How much does Medicare pay for CPT 93454?

Medicare allowed an average of $211.98 per service and paid $166.56 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $1265.89, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 93454?

Insertion of tube in coronary artery for diagnosis with review by radiologist. It was billed 80,523 times to 78,786 Medicare beneficiaries by 2,626 providers in 2024.

Does 93454 pay differently in an office than a hospital?

Yes. The allowed amount averaged $558.67 in an office setting and $211.05 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 93454 most?

Interventional Cardiology, with 41,746 services from 1,310 clinicians. Next are Cardiology, Internal Medicine, Ambulatory Surgical Center.

CPT 93454

Insertion of tube in coronary artery for diagnosis with review by radiologist

$211.98Medicare-allowed amount per service, averaged across 80,523 services

Providers submitted

$1265.89

Asking price, not received

Medicare allowed

$211.98

The fee schedule figure

Medicare paid

$166.56

Balance is patient coinsurance

Providers submitted an average of $1265.89 for this code and Medicare allowed $211.98 — 6.0× 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 $166.56 (79%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $558.67
Hospital / facility: $211.05

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. 215 services were billed in an office setting and 80,308 in a facility.

Services: 80,523
Beneficiaries: 78,786
Providers billing it: 2,626
Total allowed: $17,069,266

What Medicare pays for CPT 93454

Across 80,523 services billed by 2,626 providers to 78,786 beneficiaries, Medicare allowed an average of $211.98 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 93454

Specialty	Services	Beneficiaries	Avg allowed	Providers
Interventional Cardiology	41,746	40,928	$190.70	1,310
Cardiology	33,494	32,668	$191.06	1,147
Internal Medicine	2,721	2,664	$192.93	92
Ambulatory Surgical Center	1,466	1,448	$1336.24	37
Advanced Heart Failure and Transplant Cardiology	278	276	$203.91	11
Peripheral Vascular Disease	193	190	$200.59	5
Cardiac Surgery	138	137	$208.51	3
Hospitalist	104	103	$222.96	3
Adult Congenital Heart Disease	95	92	$216.56	4
Clinical Cardiac Electrophysiology	71	70	$200.53	4
Undefined Physician type	68	65	$184.02	3
Interventional Radiology	61	61	$189.82	3
Vascular Surgery	43	41	$219.59	1
Osteopathic Manipulative Medicine	18	18	$206.80	1
Nuclear Medicine	15	13	$219.17	1

93454 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
California	7,611	$188.24	$141.69	211
Florida	5,357	$232.90	$176.87	186
New York	5,142	$215.88	$145.24	143
Pennsylvania	4,322	$194.74	$151.05	130
Massachusetts	4,171	$198.78	$149.06	92
Illinois	3,879	$207.26	$149.28	137
Texas	3,776	$255.74	$206.16	143
Ohio	3,243	$193.96	$154.23	108
Minnesota	3,063	$183.96	$152.84	86
Arizona	2,583	$395.40	$320.63	74
Maryland	2,166	$202.17	$149.00	49
New Jersey	1,977	$195.42	$144.74	81
Wisconsin	1,952	$172.54	$147.09	50
Virginia	1,845	$183.22	$144.76	74
Indiana	1,625	$173.96	$148.07	54
North Carolina	1,570	$183.37	$148.12	59
Kansas	1,530	$225.46	$191.37	41
Washington	1,448	$189.14	$146.07	66
Michigan	1,387	$201.49	$154.29	64
Iowa	1,356	$175.89	$149.44	33
Missouri	1,320	$190.74	$149.82	63
Colorado	1,298	$177.01	$139.15	48
Louisiana	1,270	$358.28	$303.01	47
Tennessee	1,159	$176.54	$146.01	49
Kentucky	1,083	$182.51	$145.54	41
Oregon	1,067	$235.57	$182.21	33
Georgia	962	$190.36	$148.96	45
Arkansas	927	$216.23	$182.02	33
Mississippi	901	$417.28	$363.51	26
South Dakota	848	$184.35	$150.40	17
Alabama	793	$173.62	$143.69	25
New Hampshire	777	$192.62	$151.57	23
South Carolina	770	$185.10	$150.61	32
Oklahoma	634	$286.18	$236.17	27
Montana	625	$195.18	$152.53	16
Nevada	623	$179.90	$146.10	29
Connecticut	618	$201.55	$146.88	28
Nebraska	575	$238.90	$201.52	22
Maine	555	$187.69	$154.07	18
District of Columbia	538	$210.31	$151.11	9
Idaho	504	$166.71	$140.86	19
Utah	477	$185.42	$149.67	21
North Dakota	415	$170.46	$143.20	12
Vermont	377	$192.16	$156.63	8
West Virginia	364	$175.10	$135.67	18
Delaware	329	$189.13	$149.22	12
Alaska	318	$232.09	$136.08	7
New Mexico	177	$167.58	$132.07	10
Rhode Island	173	$196.83	$154.57	5
Hawaii	43	$188.63	$159.93	2

Related codes

93458Insertion of tube in left lower heart chamber and coronary artery for$272.38
93460Insertion of tube in right and left heart chambers and coronary artery$366.63
93451Insertion of tube in right heart chambers for measurement$131.03
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.