How much does Medicare pay for CPT 93456?

Medicare allowed an average of $300.71 per service and paid $237.28 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $1572.24, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 93456?

Insertion of tube in right heart chambers and coronary artery for diagnosis with review by radiologist. It was billed 9,392 times to 9,357 Medicare beneficiaries by 474 providers in 2024.

Does 93456 pay differently in an office than a hospital?

Yes. The allowed amount averaged $1084.39 in an office setting and $299.79 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 93456 most?

Interventional Cardiology, with 5,284 services from 269 clinicians. Next are Cardiology, Internal Medicine, Ambulatory Surgical Center.

CPT 93456

Insertion of tube in right heart chambers and coronary artery for diagnosis with review by radiologist

$300.71Medicare-allowed amount per service, averaged across 9,392 services

Providers submitted

$1572.24

Asking price, not received

Medicare allowed

$300.71

The fee schedule figure

Medicare paid

$237.28

Balance is patient coinsurance

Providers submitted an average of $1572.24 for this code and Medicare allowed $300.71 — 5.2× 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 $237.28 (79%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $1084.39
Hospital / facility: $299.79

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. 11 services were billed in an office setting and 9,381 in a facility.

Services: 9,392
Beneficiaries: 9,357
Providers billing it: 474
Total allowed: $2,824,268

What Medicare pays for CPT 93456

Across 9,392 services billed by 474 providers to 9,357 beneficiaries, Medicare allowed an average of $300.71 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 93456

Specialty	Services	Beneficiaries	Avg allowed	Providers
Interventional Cardiology	5,284	5,266	$296.65	269
Cardiology	3,437	3,421	$282.76	173
Internal Medicine	485	484	$281.69	22
Ambulatory Surgical Center	78	78	$1465.75	4
Advanced Heart Failure and Transplant Cardiology	46	46	$291.68	2
Hospitalist	19	19	$336.79	1
Peripheral Vascular Disease	17	17	$374.75	1
Adult Congenital Heart Disease	15	15	$292.46	1
Cardiac Surgery	11	11	$308.71	1

93456 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	1,447	$291.81	$223.29	71
New York	1,168	$323.79	$216.01	46
Massachusetts	839	$275.63	$211.91	36
Illinois	487	$306.77	$221.33	25
Maine	425	$279.24	$227.53	18
Florida	380	$375.00	$281.82	22
California	376	$284.52	$220.27	20
North Carolina	371	$271.65	$219.99	22
Ohio	367	$284.77	$230.57	24
Alabama	292	$268.39	$223.07	10
District of Columbia	288	$314.21	$224.03	6
Virginia	264	$268.37	$209.32	15
Minnesota	241	$252.91	$215.73	14
Tennessee	236	$254.40	$211.35	15
Washington	217	$286.04	$227.93	9
New Jersey	215	$301.80	$216.58	14
Texas	207	$271.53	$214.49	14
Maryland	194	$296.64	$218.43	6
Arizona	192	$577.78	$475.44	11
Michigan	178	$299.67	$221.74	11
Colorado	133	$288.69	$225.46	8
Oregon	118	$287.00	$221.60	8
Wisconsin	117	$261.03	$219.79	8
New Hampshire	83	$275.88	$216.64	5
Connecticut	72	$322.01	$233.51	5
Indiana	64	$263.77	$221.41	5
Utah	62	$289.25	$221.81	4
Oklahoma	49	$280.32	$229.45	2
Idaho	39	$263.06	$227.88	3
Mississippi	39	$712.03	$664.31	3
Alaska	39	$367.58	$212.20	2
Georgia	35	$264.91	$215.81	2
Kentucky	32	$290.51	$203.51	2
New Mexico	28	$288.88	$235.27	2
Rhode Island	24	$276.19	$225.87	1
Louisiana	21	$281.78	$222.40	1
Vermont	17	$303.08	$228.15	1
Iowa	13	$312.86	$235.22	1
Delaware	12	$270.93	$206.31	1
Nebraska	11	$233.91	$193.14	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
93451Insertion of tube in right heart chambers for measurement$131.03
93459Insertion of tube in left lower heart chamber$296.47
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.