CPT 93580 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 • GC - Service performed by resident under supervision • 74 - Discontinued After Anesthesia |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 93580 |
National average reimbursement for CPT 93580 by major payers:
$1,296.63
$1,321.73
$1,403.88
$1,566.31
| 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 93580 | ||||||
United | 93580 | $32000.00 | 1548854524 - CFHS SUB I, LLC, UCF LAKE NONA HOSPITAL | 854247323 - (FL) CFHS SUB I LLC | FL | General Acute Care Hospital (282N00000X) |
United | 93580 | $21016.00 | 1265539498 - BAPTIST HEALTHCARE SYSTEM INC., BAPTIST HEALTH LOUISVILLE | 610444707 - BAPTIST HEALTHCARE SYSTEM INC | KY | General Acute Care Hospital (282N00000X) |
United | 93580 | $8095.00 | 1215030697 - NEW YORK COMMUNITY HOSPITAL OF BROOKLYN INC | 111986351 - NEW YORK COMMUNITY HOSPITAL OF BROOKLYN INC | NY | General Acute Care Hospital (282N00000X) |
United | 93580 | $9662.00 | 1144675745 - THEDACARE MEDICAL CENTER, NEW LONDON FAMILY MEDICAL CENTER, INC | 390869788 - (WI) THEDACARE MEDICAL CENTER NEW LONDON INC | WI | Critical Access Hospital (282NC0060X) |
United | 93580 | $6939.00 | 1790747491 - SAINT BARNABAS OUTPATIENT CENTERS, RADIOLOGY IMAGING BREAST CENTER | 222458479 - (NJ) SAINT BARNABAS OUTPATIENT CENTERS | NJ | Radiology Clinic/Center (261QR0200X) |
United | 93580 | $1573.00 | 1215190202 - HARRIS COUNTY HOSPITAL DISTRICT BEN TAUB | 741536936 | TX | General Acute Care Hospital (282N00000X) |
United | 93580 | $24508.09 | 1225077035 - KAY COUNTY OKLAHOMA HOSPITAL COMPANY LLC, ALLIANCEHEALTH PONCA CITY | 932949739 | OK | General Acute Care Hospital (282N00000X) |
United | 93580 | $30164.00 | 1790297547 - HMH HOSPITALS CORPORATION, JERSEY SHORE UNIVERSITY MEDICAL CENTER | 221487576 - HACKENSACK MERIDIAN HEALTH INC | NJ | General Acute Care Hospital (282N00000X) |
United | 93580 | $22029.00 | 1093397184 - SPRINGFIELD HEALTH SERVICES, LLC | 854366763 | TN | General Acute Care Hospital (282N00000X) |
United | 93580 | $20821.00 | 1770520462 - THE MIRIAM HOSPITAL | 50258905 - THE MIRIAM HOSPITAL | RI | General Acute Care Hospital (282N00000X) |
United | 93580 | $7606.00 | 1154489797 - SAINT LOUISE REGIONAL HOSPITAL | 946000533 | CA | General Acute Care Hospital (282N00000X) |
United | 93580 | $13906.00 | 1699765453 - MILAN GENERAL HOSPITAL, INC., WEST TENNESSEE HEALTHCARE MILAN HOSPITAL | 621753289 - (TN) MILAN GENERAL HOSPITAL INC | TN | General Acute Care Hospital (282N00000X) |
United | 93580 | $8859.00 | 1154568384 - THE GRIFFIN HOSPITAL | 60647014 - (CT) GRIFFIN HOSPITAL | CT | Radiation Oncology Clinic/Center (261QX0203X) |
United | 93580 | $7835.00 | 1164447850 - PUBLIC HOSPITAL DISTRICT NO 2 SKAGIT COUNTY WASHINGTON, ISLAND HOSPITAL | 910729255 - (WA) PUBLIC HOSPITAL DISTRICT NO 2 | WA | General Acute Care Hospital (282N00000X) |
United | 93580 | $6973.00 | 1679587679 - NEW YORK CITY HEALTH AND HOSPITALS CORPORATION, NORTH CENTRAL BRONX HOSPITAL | 132655001 - NEW YORK CITY HEALTH AND HOSPITALS CORPORATION | NY | General Acute Care Hospital (282N00000X) |
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 93580 vs. Other Cardiovascular Procedures Codes
The CPT 93580 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 93580 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 |
| 93580-CPT | High | Percutaneous Transcatheter Closure Of Congenital Interatrial Communication W/Implant - Dos<01/01/14 Elig Dx=42971,7455,74569,7459:Others=rn Review |
| 93581-CPT | High | Percutaneous Transcatheter Closure Of Congenital Ventricular Septal Defect W/Implant - Dos<01/01/14 Elig Dx=42971,7452,7454,7457-7459:Others=rn Review |
| 93582-CPT | Moderate | Closure Of Congenital Heart Defect From Pulmonary (Lung) Artery To Aorta Via Catheter Accessed Throu |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 93580. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 93580 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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