CPT 93631Cardiology

Ntraop epicar&endcar pac&map

CPT 93631 covers intraoperative cardiac pacing and mapping performed during open-heart surgery, where the surgeon or electrophysiologist tests the heart's electrical pathways by placing electrodes directly on or inside the heart to identify abnormal rhythms and guide surgical treatment.

Showing rates for

National Average

Base Medicare rate

$370.69

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

7.59

PE RVU (NF)

2.34

MP RVU

1.53

Total RVU

11.46

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

NCCI bundling edits

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Billing tips

Document both epicardial AND endocardial components explicitly in operative report, as the descriptor requires both for full reimbursement
Impact: Prevents downcoding to lower-paying EP codes; maintains full $370.69 payment versus potential $150-250 for incomplete mapping codes
Bill on the same date as the primary cardiac surgical procedure (CABG, valve surgery, etc.) but ensure separate dictation section for EP mapping with time stamps
Impact: Supports add-on nature of service and prevents denials for lack of medical necessity; typically adds $370.69 to surgical case reimbursement
Capture equipment and supply costs separately through hospital charging mechanisms, as the 2.34 PE RVU reflects physician work, not facility costs
Impact: Hospital can bill separately for EP recording equipment, catheters, and mapping systems worth $2,000-5,000 per case
Use modifier 62 when EP cardiologist performs mapping while CT surgeon performs concurrent ablation, with both documenting distinct roles
Impact: Each provider receives $231.68 instead of requiring a split or losing reimbursement entirely
Include mapping grid diagrams, voltage maps, and activation sequence documentation in medical record to support complexity
Impact: Strengthens medical necessity defense and supports modifier 22 claims for additional 20-30% reimbursement in complex cases
Verify that intraoperative mapping is not included in the surgical package of the primary procedure; 93631 is typically separately billable during open procedures
Ensures $370.69 is not lost to global surgical bundling; confirm payer-specific policies before surgery

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Frequently asked questions

What is the Medicare reimbursement rate for CPT 93631 in 2025?

The 2025 Medicare national average reimbursement for CPT 93631 is $370.69 for both facility and non-facility settings. This is based on 11.46 total RVUs multiplied by the 2025 conversion factor of 32.3465.

Can CPT 93631 be billed with cardiac surgery codes on the same day?

Yes, CPT 93631 is specifically designed as an add-on service to be billed with open cardiac surgical procedures when intraoperative EP mapping is medically necessary. However, documentation must clearly show the mapping service was distinct from the primary surgery and influenced surgical decision-making. Verify individual payer policies as some may bundle this service.

What is the difference between CPT 93631 and other electrophysiology mapping codes?

CPT 93631 is unique because it requires BOTH epicardial (surface of heart) and endocardial (inside chambers) mapping performed during OPEN cardiac surgery. Other EP codes like 93609-93612 describe closed-chest catheter-based mapping. The intraoperative nature and dual approach distinguish 93631 from diagnostic EP studies.

How many RVUs is CPT 93631 worth in 2025?

CPT 93631 has a total of 11.46 RVUs in 2025, consisting of 7.59 work RVUs, 2.34 practice expense RVUs, and 1.53 malpractice RVUs. Both facility and non-facility PE RVU values are identical at 2.34.

Who can perform and bill CPT 93631?

CPT 93631 is typically performed and billed by cardiac electrophysiologists or cardiothoracic surgeons with specialized EP training. The physician must personally perform or directly supervise the intraoperative mapping and provide interpretation. Co-surgeon billing with modifier 62 is common when an EP cardiologist works with a CT surgeon.

What documentation is required to bill CPT 93631?

Required documentation includes explicit mention of both epicardial and endocardial electrode placement with specific anatomic locations, the arrhythmia being mapped, pacing protocols used, mapping findings, how results influenced surgical strategy, time spent on mapping, and the physician's interpretation. Mapping diagrams or voltage maps strengthen documentation.

Is CPT 93631 bundled with ablation procedures during cardiac surgery?

CPT 93631 represents the mapping component and is generally separately billable from surgical ablation codes. However, verify NCCI edits and payer-specific policies, as some payers may bundle mapping with certain ablation procedures. Modifier 59 may be needed to indicate distinct services when appropriate.