CPT 93596 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 93596 by major payers:
$1,510.31
$512.66
$1,496.40
$1,048.47
| 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 93596 | ||||||
United | 93596 | $813.66 | 1073502985 - CHU CHEN | 42484572 - (MA) MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC. | MA | Pediatrics Physician (208000000X) |
United | 93596 | $371.55 | 1114905429 - CHAD ALFORD | 631159436 - (AL) MOBILE HEART SPECIALISTS, P.C. | AL | Interventional Cardiology Physician (207RI0011X) |
United | 93596 | $570.04 | 1043266919 - ERIK EWAYS | 630889615 - (AL) CARDIOLOGY ASSOCIATES OF MOBILE, INC. | AL | Interventional Cardiology Physician (207RI0011X) |
United | 93596 | $377.52 | 1780648394 - WILLIAM HILL | 630837257 - (AL) CARDIOLOGY CONSULTANTS, P.C. | AL | Interventional Cardiology Physician (207RI0011X) |
United | 93596 | $371.55 | 1497966287 - JAMES TOWERY | 631119002 - (AL) BIRMINGHAM HEART CLINIC, PC | AL | Interventional Cardiology Physician (207RI0011X) |
United | 93596 | $0.01 | 1164737490 - MOHAN EDUPUGANTI | 452867352 - INTEGRIS CARDIOVASCULAR PHYSICIANS LLC | MO | Interventional Cardiology Physician (207RI0011X) |
United | 93596 | $371.55 | 1104037027 - JOSHUA COCKRELL | 631119002 - (AL) BIRMINGHAM HEART CLINIC, PC | AL | Interventional Cardiology Physician (207RI0011X) |
United | 93596 | $326.04 | 1124414958 - AREEN AL-TAIE | 630779298 - (AL) HEART HEALTH CENTER, PC | AL | Interventional Cardiology Physician (207RI0011X) |
United | 93596 | $813.66 | 1073502985 - CHU CHEN | 42484572 - (MA) MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC. | MA | Pediatrics Physician (208000000X) |
United | 93596 | $335.10 | 1457345910 - BRADLEY SMITH | 561079264 - EMERGEORTHO, P.A. | NC | Orthopaedic Surgery Physician (207X00000X) |
United | 93596 | $335.10 | 1457345910 - BRADLEY SMITH | 561079264 - EMERGEORTHO, P.A. | NC | Orthopaedic Surgery Physician (207X00000X) |
United | 93596 | $343.20 | 1285668699 - PAUL MOORE | 630691533 - (AL) MONTGOMERY CARDIOVASCULAR ASSOCIATES, P.C. | AL | Interventional Cardiology Physician (207RI0011X) |
United | 93596 | $677.77 | 1174781017 - KEVIN DEANDRADE | 631159436 - (AL) MOBILE HEART SPECIALISTS, P.C. | AL | Interventional Cardiology Physician (207RI0011X) |
United | 93596 | $371.57 | 1598729105 - JEFFREY ANDERSON | 630837257 - (AL) CARDIOLOGY CONSULTANTS, P.C. | AL | Interventional Cardiology Physician (207RI0011X) |
United | 93596 | $481.33 | 1164493367 - ALEJANDRO VASQUEZ | 823333903 - HUNTSVILLE HOSPITAL PROFESSIONAL SERVICES | AL | Interventional Cardiology Physician (207RI0011X) |
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 93596 vs. Other Cardiovascular Procedures Codes
The CPT 93596 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 93596 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 |
| 93593-CPT | Moderate | Right Heart Catheterization For Congenital Heart Defect(S) Including Imaging Guidance By The Pro- Ceduralist To Advance The Catheter To The Target Zone; Normal Native Connections |
| 93596-CPT | High | Right And Left Heart Catheterization For Congeni- Tal Heart Defect(S) Including Imaging Guidance By The Proceduralist To Advance The Catheter To The Target Zone(S); Normal 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 93596. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 93596 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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