CPT 93461 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address high-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | • Medicine Services and Procedures • Cardiovascular Procedures |
| Common Place of Service | • 22 - On Campus Outpatient Hospital • 21 - Inpatient Hospital |
| Common Modifiers | • None • 26 - Professional component • 59 - Distinct Procedural Service |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 93461 |
National average reimbursement for CPT 93461 by major payers:
$1,428.70
$1,938.67
$1,937.56
$2,328.90
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 93461 | ||||||
United | 93461 | $726.83 | 1770014920 - JOSEPH PEPITONE | 581672987 - (IL) EDWARD HEALTH VENTURES | VT | Psychiatry Physician (2084P0800X) |
United | 93461 | $1420.45 | 1437438249 - KAPIL AEDMA | 430957840 - SWOPE HEALTH SERVICES | MO | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 93461 | $878.10 | 1760412621 - RHONDA LAMPEN | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | WI | Psychiatry Physician (2084P0800X) |
United | 93461 | $978.09 | 1891921367 - KAVITA THAKKAR | 363279680 - (IL) PEDIATRIC FACULTY FOUNDATION IN | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 93461 | $2221.94 | 1700278546 - VERONIKA HANKO | 363149833 - NORTHWESTERN MEMORIAL HEALTHCARE | IL | Psychiatry Physician (2084P0800X) |
United | 93461 | $776.20 | 1205831393 - PRITI SINGH | 461302245 - (IL) ASSOCIATES IN PEDIATRIC NEUROLOGY SC | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 93461 | $388.79 | 1306391610 - CAMILLA GRANT | 541383504 - TOWN CENTER ORTHOPAEDIC ASSOCIATES, P.C. | VA | Physical Therapist (225100000X) |
United | 93461 | $2905.14 | 1942461231 - ANUPAMA WADHWA | 756002868 | IL | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 93461 | $878.10 | 1740201425 - JOSEPH DIVINCENZO | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | PA | Psychiatry Physician (2084P0800X) |
United | 93461 | $2426.15 | 1033435557 - JESSICA NICHOLSON | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IL | Psychiatry Physician (2084P0800X) |
United | 93461 | $728.09 | 1962664789 - JAMIE EVANS | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | IL | Psychiatry Physician (2084P0800X) |
United | 93461 | $978.09 | 1386800662 - NICHOLAS HATZIS | 364187449 | IL | Psychiatry Physician (2084P0800X) |
United | 93461 | $3645.91 | 1790936540 - SRISHTI NANGIA | 131623978 | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 93461 | $1967.09 | 1689787426 - KAREN SEVERSON | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | MT | Psychiatry Physician (2084P0800X) |
United | 93461 | $2474.28 | 1225285703 - ANDREI PANKOV | 320552496 | IL | Psychiatry Physician (2084P0800X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 93461 vs. Other Cardiovascular Procedures Codes
The CPT 93461 code is part of the Medicine Services and Procedures services used for Cardiovascular Procedures. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 93461 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 93461-CPT | High | Catheter Placement In Coronary Artery(S) For Coronoary Angiography Including Intraprocedural Injection(S) For Coronary Angiography Imaging Supervision And Interpretation; With Right And Left Heart Catheterization Including Intraprocedural Injection(S) For Left Ventriculography When Performed Catheter Placement(S) In Bypass Graft(S) (Internal Mammary Free Arterial Venous Fraft(S) With Bypass Graft Angiography |
| 93462-CPT | Moderate | Left Heart Catheterization By Transseptal Puncture Through Intact Septum Or By Transapical Puncture (List Separately In Addition To Code For Primary Procedure) |
| 93563-CPT | Low | Injection Procedure During Cardiac Catheterization Including Imaging Supervision, Interpretation, And Report; For Selective Coronary Angiography During Congenital Heart Catheterization (List Separately In Addition To Code For Primary Procedure) |
| 93564-CPT | Low | Injection Procdure During Cardiac Catheterization Including Imaging Supervision Interpretation And Report; For Selective Opacification Of Aortocoronary Venous Or Arterial Bypass Graft(S) (Eg Aortocoronary Sapheous Vein Free Radial Artery Or Free Mammary Artery Graft) To One Or More Coronary Arteries And In Situ Arterial Conduits (Eg Internal Mammary) Whether Native Or Used For Bypass To One Or More Coronary Arteries During Congential Heart Catheterization When Performed (List Separately |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 93461. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 93461 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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