CPT 93622Cardiology

Comp ep eval l ventr pac&rec

CPT 93622 covers a comprehensive electrophysiology (EP) evaluation where the heart's electrical system is tested by placing electrodes in the left ventricle to record electrical signals and test pacing responses. This specialized cardiac procedure helps diagnose complex rhythm disorders and determine optimal treatment strategies.

Showing rates for

National Average

Base Medicare rate

$160.44

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

3.1

PE RVU (NF)

1.26

MP RVU

0.6

Total RVU

4.96

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

NCCI bundling edits

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Billing tips

Document left ventricular access method (retrograde aortic, transseptal, or epicardial) separately from right-sided EP studies to justify distinct billing
Impact: Prevents bundling denials that could result in loss of the full $160.44 reimbursement when billed with comprehensive EP codes
Verify NCCI edits before billing 93622 with 93619, 93620, or ablation codes; use modifier 59/XU only when comprehensive left ventricular evaluation is truly distinct
Impact: Inappropriate bundling represents 30-40% of denials for this code; proper modifier use preserves $160.44 payment
Bill 93622 only once per session regardless of number of left ventricular sites evaluated; code represents comprehensive evaluation, not per-site basis
Impact: Duplicate billing attempts result in automatic denials and potential audit flags; single correct claim ensures timely payment
Ensure documentation includes specific left ventricular pacing protocols, capture thresholds, sensed electrogram characteristics, and refractory period measurements
Impact: Comprehensive documentation reduces audit risk and supports medical necessity; inadequate documentation accounts for 25% of post-payment recoupments
Coordinate billing with facility to ensure split billing (26/TC) is used consistently across all EP codes in the session
Impact: Inconsistent modifier use triggers edits and delays; proper coordination ensures both components paid correctly totaling $160.44
Code 93622 is not separately payable when performed solely for CRT device optimization during routine follow-up; reserve for diagnostic EP studies

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Frequently asked questions

What is the Medicare reimbursement rate for CPT 93622 in 2025?

The 2025 Medicare national average payment for CPT 93622 is $160.44 for both facility and non-facility settings. This is based on 4.96 total RVUs (3.1 work RVU, 1.26 PE RVU, 0.6 MP RVU) multiplied by the 2025 conversion factor of 32.3465.

Can CPT 93622 be billed with other EP study codes on the same date?

Yes, but with caution. CPT 93622 may be billed with other EP codes if the left ventricular evaluation is comprehensive and distinct from services included in codes like 93619 or 93620. Use modifier 59 or XU when appropriate, and ensure documentation clearly supports separate, medically necessary left ventricular assessment beyond what is included in the primary EP study code.

What documentation is required to support billing CPT 93622?

Documentation must include the method of left ventricular access, catheter positions, baseline electrogram recordings with measurements, pacing thresholds, specific pacing protocols performed, refractory period determinations, and clinical interpretation. The report should demonstrate comprehensive evaluation of left ventricular electrical properties, not just simple pacing or recording.

Is CPT 93622 billable during cardiac resynchronization therapy (CRT) device implantation?

Generally no, unless there is a distinct diagnostic indication beyond CRT optimization. If 93622 is billed during CRT implant, documentation must clearly support a separate diagnostic EP study for arrhythmia evaluation, not merely left ventricular lead placement or threshold testing included in the device implant procedure.

What is the difference between CPT 93622 and 93621?

CPT 93621 covers left atrial pacing and recording, while 93622 specifically addresses left ventricular pacing and recording. The codes represent different cardiac chambers and require distinct catheter placements and access techniques. 93622 typically involves retrograde aortic or transseptal access to reach the left ventricle, while 93621 focuses on left atrial evaluation.

How many RVUs is CPT 93622 worth in 2025?

CPT 93622 has 4.96 total RVUs in 2025, consisting of 3.1 work RVUs, 1.26 practice expense RVUs (both facility and non-facility), and 0.6 malpractice RVUs. This reflects the technical complexity and risk associated with left ventricular access and comprehensive electrophysiology evaluation.

Do I need modifier 26 or TC when billing CPT 93622?

Use modifier 26 for professional component only (physician interpretation) or TC for technical component only (facility, equipment, staff) when services are split between physician and facility. If the physician performs and interprets in their own facility with their equipment, bill without modifiers for the global service receiving the full $160.44 reimbursement.