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 |
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 | $1944.43 | 1942685037 - PRAKASH MISHRA | 363305449 - (IL) MOUNT SINAI COMMUNITY FOUNDATION | IL | Psychiatry Physician (2084P0800X) |
United | 93461 | $748.78 | 1134741028 - SHAHZAIB KHAN | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IL | Psychiatry Physician (2084P0800X) |
United | 93461 | $913.15 | 1942650130 - MALIK NASSAN | 362679194 - (IL) HEAD & NECK AND COSMETIC SURGERY ASSOCIATES, LLC | MN | Psychiatry Physician (2084P0800X) |
United | 93461 | $1967.09 | 1306340880 - GEORGE GIANAKAKOS | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | IL | Psychiatry Physician (2084P0800X) |
United | 93461 | $495.14 | 1922111657 - CLINT ANTHONY | 208106540 - DISTRICT MEDICAL GROUP INC | IL | Psychiatry Physician (2084P0800X) |
United | 93461 | $2617.55 | 1225211600 - JOHN MILLICHAP | 260899565 - MERCY SPECIALTY CLINIC | CO | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 93461 | $1738.81 | 1669678009 - NADIA MIRZA | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IL | Psychiatry Physician (2084P0800X) |
United | 93461 | $2426.15 | 1356352447 - MARLA HARTZEN | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IL | Psychiatry Physician (2084P0800X) |
United | 93461 | $2412.08 | 1083622955 - ALMA BICKNESE | 363279680 - (IL) PEDIATRIC FACULTY FOUNDATION IN | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 93461 | $2295.95 | 1730214206 - KALYANI GAVINI | 371158318 - (IL) SOUTHERN ILLINOIS HEALTHCARE FOUNDATION INC | IL | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 93461 | $3342.13 | 1659714806 - RAVI RAMASAMY | 911336707 - THE ASSOCIATION OF CHRMC AND UNIVERSITY PHYSICIANS | IL | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 93461 | $728.09 | 1063972404 - MAANASA BANDLA | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | MA | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 93461 | $1420.45 | 1437438249 - KAPIL AEDMA | 430957840 - SWOPE HEALTH SERVICES | MO | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 93461 | $1883.90 | 1639673916 - BISHOY GOUBRAN | 911780160 | IL | Psychiatry Physician (2084P0800X) |
United | 93461 | $1270.75 | 1144420365 - ALMA RAMIC | 366006541 - (IL) VETERANS ASSISTANCE COMMISSION C | 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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