CPT 93655Cardiology

Icar cath abltj dscrt arrhyt

CPT 93655 covers additional cardiac catheter ablation procedures performed to treat irregular heartbeats (arrhythmias) that occur in discrete areas of the heart outside the primary ablation zone. This is an add-on code used when the physician needs to ablate multiple separate arrhythmia sites during the same session.

Showing rates for

National Average

Base Medicare rate

$290.47

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

5.5

PE RVU (NF)

2.23

MP RVU

1.25

Total RVU

8.98

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

NCCI bundling edits

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Billing tips

Always verify the primary ablation code is appropriately documented and billed, as 93655 cannot be reported alone and will be denied without a qualifying base procedure
Impact: Prevents 100% denial of the $290.47 reimbursement; common denial reason when base code is missing or denied
Document each discrete arrhythmogenic focus separately with specific anatomic location, electrophysiologic characteristics, and number of ablation lesions delivered to each site
Impact: Supports medical necessity and prevents downcoding; inadequate documentation can result in denial of 50-100% of claims during post-payment audits
Report 93655 only once per session regardless of the number of additional discrete foci ablated, per CPT guidelines; multiple units are not separately reimbursable
Impact: Billing multiple units will result in denial of additional units; prevents overbilling flags and potential fraud investigation
Ensure operative report clearly distinguishes between linear ablation lesion sets (part of base procedure) and discrete focal ablations (reportable with 93655)
Impact: Prevents challenges during payer review; clear distinction supports the 8.98 total RVUs and justifies additional payment beyond base procedure
Verify LCD/NCD requirements for your MAC jurisdiction as some payers have specific documentation requirements for add-on electrophysiology codes
Impact: Reduces denial rates by 20-30%; regional MACs may have varying coverage policies affecting reimbursement
Bill 93655 with appropriate diagnosis codes that support multiple arrhythmia foci, such as codes indicating complex or multifocal atrial or ventricular arrhythmias

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Frequently asked questions

What is the Medicare reimbursement rate for CPT code 93655 in 2025?

The 2025 Medicare national average reimbursement rate for CPT 93655 is $290.47 for both facility and non-facility settings. This rate is based on 8.98 total RVUs (5.5 work RVU, 2.23 PE RVU, 1.25 MP RVU) multiplied by the 2025 conversion factor of 32.3465.

Can CPT 93655 be billed alone or does it require a primary procedure code?

CPT 93655 is an add-on code and cannot be billed alone. It must be reported in conjunction with a primary cardiac ablation procedure code such as 93653, 93654, 93656, or other appropriate base ablation codes. Billing 93655 without a primary code will result in automatic denial.

How many times can you bill CPT 93655 in a single session?

According to CPT guidelines, code 93655 should only be reported once per session regardless of the number of additional discrete arrhythmogenic foci ablated. Multiple units of 93655 are not separately reimbursable, and billing multiple units will result in denial of the additional units.

What documentation is required to support billing CPT 93655?

Documentation must include a complete electrophysiology study report clearly identifying the primary ablation target and each discrete additional arrhythmogenic focus with specific anatomic locations, electrophysiologic mapping data, activation sequences, number of ablation lesions delivered to each site, energy parameters, and post-ablation testing results confirming elimination of the arrhythmia from the discrete focus.

What is the difference between CPT 93655 and the primary ablation codes?

Primary ablation codes (such as 93653, 93654, 93656) represent the complete procedure for ablating the main arrhythmia target. CPT 93655 is an add-on code used only when additional discrete arrhythmogenic foci separate from the primary target are identified and ablated during the same session, representing extra work beyond the base procedure.

Which medical specialties typically bill CPT code 93655?

CPT 93655 is primarily billed by cardiac electrophysiologists and interventional cardiologists with specialized training in electrophysiology procedures. The procedure must be performed by board-certified or board-eligible cardiologists with hospital privileges for invasive cardiac electrophysiology studies and ablation procedures.

What are common reasons for denial of CPT 93655 claims?

Common denial reasons include missing or denied primary procedure codes, insufficient documentation to demonstrate a discrete arrhythmogenic focus separate from the primary ablation target, medical necessity challenges stating the additional ablation was part of routine strategy rather than a distinct focus, and bundling denials where payers consider the work part of the primary procedure.