Left hrt cath w/ventrclgrphy
CPT 93452 covers a left heart catheterization with ventriculography, a diagnostic procedure where a cardiologist threads a catheter through blood vessels into the left side of the heart and injects contrast dye to visualize the heart's pumping chambers on X-ray.
This calculator gives a typical-case estimate using standard Medicare modifier rules. Actual payment depends on payer policies, documentation, code-specific CMS status indicators, and locality. Verify before billing.
RVU breakdown
Conversion factor: 32.3465 · Source: CMS MPFS RVU25A · Confidence: High
NCCI bundling edits
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Billing tips
Document the specific injection of contrast material into the left ventricle and the recording of ventriculography images to support 93452 versus 93458 (without ventriculography)
Impact: Difference of $79.82 in Medicare payment between 93452 and 93458; failure to document ventriculography results in automatic downcoding
Do not separately bill for add-on codes 93565 (imaging supervision for injection procedures) or 93567 (cardiac output measurement) as these are bundled into 93452
Impact: Prevents denials and recoupment; these services are included in the $830.01 payment
When coronary angiography is performed during the same session, use combination code 93458 instead of billing 93452 and 93454 separately
Impact: Proper combination coding prevents unbundling denials and provides correct total reimbursement
Ensure the procedure note includes pre- and post-procedure timeout documentation, catheter sizes, approach sites, pressure measurements, and physician interpretation of ventriculography findings
Impact: Comprehensive documentation reduces audit risk and supports medical necessity in 15-20% of reviewed claims
Bill only the date of service when the catheterization is performed, not the date of interpretation if read later; supervision and interpretation are bundled
Impact: Prevents duplicate billing and date-of-service denials that delay payment by 30-45 days
Verify that 93452 is billed with the correct place of service code (22 for outpatient hospital, 24 for ASC) as this affects the facility vs non-facility rate determination
Ensures correct payment rate; both facility and non-facility rates are $830.01 for 2025 but place of service errors trigger audits
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