Billing code 93657: AF ablationMedicare rate & RVUs in Washington
Reports additional linear or focal left or right atrial ablation for atrial fibrillation after pulmonary vein isolation during a catheter ablation procedure.
CMS doesn’t publish an office rate for 93657 in Washington.
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 93657 covers
Code 93657 describes additional catheter-based ablation in the left or right atrium to treat atrial fibrillation after pulmonary vein isolation has been completed. An electrophysiologist typically performs this work in an electrophysiology lab during an AF ablation, creating additional linear lesions or ablating focal targets beyond the pulmonary vein isolation itself.
Report 93657 as an add-on with the primary procedure, typically 93656; it is not reported by itself. The record should establish that pulmonary vein isolation was completed and describe the additional atrial ablation performed for AF, including the treated chamber and lesion or target. Medicare pays this add-on within the primary procedure’s global period.
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 93657 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | Unavailable | $255.14 |
| Seattle (King Cnty) | Unavailable | $271.00 |
How the 93657 rate is calculated
Each of 93657’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 · 93657
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 5.36Practice expense 1.18Malpractice 1.27
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 93657
The CMS indicators that decide how 93657 is paid alongside other services.
CMS payment indicators · 93657
AF ablation
| Rule | CMS value | What it means |
|---|---|---|
| Global period | ZZZ | Add-on code: falls within the primary procedure’s global period. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| 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. |
93657 compared with similar codes
Compare codes
93657 vs 93656 vs 93655 vs 93653 vs 93654: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 93656AF ablation
- 93656 reports the primary AF ablation with pulmonary vein isolation. Use 93657 for additional linear or focal atrial ablation for AF performed after that isolation.
- 93655Catheter ablation
- 93655 addresses ablation of a distinct arrhythmia mechanism. 93657 is specific to additional left or right atrial ablation for AF after pulmonary vein isolation.
- 93653SVT ablation
- 93653 is for comprehensive ablation treating supraventricular tachycardia; 93657 is an add-on for additional AF ablation following pulmonary vein isolation.
- 93654VT ablation
- 93654 is for comprehensive ablation treating ventricular tachycardia. 93657 describes additional atrial ablation for AF after pulmonary vein isolation.
93657 billing questions
Can 93657 be reported without 93656?
No. It is an add-on code and must be billed with a primary procedure; 93656 is the primary AF ablation code associated with this additional work.
How is 93657 different from 93655?
93657 describes additional left or right atrial ablation for AF after pulmonary vein isolation. 93655 is used for ablation of a distinct arrhythmia mechanism during an electrophysiology procedure.
What documentation supports reporting 93657?
Document completion of pulmonary vein isolation and the additional linear or focal ablation performed for AF, including the atrial site and target.
Does every lesion after pulmonary vein isolation support 93657?
The additional work must be linear or focal atrial ablation performed to treat AF after pulmonary vein isolation. The record should identify that work rather than merely list lesion counts.
How does Medicare treat the add-on payment?
Medicare requires 93657 to be billed with a primary procedure and pays it within that procedure’s global period.
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
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