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 | • Medicine Services and Procedures • Cardiovascular 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
$1,083.35
| 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 93505 | ||||||
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 Cardiovascular Procedures Codes
The CPT 93505 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 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 | Catheterizat Hrt Rt+Swan-Ganz Cath |
| 93505-CPT | Moderate | Endomyocardial Biopsy |
| 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) |
| 93594-CPT | High | Right Heart Catheterization For Congenital Heart Defect(S) Including Imaging Guidance By The Pro- Ceduralist To Advance The Catheter To The Target Zone; Abnormal 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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