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See a sample rate comparisonHealthcare 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 | 26 - Professional component 59 - Distinct Procedural Service |
| Complexity Level | High |
| Medicare Fee Schedule | $315.64 national non-facility rate (2026) · View Medicare rates for 93596 |
| Medicaid Fee Schedule | $383.72 median of the 6 states in the free preview · View Medicaid rates for 93596 |
National average reimbursement for CPT 93596 by major payers:

$1,510.31

$512.66

$1,496.40

$983.47
Choose a payer to see a sample of rates for CPT 93596.
Texas Health Presbyterian Hospital Kaufman, Texas Health Kaufman Midwife Care Center
Texas Health Presbyterian Hospital Kaufman
Ascension Seton, Ascension Seton Medical Center Austin
Ascension Seton
Alejandro Vasquez
Huntsville Hospital Professional Services
William Hill
Cardiology Consultants, P.C.
Mohan Edupuganti
Integris Cardiovascular Physicians LLC
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Rate Benchmarking
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See a sample rate comparisonPayer Contract Negotiation
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 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 |
|---|---|---|
| 93593-CPT | Moderate | 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 Zonenormal Native Connections |
| 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 |
| 93595-CPT | High | Left Heart Catheterization For, Left Heart Catheterization For Congenital Heart Defect(S) Including Imaging Guidance By The Proceduralist To Advance The Catheter To The Target Zone Normal Or Abnormal Native Connections |
| 93596-CPT | High | Right And Left Heart Catheteri, Right And Left Heart Catheterization For Congenital 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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