CPT 93451
Global 000 ActiveRight heart cath
CPT 93451 Billing & Documentation Guide
CPT code 93451 (Right heart cath) is classified under Cardiovascular with a global period indicator of 000. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 2.41, a non-facility practice expense RVU of 22.66, and a malpractice RVU of 0.42, a total non-facility RVU of 25.49 and facility RVU of 25.49. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $884.04, though rates vary from $737.87 to $1188.27 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 93451, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 93451 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
Endoscopic or minor procedure with related preoperative and postoperative work performed on the same day
MUE Limit (Medically Unlikely Edits)
Submitting more than 1 units of 93451 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 93451
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 2.41 | 2.41 |
| Practice Expense RVU | 22.66 | 22.66 |
| Malpractice RVU | 0.42 | 0.42 |
| Total RVU | 25.49 | 25.49 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 93451
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $986.57 | $986.57 | $918.91 - $1188.27 | 29 |
| Florida | $867.19 | $867.19 | $825.14 - $903.87 | 3 |
| Georgia | $819.45 | $819.45 | $772.34 - $866.56 | 2 |
| Illinois | $838.91 | $838.91 | $793.44 - $883.22 | 4 |
| Michigan | $810.94 | $810.94 | $787.35 - $834.52 | 2 |
| North Carolina | $795.61 | $795.61 | $795.61 - $795.61 | 1 |
| New York | $947.74 | $947.74 | $809.38 - $1011.61 | 5 |
| Ohio | $785.65 | $785.65 | $785.65 - $785.65 | 1 |
| Pennsylvania | $837.57 | $837.57 | $788.55 - $886.58 | 2 |
| Texas | $839.1 | $839.1 | $782.28 - $893.85 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 93451
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 93451 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 01920 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 0213T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0216T | Column 1 (primary), can be billed with modifier | No | Standards of medical/surgical practice |
| 0544T | Column 1 (primary), can be billed with modifier | Yes | CPT Manual or CMS manual coding instruction |
| 0569T | Column 1 (primary), can be billed with modifier | Yes | CPT Manual or CMS manual coding instruction |
| 0570T | Column 1 (primary), can be billed with modifier | Yes | CPT Manual or CMS manual coding instruction |
| 0596T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0597T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0708T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0709T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
Frequently Asked Questions, CPT 93451
What does CPT code 93451 mean? +
CPT code 93451 represents: Right heart cath. It's in the Cardiovascular category with a global period of 000.
What is the Medicare reimbursement for CPT 93451? +
The 2026 Medicare national average non-facility payment for CPT 93451 is $884.04. Rates range from $737.87 to $1188.27 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 93451? +
Medicine section spans a wide range: therapy services use GP/GO/GN (PT/OT/SLP plans of care) and KX (above cap with documentation). Drug administration uses JW (waste) and JZ (no waste). Professional/technical split applies to some diagnostic codes.
What bundling edits apply to CPT 93451? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
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