Billing code 93654: VT ablationMedicare rate & RVUs in Washington

Reports a comprehensive electrophysiology study with catheter ablation to treat ventricular tachycardia, including evaluation and treatment during the same procedure.

CMS RVU26DEffective Oct 1, 20262 payment localities8.6K Medicare services in 2024

CMS doesn’t publish an office rate for 93654 in Washington.

—Office (non-facility)
$838.79–$890.85Hospital or facility

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 93654 for the payment locality that covers the ZIP.

On this page 9 sections
  1. Rate in Washington
  2. What 93654 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. Sources

What 93654 covers

An electrophysiologist performs this procedure in an electrophysiology lab, typically in a hospital or other facility, to evaluate and ablate ventricular tachycardia. The work includes placing and positioning intracardiac electrode catheters, recording and pacing the heart, inducing or attempting to induce the arrhythmia, and using catheter ablation to treat the ventricular tachycardia. A common clinical setting is treatment of scar-related VT in a patient with structural heart disease.

Select 93654 when the procedure includes comprehensive EP evaluation and catheter ablation for VT; an EP study without ablation or ablation for another arrhythmia type points to a different code. The operative report should support the arrhythmia treated, evaluation and mapping performed, and ablation delivered. The same-day preoperative and postoperative care is included in the 0-day global period. For multiple procedures in one session, CMS pays the highest-valued procedure in full and reduces the others to 50%. Modifier 50 is inappropriate. Assistant-at-surgery payment requires documentation of 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 93654 pays more and less in Washington

93654 office and facility rates by payment locality
Payment localityOfficeFacility
Rest Of WashingtonUnavailable$838.79
Seattle (King Cnty)Unavailable$890.85

How the 93654 rate is calculated

Each of 93654’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 · 93654

RVUs × geographic indexes × conversion factor

Swap in your local Medicare rate.

Work 17.65Practice expense 3.87Malpractice 4.15

25.6700 adjusted RVUs×$33.4009 conversion factor=$857.40

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 93654

The CMS indicators that decide how 93654 is paid alongside other services.

CMS payment indicators · 93654

VT ablation

RuleCMS valueWhat it means
Global period000Same-day global: pre- and post-op care on the day of the procedure is included.
Multiple procedures2Standard reduction: highest-valued procedure at 100%, others at 50%.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical0Physician service: no professional/technical split.

What modifiers do to the payment

Modifier 51 · payment effect

With and without the modifier

93654 without 51 · national facility

$857.40

VT ablation

93654-51 · Second procedure: 50%

$428.70

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%).

When to use modifier 51

93654 compared with similar codes

Compare codes

93654 vs 93653 vs 93656 vs 93655 vs 93619: national Medicare rates

Swap in your local Medicare rate.

  • 93654
    VT ablation · 17.65 wRVU
    —
  • 93653
    SVT ablation · 14.63 wRVU
    —
  • 93656
    AF ablation · 16.58 wRVU
    —
  • 93655
    Catheter ablation · 5.36 wRVU
    —
  • 93619
    · 0 wRVU
    —

How to choose

93653SVT ablation
Choose 93653 when the ablation treats supraventricular tachycardia; choose 93654 when it treats ventricular tachycardia.
93656AF ablation
93656 describes comprehensive EP evaluation and ablation for atrial fibrillation, not VT.
93655Catheter ablation
93655 is an add-on for a distinct additional arrhythmia mechanism treated during a primary ablation procedure; it does not replace 93654 for VT ablation.
93619Comprehensive ep evaluation
93619 represents comprehensive EP evaluation without the VT ablation included in 93654.

93654 billing questions

How does 93654 differ from 93653?

93654 is for catheter ablation treating ventricular tachycardia. Use 93653 for comprehensive EP evaluation and ablation treating supraventricular tachycardia.

Can 93654 be reported with 93613?

93613 may be reported when intracardiac three-dimensional electroanatomic mapping is performed and documented. The record should support the mapping service in addition to the VT ablation.

Can 93655 be added to 93654?

93655 is an add-on for ablation of an additional, distinct arrhythmia mechanism. It is not for additional lesions used to treat the same VT mechanism.

Should modifier 50 be used for VT ablation?

No. CMS identifies bilateral adjustment as inappropriate for this code, so modifier 50 is not appropriate.

What documentation supports 93654?

The procedure report should identify VT as the arrhythmia treated and describe the comprehensive EP evaluation, catheter mapping or localization, and ablation performed. Assistant-at-surgery payment requires documentation of medical necessity.

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
RVUs for 93654PPRRVU2026_Oct_nonQPP.csv, line 12,242 (RVU26D)

Open CMS sourceHow we calculate rates

Did this answer your question about what 93654 pays in Washington?

Tell us what you were actually trying to work out. We’ll answer you directly, or build the page that does.

Fee sheets

Put 93654 and the rest of your codes on one sheet

Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.

Build my fee sheetOr price your code list free →