CPT 93581 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 | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • GC - Service performed by resident under supervision • 80 - Assistant surgeon |
| Complexity Level | High |
National average reimbursement for CPT 93581 by major payers:
$1,761.19
$1,784.87
$1,742.60
$2,115.96
| 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 93581 | ||||||
United | 93581 | $13891.00 | 1568553519 - SILVER CROSS HOSPITAL & MEDICAL CENTERS, SILVER CROSS HOSPITAL | 362174832 - (IL) SILVER CROSS HOSPITAL & MEDICAL CENTERS | IL | General Acute Care Hospital (282N00000X) |
United | 93581 | $13084.00 | 1174553598 - WELLMONT HAWKINS COUNTY MEMORIAL HOSPITAL INC, HAWKINS COUNTY MEMORIAL HOSPITAL | 621816368 - (TN) WELLMONT HAWKINS COUNTY MEMORIAL HOSPITAL INC | TN | General Acute Care Hospital (282N00000X) |
United | 93581 | $16621.00 | 1427064641 - CLINTON MEMORIAL HOSPITAL OF WILMINGTON CLINTON COUNTY OHIO, CMH REGIONAL HEALTH SYSTEM | 273633811 | OH | Rural Acute Care Hospital (282NR1301X) |
United | 93581 | $31392.00 | 1124218367 - METHODIST HEALTHCARE SYSTEM OF SAN ANTONIO LTD LLP, METHODIST SPECIALTY AND TRANSPLANT HOSPITAL | 742730328 | TX | General Acute Care Hospital (282N00000X) |
United | 93581 | $13880.00 | 1700826575 - SOMERVELL COUNTY HOSPITAL DISTRICT, GLEN ROSE MEDICAL CENTER | 463085950 - (TX) SOMERVELL COUNTY HOSPITAL DISTRICT | TX | Rural Acute Care Hospital (282NR1301X) |
United | 93581 | $11693.00 | 1386796670 - ST. ANTHONY'S HOSPITAL ASSOCIATION, ST. VINCENT MORRILTON | 710245507 - (AR) ST ANTHONYS HOSPITAL ASSOCIATION | AR | Critical Access Hospital (282NC0060X) |
United | 93581 | $6818.00 | 1942685920 - SSM-SLUH INC, SSM HEALTH SAINT LOUIS UNIVERSITY HOSPITAL | 474196634 - (MO) SSM-SLUH INC | MO | General Acute Care Hospital (282N00000X) |
United | 93581 | $22967.00 | 1538173372 - THE MOUNT VERNON HOSPITAL | 462916938 - (NY) MONTEFIORE MOUNT VERNON HOSPITAL | NY | General Acute Care Hospital (282N00000X) |
United | 93581 | $26424.00 | 1558877787 - LONGMONT UNITED HOSPITAL, CENTURA LONGMONT UNITED HOSPITAL | 840460697 - LONGMONT UNITED HOSPITAL | CO | General Acute Care Hospital (282N00000X) |
United | 93581 | $7524.00 | 1225289499 - LUBBOCK HERITAGE HOSPITAL, LLC., GRACE SURGICAL HOSPITAL | 264021016 - (TX) LUBBOCK HERITAGE HOSPITAL LLC | TX | General Acute Care Hospital (282N00000X) |
United | 93581 | $12661.00 | 1477644284 - VILLE PLATTE MEDICAL CENTER, LLC, ACADIAN MEDICAL CENTER, A CAMPUS OF MERCY REGIONAL MEDICAL CENTER | 825359949 | LA | Rural Acute Care Hospital (282NR1301X) |
United | 93581 | $7262.00 | 1649381682 - O'CONNOR HOSPITAL | 946000533 | CA | General Acute Care Hospital (282N00000X) |
United | 93581 | $6947.00 | 1487771812 - CENTENNIAL HILLS HOSPITAL MEDICAL CENTER | 204993360 | NV | General Acute Care Hospital (282N00000X) |
United | 93581 | $987.00 | 1063571107 - CHICOT MEMORIAL HOSPITAL | 383807713 - (AR) CHICOT MEMORIAL MEDICAL CENTER | AR | Critical Access Hospital (282NC0060X) |
United | 93581 | $14164.00 | 1649226952 - ANDERSON REGIONAL MEDICAL CENTER, ANDERSON REGIONAL MEDICAL CENTER | 640362400 - (MS) ANDERSON REGIONAL MEDICAL CENTER | MS | 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 93581 vs. Other Cardiovascular Procedures Codes
The CPT 93581 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 93581 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 |
|---|---|---|
| 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 |
| 93583-CPT | High | Percutaneous Transcatheter Septal Reduction Therapy (Eg Alcohol Septal Ablation) Including Temporary Pacemaker Insertion When Performed |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 93581. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 93581 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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