CPT 93458Cardiology

L hrt artery/ventricle angio

CPT 93458 covers a diagnostic heart catheterization procedure where a doctor threads a thin tube through blood vessels to reach the left side of the heart and injects dye to take X-ray pictures of the coronary arteries and heart chamber.

Showing rates for

National Average

Base Medicare rate

$962.96

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

Work RVU

5.6

PE RVU (NF)

23.08

MP RVU

1.09

Total RVU

29.77

Conversion factor: 32.3465 · Source: CMS MPFS RVU25A · Confidence: High

NCCI bundling edits

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Billing tips

Ensure documentation explicitly states 'left ventriculography performed' and describes all coronary arteries visualized (RCA, LM, LAD, LCX) with separate selective injections
Impact: Missing documentation of ventriculography or incomplete coronary imaging downgrades claim to 93454 ($746.31), resulting in $216.65 loss per case
Do not bill 93458 with 93454, 93455, 93456, or 93457 for the same session - 93458 is the most comprehensive left heart code and includes these components
Impact: Unbundling results in denial of additional codes and potential RAC audit; can trigger prepayment review for all cardiac cath claims
Bill same-day PCI separately with appropriate intervention codes (92920-92944) as these are not bundled with 93458; append modifier 59 if required by payer
Impact: Properly billing diagnostic cath plus intervention can yield combined reimbursement of $2,500-$4,000 depending on complexity
Verify whether facility or non-facility setting applies; 93458 has identical rates ($962.96) for both in 2025, but setting affects other billable services
Impact: No direct impact on 93458 payment, but affects facility fees and separately billable services
When converting diagnostic cath to PCI in same session, ensure documentation shows diagnostic images were interpreted before decision to intervene
Impact: Without clear timeline showing diagnostic decision preceded intervention, payers may deny 93458 and allow only intervention codes, losing $962.96
Bill professional component only (modifier 26) when performed in hospital-owned cath lab; facility bills technical component separately

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Frequently asked questions

What is the 2025 Medicare reimbursement rate for CPT 93458?

The 2025 Medicare national average reimbursement for CPT 93458 is $962.96 for both facility and non-facility settings, based on 29.77 total RVUs and the 2025 conversion factor of $32.3465.

Can CPT 93458 be billed with PCI codes on the same day?

Yes, CPT 93458 can be billed separately with PCI codes (92920-92944) when the diagnostic catheterization is performed before the decision to intervene and no prior catheterization data is available. Documentation must clearly show the diagnostic study was interpreted before the intervention decision was made.

What is the difference between CPT 93458 and 93454?

CPT 93458 includes both coronary angiography and left ventriculography, while CPT 93454 includes only coronary angiography without ventriculography. The reimbursement difference is significant: 93458 pays $962.96 versus 93454 at approximately $746.31, a difference of over $216.

How many RVUs is CPT code 93458 worth in 2025?

CPT 93458 has 29.77 total RVUs in 2025, consisting of 5.6 work RVUs, 23.08 practice expense RVUs, and 1.09 malpractice RVUs. This makes it one of the highest-valued diagnostic cardiology procedures.

What documentation is required to bill CPT 93458?

Required documentation includes catheter placement in the left ventricle, explicit statement that left ventriculography was performed with findings, selective coronary angiography of all major vessels (RCA, left main, LAD, circumflex), arterial access site, contrast administration, hemodynamic measurements, and a complete interpretation report with clinical recommendations.

Does CPT 93458 include the interpretation and report?

Yes, CPT 93458 is a global code that includes catheter placement, imaging supervision and interpretation, and the written report. If billing only the professional component (interpretation), append modifier 26; if billing only the technical component, append modifier TC.

Why was my CPT 93458 claim denied when billed with an intervention code?

Common reasons include: lack of documentation showing the diagnostic cath was performed and interpreted before deciding to intervene, availability of recent prior catheterization data making a new diagnostic study unnecessary, or payer policy requiring modifier 59 to indicate a distinct diagnostic service. Appeals should include timeline documentation showing diagnostic interpretation preceded intervention decision.