CPT 93455
Global 000 ActiveCoronary art/grft angio s&i
CPT 93455 Billing & Documentation Guide
CPT code 93455 (Coronary art/grft angio s&i) is classified under Cardiovascular with a global period indicator of 000. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 5.16, a non-facility practice expense RVU of 23.08, and a malpractice RVU of 1.08, a total non-facility RVU of 29.32 and facility RVU of 29.32. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $1011.28, though rates vary from $853.12 to $1322.27 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 93455, 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 93455 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 93455 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 93455
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 5.16 | 5.16 |
| Practice Expense RVU | 23.08 | 23.08 |
| Malpractice RVU | 1.08 | 1.08 |
| Total RVU | 29.32 | 29.32 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 93455
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 | $1110.27 | $1110.27 | $1039.51 - $1322.27 | 29 |
| Florida | $1016.03 | $1016.03 | $963.54 - $1066.08 | 3 |
| Georgia | $951.2 | $951.2 | $902.98 - $999.42 | 2 |
| Illinois | $986.76 | $986.76 | $932.56 - $1031.09 | 4 |
| Michigan | $946.99 | $946.99 | $916.9 - $977.08 | 2 |
| North Carolina | $914.64 | $914.64 | $914.64 - $914.64 | 1 |
| New York | $1089.57 | $1089.57 | $930.06 - $1166.96 | 5 |
| Ohio | $912.54 | $912.54 | $912.54 - $912.54 | 1 |
| Pennsylvania | $967.56 | $967.56 | $914.12 - $1020.99 | 2 |
| Texas | $965.75 | $965.75 | $907.37 - $1020.26 | 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 93455
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 93455 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 |
| 01924 | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 01925 | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 01926 | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 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 |
| 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 |
| 0632T | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
Frequently Asked Questions, CPT 93455
What does CPT code 93455 mean? +
CPT code 93455 represents: Coronary art/grft angio s&i. It's in the Cardiovascular category with a global period of 000.
What is the Medicare reimbursement for CPT 93455? +
The 2026 Medicare national average non-facility payment for CPT 93455 is $1011.28. Rates range from $853.12 to $1322.27 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 93455? +
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 93455? +
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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