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93597 R&l hrt cath chd abnl nt cnj

What 93597 is

CMS fee schedule short descriptor: R&l hrt cath chd abnl nt cnj.

Full CPT long descriptions are licensed by the American Medical Association and are not published on this site; the short descriptor above is the one CMS prints in its own fee schedule file. See About CPT.

Medicare payment for 93597 (CY2026)

This code has no Physician Fee Schedule rate: Carrier-priced - the Medicare contractor sets the price. It may be paid under a different fee schedule (clinical laboratory, DMEPOS, anesthesia) or not paid at all - check the relevant CMS schedule.

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Medically Unlikely Edit (MUE)

Medicare caps 93597 at 1 unit per date of service for practitioner claims (MAI 3 - date of service edit (clinical): units above the MUE may pay with documentation on appeal), rationale: Nature of Service/Procedure. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.

Billed with 93597? These codes are bundled into it

93597 is a Column 1 code in 302 active NCCI PTP edits. When one of these Column 2 codes is reported on the same date of service, it is denied as bundled - unless the edit's modifier indicator is 1 and documentation supports a distinct service with an NCCI-associated modifier.

Column 2 codeShort descriptionModifier indicator
01920Anes cardiac catheterization0 - no modifier bypassCheck pair
01924Anes ther ivntl rad artl nos0 - no modifier bypassCheck pair
01925Anes ivntl rad artl crtd/c0 - no modifier bypassCheck pair
01926Anes ivntl rad icr icar/aort0 - no modifier bypassCheck pair
0213TNjx paravert w/us cer/thor0 - no modifier bypassCheck pair
0216TNjx paravert w/us lumb/sac0 - no modifier bypassCheck pair
0596TTemp fml iu vlv-pmp 1st insj1 - modifier may bypassCheck pair
0597TTemp fml iu valve-pmp rplcmt1 - modifier may bypassCheck pair
0798TTcat rmv 2chmbr ldls pm cmpl0 - no modifier bypassCheck pair
0799TTcat rmvl 2chmbr ldls pm ra0 - no modifier bypassCheck pair
0800TTcat rmvl 2chmbr ldls pm rv0 - no modifier bypassCheck pair
0903TEcg alg 12 lead reduced i&r1 - modifier may bypassCheck pair
0904TEcg alg 12 ld rdcd trcg only1 - modifier may bypassCheck pair
0905TEcg alg 12 ld rdcd i&r only1 - modifier may bypassCheck pair
0930TEphys eval ccm-d ld 1st impl1 - modifier may bypassCheck pair
0931TEphys eval ccm-d ld separate1 - modifier may bypassCheck pair
12001Rpr s/n/ax/gen/trnk 2.5cm/<1 - modifier may bypassCheck pair
12002Rpr s/n/ax/gen/trnk2.6-7.5cm1 - modifier may bypassCheck pair
12004Rpr s/n/ax/gen/trk7.6-12.5cm1 - modifier may bypassCheck pair
12005Rpr s/n/a/gen/trk12.6-20.0cm1 - modifier may bypassCheck pair
12006Rpr s/n/a/gen/trk20.1-30.0cm1 - modifier may bypassCheck pair
12007Rpr s/n/ax/gen/trnk >30.0 cm1 - modifier may bypassCheck pair
12011Rpr f/e/e/n/l/m 2.5 cm/<1 - modifier may bypassCheck pair
12013Rpr f/e/e/n/l/m 2.6-5.0 cm1 - modifier may bypassCheck pair
12014Rpr f/e/e/n/l/m 5.1-7.5 cm1 - modifier may bypassCheck pair
12015Rpr f/e/e/n/l/m 7.6-12.5 cm1 - modifier may bypassCheck pair
12016Rpr fe/e/en/l/m 12.6-20.0 cm1 - modifier may bypassCheck pair
12017Rpr fe/e/en/l/m 20.1-30.0 cm1 - modifier may bypassCheck pair
12018Rpr f/e/e/n/l/m >30.0 cm1 - modifier may bypassCheck pair
12020Tx supfc wnd dehsn smpl clsr1 - modifier may bypassCheck pair

Showing 30 of 302 column 2 codes. Use the pair checker for any specific combination.

93597 is bundled into these codes

93597 appears as a Column 2 code in 77 active edits. Reported with one of these Column 1 codes on the same date of service, 93597 is the code that denies.

Column 1 codeShort descriptionModifier indicator
0345TTranscath mtral vlve repair1Check pair
0483TTmvi percutaneous approach0Check pair
0484TTmvi transthoracic exposure0Check pair
0515TInsj wcs lv compl sys1Check pair
0516TInsj wcs lv eltrd only1Check pair
0517TInsj wcs lv both compnt pg1Check pair
0518TRmvl pg wcs lv battery only1Check pair
0519TRmv&rplcmt pg wcs lv both1Check pair
0520TRmv&rplcmt pg wcs lv battery1Check pair
0544TTcat mv annulus rcnstj1Check pair
0545TTcat tv annulus rcnstj1Check pair
0569TTtvr perq appr 1st prosth1Check pair
0570TTtvr perq ea addl prosth1Check pair
0577TEphys eval icds ss1Check pair
0613TPerq tcat intratrl septl sht1Check pair

Data: CMS CY2026 Physician Fee Schedule RVU file (October release, RVU26D) and Medicare NCCI PTP practitioner edits v32.3 (2026 Q4). Verify against the official files before billing or contracting decisions.