CPT 93619Cardiology

Comprehensive ep evaluation

CPT 93619 covers a comprehensive electrophysiology (EP) study where a cardiologist tests the electrical system of your heart using specialized catheters to diagnose and map abnormal heart rhythms. This detailed evaluation helps determine the source and mechanism of arrhythmias to guide treatment decisions.

Showing rates for

National Average

Base Medicare rate

$361.63

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

7.06

PE RVU (NF)

2.83

MP RVU

1.29

Total RVU

11.18

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

NCCI bundling edits

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Billing tips

Verify all four required components are documented: right atrial pacing/recording, right ventricular pacing/recording, His bundle recording, and attempted arrhythmia induction
Impact: Missing any component may result in downcoding to 93620 ($314.08 in 2025) or denial, losing $47.55 per case
Do not separately bill basic EP study codes (93600-93603) when performing 93619, as these are bundled components
Impact: Unbundling violations trigger automatic denials and potential audit flags; recover denied claims by appealing with corrected coding
Bill 93619 only once per session regardless of number of catheters used or arrhythmias induced; additional mapping may justify add-on codes
Impact: Units greater than 1 will be denied; proper use of add-on codes like 93613 or 93656 can add $150-300 in legitimate additional reimbursement
Document start and stop times, all pacing protocols performed, measurements obtained, and arrhythmias induced or attempted with specific details
Impact: Comprehensive documentation protects against audit recoupment of $361.63 per case and supports medical necessity
When performed on same date as ablation (93653-93657), ensure 93619 represents diagnostic study before ablation decision; otherwise it may be considered bundled
Impact: Improper billing with ablation codes can result in denial of 93619 entirely; modifier 59 may be appropriate only when diagnostic study precedes therapeutic decision
Verify payer-specific policies on global period restrictions, as some Medicare contractors consider 93619 included in post-operative care of previous ablations

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Frequently asked questions

What is the Medicare reimbursement rate for CPT 93619 in 2025?

The 2025 Medicare national average reimbursement for CPT 93619 is $361.63 for both facility and non-facility settings. This is based on 11.18 total RVUs (7.06 work RVU + 2.83 PE RVU + 1.29 MP RVU) multiplied by the 2025 conversion factor of 32.3465.

Can CPT 93619 be billed with ablation codes on the same day?

CPT 93619 can be billed with ablation codes (93653-93657) only when the comprehensive EP study is a distinct diagnostic evaluation completed before the decision to perform ablation. Documentation must clearly show the diagnostic findings from 93619 influenced the treatment decision. Most payers consider 93619 bundled when performed solely for ablation mapping.

What is the difference between CPT 93619 and 93620?

CPT 93619 is a comprehensive EP evaluation including right atrial and ventricular pacing/recording, His bundle recording, and arrhythmia induction. CPT 93620 includes induction or attempted induction of arrhythmia by pacing but without the comprehensive components required for 93619. The reimbursement difference is approximately $47.55 in 2025.

What documentation is required to support billing CPT 93619?

Documentation must include medical necessity/indication, right atrial pacing and recording, right ventricular pacing and recording, His bundle electrogram recording with measurements, arrhythmia induction attempts with specific protocols, all intracardiac measurements, description of induced arrhythmias, procedure times, and physician interpretation correlating findings to clinical presentation.

How many RVUs is CPT 93619 worth in 2025?

CPT 93619 has 11.18 total RVUs in 2025, consisting of 7.06 work RVUs, 2.83 practice expense RVUs (both facility and non-facility), and 1.29 malpractice RVUs, making it one of the higher-valued diagnostic EP codes.

Do I need prior authorization for CPT 93619?

Prior authorization requirements vary by payer. Medicare typically does not require prior authorization for 93619, but Medicare Advantage plans and commercial insurers often do require it. Always verify with the specific payer before scheduling, as lack of authorization commonly results in claim denial despite medical necessity.

Can CPT 93619 be billed bilaterally or with multiple units?

No, CPT 93619 should only be billed once per session regardless of the number of catheters used or arrhythmias induced. It is a comprehensive evaluation code representing the entire EP study. Billing multiple units will result in denial of additional units. Additional mapping or ablation services require separate add-on codes.