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See a sample rate comparisonCPT 93597 Fee Schedule
Last Verified: October 2026
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.
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) Abnormal Native Connections
| 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 | $409.16 national non-facility rate (2026) · View Medicare rates for 93597 |
| Medicaid Fee Schedule | $506.705 median of the 6 states in the free preview · View Medicaid rates for 93597 |
National average reimbursement for CPT 93597 by major payers:
$1,479.21
$710.54
$2,404.58
$1,448.89
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CPT 93597
5 of 25 sample ratesHigher to lower in this preview
Texas Health Presbyterian Hospital Plano
$12,044.00Published rateZakaria Almuwaqqat
Emory University
$4,208.08Published rateFakhir Elmasri
University Of Miami
$862.61Published rateGeorge Hemstreet
Bama Heart Doc, PC Dba Alabama Heart & Vascular Medicine
$535.17Published rateCabrini Sutherland
Surgical Specialists Of Charlotte, PA
$0.02Published rate
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See a sample payer proposalCPT 93597 vs. Other Cardiovascular Procedures Codes
The CPT 93597 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 93597 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 |
|---|---|---|
| 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 |
| 93597-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) 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 93597. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 93597 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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