CPT 93563
Global ZZZ ActiveNjx cgen car cth slctv c ang
CPT 93563 Billing & Documentation Guide
CPT code 93563 (Njx cgen car cth slctv c ang) is classified under Cardiovascular with a global period indicator of ZZZ. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 0.98, a non-facility practice expense RVU of 0.37, and a malpractice RVU of 0.16, a total non-facility RVU of 1.51 and facility RVU of 1.33. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $50.87, though rates vary from $46.1 to $65.21 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 93563, 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 93563 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
Add-on code (global concept does not apply)
MUE Limit (Medically Unlikely Edits)
Submitting more than 1 units of 93563 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 93563
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 0.98 | 0.98 |
| Practice Expense RVU | 0.37 | 0.19 |
| Malpractice RVU | 0.16 | 0.16 |
| Total RVU | 1.51 | 1.33 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 93563
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 | $51.43 | $44.31 | $49.7 - $57.02 | 29 |
| Florida | $55.53 | $49.5 | $52.58 - $59.11 | 3 |
| Georgia | $50.97 | $45.23 | $50.13 - $51.81 | 2 |
| Illinois | $55 | $49.19 | $52.37 - $57.65 | 4 |
| Michigan | $51.86 | $46.22 | $50.05 - $53.67 | 2 |
| North Carolina | $47.68 | $42.07 | $47.68 - $47.68 | 1 |
| New York | $55.34 | $48.63 | $48.23 - $59.45 | 5 |
| Ohio | $49.4 | $43.91 | $49.4 - $49.4 | 1 |
| Pennsylvania | $50.85 | $44.96 | $49.13 - $52.56 | 2 |
| Texas | $50.04 | $44.12 | $48.94 - $52.62 | 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 93563
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 93563 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 |
| 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 |
Frequently Asked Questions, CPT 93563
What does CPT code 93563 mean? +
CPT code 93563 represents: Njx cgen car cth slctv c ang. It's in the Cardiovascular category with a global period of ZZZ.
What is the Medicare reimbursement for CPT 93563? +
The 2026 Medicare national average non-facility payment for CPT 93563 is $50.87. Rates range from $46.1 to $65.21 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 93563? +
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 93563? +
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 June 1, 2026.
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