CPT 93564
Global ZZZ ActiveNjx cgen car cath slctv opac
CPT 93564 Billing & Documentation Guide
CPT code 93564 (Njx cgen car cath slctv opac) is classified under Cardiovascular with a global period indicator of ZZZ. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 1, a non-facility practice expense RVU of 0.37, and a malpractice RVU of 0.23, a total non-facility RVU of 1.6 and facility RVU of 1.42. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $53.56, though rates vary from $47.61 to $67.5 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 93564, 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 93564 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 93564 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 93564
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 1 | 1 |
| Practice Expense RVU | 0.37 | 0.19 |
| Malpractice RVU | 0.23 | 0.23 |
| Total RVU | 1.6 | 1.42 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 93564
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 | $53.39 | $46.27 | $51.63 - $59.01 | 29 |
| Florida | $60.75 | $54.72 | $56.76 - $65.69 | 3 |
| Georgia | $54.43 | $48.7 | $53.58 - $55.28 | 2 |
| Illinois | $60.14 | $54.33 | $56.69 - $63.69 | 4 |
| Michigan | $55.82 | $50.18 | $53.36 - $58.28 | 2 |
| North Carolina | $49.84 | $44.23 | $49.84 - $49.84 | 1 |
| New York | $59.21 | $52.51 | $50.54 - $64.5 | 5 |
| Ohio | $52.43 | $46.94 | $52.43 - $52.43 | 1 |
| Pennsylvania | $54.02 | $48.13 | $52.01 - $56.03 | 2 |
| Texas | $52.89 | $46.97 | $51.78 - $56.51 | 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 93564
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 93564 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 |
| 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 |
Frequently Asked Questions, CPT 93564
What does CPT code 93564 mean? +
CPT code 93564 represents: Njx cgen car cath slctv opac. It's in the Cardiovascular category with a global period of ZZZ.
What is the Medicare reimbursement for CPT 93564? +
The 2026 Medicare national average non-facility payment for CPT 93564 is $53.56. Rates range from $47.61 to $67.5 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 93564? +
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 93564? +
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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