CPT 93609 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-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 | Moderate |
| Medicare Fee Schedule | View Medicare rates for 93609 |
National average reimbursement for CPT 93609 by major payers:
$453.55
$562.78
$477.28
$632.17
| 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 93609 | ||||||
United | 93609 | $1019.46 | 1073502985 - CHU CHEN | 42484572 - MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC. | MA | Pediatrics Physician (208000000X) |
United | 93609 | $64.97 | 1972580322 - FRANCELIS GONZALEZ | 472763901 - (FL) FAMILY TREE MEDICAL GROUP PA | FL | Pediatrics Physician (208000000X) |
United | 93609 | $547.64 | 1457883878 - ALEXANDER TURFE | 273143717 | MI | Pain Medicine (Physical Medicine & Rehabilitation) Physician (2081P2900X) |
United | 93609 | $262.13 | 1477983385 - ASMITA AMBARDEKAR | 541383504 - TOWN CENTER ORTHOPAEDIC ASSOCIATES, P.C. | VA | Physical Therapist (225100000X) |
United | 93609 | $633.14 | 1558326736 - NAFI AYGUN | 593238640 - H LEE MOFFITT CANCER CTR & RES INST LIFE TIME CANCER SCRN CTR INC | FL | Diagnostic Radiology Physician (2085R0202X) |
United | 93609 | $525.26 | 1992911457 - JAMIE LOEHRKE | 822768899 - BEAUMONT MEDICAL GROUP - HOSPITAL-BASED SERVICES | MI | Obstetrics & Gynecology Physician (207V00000X) |
United | 93609 | $560.27 | 1710206545 - NEIL JARIWALA | 910844563 | TX | Psychiatry Physician (2084P0800X) |
United | 93609 | $232.41 | 1386732675 - JOSE GABRIEL MILLAR | 721549711 | TX | Pediatrics Physician (208000000X) |
United | 93609 | $464.45 | 1225211600 - JOHN MILLICHAP | 262037695 - GRADY MEMORIAL HOSPITAL CORPORATION | NC | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 93609 | $422.47 | 1487009593 - RACHEL NEWMAN | 760459500 - U T PHYSICIANS | TX | Maternal & Fetal Medicine Physician (207VM0101X) |
United | 93609 | $123.70 | 1639171986 - ROSS COHEN | 592485899 | FL | Urology Physician (208800000X) |
United | 93609 | $65.87 | 1457365637 - CHARLES SEAL | 541383504 - TOWN CENTER ORTHOPAEDIC ASSOCIATES, P.C. | VA | Orthopaedic Surgery Physician (207X00000X) |
United | 93609 | $290.51 | 1114333671 - KEDAR SHARBIDRE | 850214117 - RADIOLOGY ASSOCIATES OF ALBUQUERQUE , P.A. | AL | Diagnostic Radiology Physician (2085R0202X) |
United | 93609 | $244.22 | 1700956414 - CHARLES WELLY | 455310838 - (VA) UNIVERSAL HEALTH CORPORATION | VA | Family Medicine Physician (207Q00000X) |
United | 93609 | $273.04 | 1629502513 - ELAINE AQUINO | 270858619 - (FL) ACCORD MEDICAL GROUP, PLLC | FL | Internal Medicine Physician (207R00000X) |
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 93609 vs. Other Cardiovascular Procedures Codes
The CPT 93609 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 93609 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 |
|---|---|---|
| 93609-CPT | Moderate | Intraventricular And/Or Intra-Atrial Mapping Of Tachycardia Site(S) With Catheter Manipulation To Record From Multiple Sites To Identify Origin Of Tachycardia (List Separately In Addition To Code For Primary Procedure) |
| 93610-CPT | High | Intra-Atrial Pacing |
| 93612-CPT | High | Intraventricular Pacing |
| 93613-CPT | Moderate | Intracardiac Electrophysiologic 3-Dimensional Mapping (List Separately In Addition To Code For Primary Procedure) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 93609. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 93609 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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