How much does Medicare pay for CPT 93451?

Medicare allowed an average of $131.03 per service and paid $102.66 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $799.75, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 93451?

Insertion of tube in right heart chambers for measurement. It was billed 25,610 times to 24,222 Medicare beneficiaries by 1,142 providers in 2024.

Does 93451 pay differently in an office than a hospital?

Yes. The allowed amount averaged $625.59 in an office setting and $129.96 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 93451 most?

Cardiology, with 8,569 services from 396 clinicians. Next are Interventional Cardiology, Advanced Heart Failure and Transplant Cardiology, Pulmonary Disease.

CPT 93451

Insertion of tube in right heart chambers for measurement

$131.03Medicare-allowed amount per service, averaged across 25,610 services

Providers submitted

$799.75

Asking price, not received

Medicare allowed

$131.03

The fee schedule figure

Medicare paid

$102.66

Balance is patient coinsurance

Providers submitted an average of $799.75 for this code and Medicare allowed $131.03 — 6.1× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $102.66 (78%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $625.59
Hospital / facility: $129.96

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 55 services were billed in an office setting and 25,555 in a facility.

Services: 25,610
Beneficiaries: 24,222
Providers billing it: 1,142
Total allowed: $3,355,678

What Medicare pays for CPT 93451

Across 25,610 services billed by 1,142 providers to 24,222 beneficiaries, Medicare allowed an average of $131.03 per service. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 93451

Specialty	Services	Beneficiaries	Avg allowed	Providers
Cardiology	8,569	8,073	$119.46	396
Interventional Cardiology	7,811	7,526	$124.30	381
Advanced Heart Failure and Transplant Cardiology	5,640	5,207	$114.67	216
Pulmonary Disease	1,661	1,594	$126.63	58
Internal Medicine	1,232	1,175	$117.64	58
Critical Care (Intensivists)	283	266	$121.96	11
Ambulatory Surgical Center	194	190	$1544.36	11
Adult Congenital Heart Disease	73	50	$96.31	3
Hospitalist	50	49	$127.34	3
Sleep Medicine	31	30	$124.08	1
Undefined Physician type	25	24	$113.15	1
Interventional Radiology	16	15	$115.31	1
Pediatric Medicine	13	11	$121.87	1
Clinical Cardiac Electrophysiology	12	12	$122.46	1

93451 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
Pennsylvania	2,069	$126.19	$95.61	93
Texas	1,875	$173.69	$139.82	86
New York	1,632	$126.26	$86.78	74
California	1,541	$114.83	$84.87	64
Florida	1,285	$122.32	$90.43	56
Massachusetts	1,267	$126.03	$93.47	54
Illinois	1,240	$133.13	$93.30	59
Maryland	987	$118.72	$87.75	33
Virginia	985	$120.80	$95.00	46
Ohio	972	$122.58	$98.01	45
North Carolina	858	$110.49	$93.04	40
Washington	758	$109.72	$81.63	36
Michigan	676	$122.12	$92.01	30
Tennessee	671	$102.63	$91.51	32
Minnesota	629	$116.56	$95.10	27
Alabama	584	$113.33	$95.12	19
Indiana	525	$105.53	$91.94	21
Colorado	499	$169.11	$132.12	17
South Carolina	465	$109.95	$89.67	21
Arizona	464	$325.35	$261.05	25
Missouri	442	$117.81	$93.56	22
Oklahoma	434	$116.61	$96.56	19
Georgia	433	$116.84	$92.44	24
New Jersey	428	$124.71	$92.39	20
District of Columbia	409	$114.42	$80.76	5
Wisconsin	368	$108.47	$90.75	16
Nebraska	361	$104.81	$90.06	9
Arkansas	293	$107.10	$91.76	10
Utah	270	$115.59	$92.70	17
Oregon	253	$270.84	$205.30	15
Kansas	234	$318.02	$271.82	13
Kentucky	223	$114.29	$89.85	11
New Hampshire	218	$117.91	$93.66	13
Louisiana	218	$119.71	$90.58	14
Connecticut	205	$126.68	$91.19	9
Mississippi	176	$112.49	$93.41	9
Delaware	155	$123.24	$98.03	8
Iowa	130	$109.46	$91.95	6
Maine	96	$123.81	$97.74	6
Rhode Island	78	$114.37	$90.92	4
New Mexico	52	$113.45	$84.38	3
North Dakota	37	$113.28	$98.72	2
Montana	34	$119.05	$95.41	3
Idaho	30	$113.91	$95.80	2
West Virginia	14	$130.88	$98.97	1
South Dakota	14	$111.40	$95.53	1
Vermont	12	$126.17	$93.25	1
Nevada	11	$125.56	$99.14	1

Related codes

93458Insertion of tube in left lower heart chamber and coronary artery for$272.38
93454Insertion of tube in coronary artery for diagnosis$211.98
93460Insertion of tube in right and left heart chambers and coronary artery$366.63
93459Insertion of tube in left lower heart chamber$296.47
93456Insertion of tube in right heart chambers and coronary artery for diag$300.71
93455Insertion of tube in bypass graft for diagnosis$237.41
93463Drug infusion during cardiac catheterization$96.67
93462Insertion of tube in left heart chamber through heart septum$200.70
93452Insertion of tube in left heart chambers for diagnosis$152.91

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.