CPT 93656 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 • GC - Service performed by resident under supervision • 59 - Distinct Procedural Service |
| Complexity Level | High |
National average reimbursement for CPT 93656 by major payers:
$1,443.83
$1,561.37
$1,457.46
$1,678.60
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
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CPT 93656 vs. Other Cardiovascular Procedures Codes
The CPT 93656 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 93656 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 |
|---|---|---|
| 93653 | High | Comprehensive Electrophysiologic Evaluation With Insertion And Repositioning Of Multiple Electrode Catheters Induction Or Attempted Induction Of An Arrhythmia With Right Atrial Pacing And Recording And Catheter Ablation Of Arrhythmogenic Focus Including Intracardiac Electrophysiologic 3-Dimensional Mapping Right Ventricular Pacing A And Recording Left Atrial Pacing And Recording From Coronary Sinus Or Left Atrium And His Bundlerecording When Performed; With (Desc Rvsd 1/1/22) |
| 93654 | High | Comprehensive Electrophysiologic Evaluation With Insertion And Repositioning Of Multiple Electrode Catheters With Induction Or Attempted Induction Of An Arrhythmia With Right Atrial Pacing And Recording And Catheter Ablation Of Arrhythmogenic Focus Including Intracardiac Electrophysiologic 3-Dimensional Mapping Right Ventricular Pacing And Recording Left Atrial Pacing And Recording From Coronary Sinus Or Left Atrium And His Bundle (Desc Rvsd 1/1/22) |
| 93655 | Moderate | Intracardiac Catheter Ablation Of A Discrete Mechanism Of Arrhythmia Which Is Distinct From From The Primary Ablated Mechanism Including Repeat Diagnostic Maneuvers To Treat A Spontaneous Or Induced Arrhythmia (List Separatelyaddition To Code For Primary Procedure) |
| 93656 | High | Comprehensive Electrophysiologic Evaluation Including Transseptal Catheterizations Insertion And Repositioning Of Multiple Electrode Catheters With Intracardiac Catheter Ablation Of Atrial Fibrillation By Pulmonary Vein Isolation Includ- Ing Intracardiac Electrophysiologic 3-Dimensional Mapping Intracardiac Echocardiography Including Imaging Supervision And Interpretation Induction Or Attempted Induction Of An Arrhythmia Including Left Or Right Atrial Pacing/ (Desc Rvsd 1/1/22) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 93656. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 93656 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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Medicare Reimbursement Lookup Tool
Medicare localities are geographic regions used to adjust reimbursement rates based on local costs. Rates vary by locality to reflect differences in wages, rent, and other expenses. Sign up to see commercial rates (United/BCBS/Cigna/Aetna)
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| Year | Billing Code | Locality | Non-Facility Fee | Facility Fee |
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