes
Office rates for Rhode Island, from the same CMS release.
No office rate
93591 identifies the aortic valve closure; 93592 reports each additional valve treated and is used as an add-on.
No office rate
33405 describes surgical aortic valve replacement. It is a different operative approach from catheter-based closure of an aortic paravalvular leak.
Compare 93591 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
Rhode Island →
Office / nonfacility
Unavailable
Facility
$762.07
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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 93591 in Rhode Island.
PPRRVU2026_Oct_nonQPP.csv
12,159
- Code
- 93591
- Physician work
- 17.52
- Practice expense
- 3.63
- Malpractice
- 1.36
GPCI2026.csv
92
- Locality
- Rhode Island
- Physician work
- 1.019
- Practice expense
- 1.033
- Malpractice
- 0.892
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 17.52 | × 1.019 | 17.8529 |
| Practice expense | 3.63 | × 1.033 | 3.7498 |
| Malpractice | 1.36 | × 0.892 | 1.2131 |
| Total RVUs | 22.8158 | ||
| Conversion factor | × 33.4009 | ||
Facility rate, Rhode Island$762.07
Explore RVUs, geographic factors and the full formula
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 17.52 | 1.019 |
| Practice expense | 3.63 | 1.033 |
| Malpractice | 1.36 | 0.892 |
(17.52 × 1.019 + 3.63 × 1.033 + 1.36 × 0.892) × $33.4009 = $762.07
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.
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 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.
12,15693587,,Vngrph chd vnvn cltrl at/abv,A,,2.06,0.38,NA,0.38,,0.15,2.59,2.59,0,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,15793588,,Vngrph chd vnvn cltrl below,A,,2.08,0.38,NA,0.38,,0.15,2.61,2.61,0,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,15893590,,Perq transcath cls mitral,A,,21.16,4.40,NA,4.40,,1.76,27.32,27.32,0,000,0.00,0.00,0.00,2,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,15993591,,Perq transcath cls aortic,A,,17.52,3.63,NA,3.63,,1.36,22.51,22.51,0,000,0.00,0.00,0.00,2,0,0,2,1,9,,33.4009,09,0,99,0.00,0.00,0.00
12,16093592,,Perq transcath closure each,A,,7.80,1.45,NA,1.45,,0.54,9.79,9.79,0,ZZZ,0.00,0.00,0.00,0,0,2,1,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,16193593,,R hrt cath chd nml nt cnj,C,,0.00,0.00,,0.00,NA,0.00,0.00,0.00,1,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,16293593,26,R hrt cath chd nml nt cnj,A,,3.89,1.53,,1.53,,0.15,5.57,5.57,1,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
8912502,PA,01,METROPOLITAN PHILADELPHIA,1.018,1.041,1.193
9012502,PA,99,REST OF PENNSYLVANIA,1.000,0.918,0.945
9109202,PR,20,PUERTO RICO,1.000,1.011,0.985
9214412,RI,01,RHODE ISLAND,1.019,1.033,0.892
9311202,SC,01,SOUTH CAROLINA,1.000,0.924,0.850
9403402,SD,02,SOUTH DAKOTA**,1.000,1.000,0.336
9510312,TN,35,TENNESSEE,1.000,0.909,0.537