CPT 93505 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | Cardiac Catheterization and Associated Procedures Cardiac Catheterization Procedures |
| Common Place of Service | 22 - On Campus Outpatient Hospital 21 - Inpatient Hospital |
| Common Modifiers | None 26 - Professional component GC - Service performed by resident under supervision |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 93505 |
National average reimbursement for CPT 93505 by major payers:
$670.82
$896.11
$974.07
$1,058.80
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
United | 93505 | $313.60 | 1255692794 - MELISSA WAGNER-SCHUMAN | 376000511 - THE BOARD OF TRUSTEES OF THE UNIVERSITY OF ILLINOIS | IL | Psychiatry Physician (2084P0800X) |
United | 93505 | $542.65 | 1750451472 - POONAM JHA | 205734385 | IL | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 93505 | $1109.75 | 1255478004 - CHRISTOPHER RAIO | 113438973 - ST JOSEPH HOSPITAL | NY | Emergency Medicine Physician (207P00000X) |
United | 93505 | $985.50 | 1992234611 - USHA APPALANENI | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 93505 | $1282.26 | 1952314106 - MORRIS GOLDMAN | 363097297 - NORTHWESTERN MEMORIAL HEALTHCARE | IL | Psychiatry Physician (2084P0800X) |
United | 93505 | $2441.58 | 1962791343 - JEREMY WONG | 742161737 - UNIVERSITY PHYSICIANS INCORPORATED | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 93505 | $1263.31 | 1356397210 - M SHEIKH | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IL | Psychiatry Physician (2084P0800X) |
United | 93505 | $1094.21 | 1104020866 - JAMIE PACIS | 363149833 - NORTHWESTERN MEMORIAL HEALTHCARE | IL | Psychiatry Physician (2084P0800X) |
United | 93505 | $913.14 | 1174859284 - MATTHEW NIEDZWIECKI | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | RI | Psychiatry Physician (2084P0800X) |
United | 93505 | $472.07 | 1841571841 - OMOTOLA AJIBADE | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | GA | Psychiatry Physician (2084P0800X) |
United | 93505 | $368.64 | 1699752394 - DAVID LOTT | 581672987 - (IL) EDWARD HEALTH VENTURES | IL | Psychiatry Physician (2084P0800X) |
United | 93505 | $209.83 | 1700162278 - ALABAMA HEART & VASCULAR, P. C. | 452803595 - (AL) ALABAMA HEART AND VASCULAR, P.C. | AL | Interventional Cardiology Physician (207RI0011X) |
United | 93505 | $751.61 | 1710969001 - LYNELLE THOMAS | 911780160 | IL | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 93505 | $542.65 | 1417900168 - SUNILA OCONNOR | 363279680 - (IL) PEDIATRIC FACULTY FOUNDATION IN | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 93505 | $1486.22 | 1134236565 - WARREN KAMMERER | 611549647 - (IL) WARREN KAMMERER MD SC | 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 93505 vs. Other Cardiac Catheterization Procedures Codes
The CPT 93505 code is part of the Cardiac Catheterization and Associated Procedures services used for Cardiac Catheterization 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 93505 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 |
|---|---|---|
| 93503-CPT | Low | Insrt & Placemnt Of Flow Direct Cathet (Eg Swan-Ganz) For, Insertion And Placement Of Flow Directed Catheter (Eg Swan-Ganz) For |
| 93505-CPT | Moderate | Biopsy Of Heart Wall, A Sample Of Tissue From The Wall Dividing The Two Sides Of The Heart Is Removed By Inserting A Catheter Into A Leg Artery And Guiding It Up Into The Heart. The Tissue Sample Is Tested In A Lab. |
| 93563-CPT | Low | Njx Cgen Car Cth Slctv C Ang, 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 |
| 93594-CPT | High | Right Heart Catheterization Fo, Right Heart Catheterization For Congenital Heart Defect(S) Including Imaging Guidance By The Proceduralist To Advance The Catheter To The Target Zoneabnormal Native Connections |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 93505. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 93505 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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