How much does Medicare pay for CPT 93458?

Medicare allowed an average of $272.38 per service and paid $214.40 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $1599.11, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 93458?

Insertion of tube in left lower heart chamber and coronary artery for diagnosis with review by radiologist. It was billed 376,348 times to 369,319 Medicare beneficiaries by 7,915 providers in 2024.

Does 93458 pay differently in an office than a hospital?

Yes. The allowed amount averaged $629.35 in an office setting and $269.66 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 93458 most?

Interventional Cardiology, with 177,823 services from 3,506 clinicians. Next are Cardiology, Internal Medicine, Ambulatory Surgical Center.

CPT 93458

Insertion of tube in left lower heart chamber and coronary artery for diagnosis with review by radiologist

$272.38Medicare-allowed amount per service, averaged across 376,348 services

Providers submitted

$1599.11

Asking price, not received

Medicare allowed

$272.38

The fee schedule figure

Medicare paid

$214.40

Balance is patient coinsurance

Providers submitted an average of $1599.11 for this code and Medicare allowed $272.38 — 5.9× 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 $214.40 (79%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $629.35
Hospital / facility: $269.66

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. 2,842 services were billed in an office setting and 373,506 in a facility.

Services: 376,348
Beneficiaries: 369,319
Providers billing it: 7,915
Total allowed: $102,509,668

What Medicare pays for CPT 93458

Across 376,348 services billed by 7,915 providers to 369,319 beneficiaries, Medicare allowed an average of $272.38 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 93458

Specialty	Services	Beneficiaries	Avg allowed	Providers
Interventional Cardiology	177,823	174,649	$240.08	3,506
Cardiology	173,182	169,703	$244.19	3,924
Internal Medicine	11,398	11,173	$244.80	289
Ambulatory Surgical Center	9,938	9,862	$1375.56	84
Clinical Cardiac Electrophysiology	909	900	$261.10	30
Advanced Heart Failure and Transplant Cardiology	599	572	$262.75	24
Hospitalist	570	553	$257.19	12
Peripheral Vascular Disease	501	496	$263.20	12
Cardiac Surgery	484	480	$295.15	12
Interventional Radiology	315	313	$230.28	7
Undefined Physician type	295	291	$234.23	5
Vascular Surgery	68	68	$234.04	2
Adult Congenital Heart Disease	61	61	$236.24	3
Emergency Medicine	54	53	$232.91	1
Nuclear Medicine	51	50	$292.34	1

93458 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
Florida	36,125	$331.06	$255.43	681
Texas	33,055	$332.94	$269.23	792
California	27,535	$237.43	$183.72	635
New York	20,266	$266.43	$184.00	362
Ohio	14,944	$235.93	$188.28	310
Illinois	14,432	$266.83	$196.07	312
Georgia	13,221	$246.56	$191.29	261
Pennsylvania	12,008	$248.52	$194.84	286
Arizona	11,145	$430.83	$347.85	233
Indiana	10,450	$222.42	$189.46	205
New Jersey	10,434	$256.33	$187.65	233
Michigan	10,342	$261.85	$198.84	293
Tennessee	10,264	$226.43	$191.40	242
Missouri	9,932	$248.23	$199.56	200
Virginia	9,895	$238.35	$188.56	196
North Carolina	9,894	$227.10	$185.89	207
Arkansas	9,361	$244.56	$208.75	132
South Carolina	8,874	$231.40	$188.40	153
Oklahoma	8,768	$299.09	$248.25	139
Louisiana	7,303	$343.72	$286.59	182
Kentucky	6,763	$239.24	$191.86	140
Washington	6,470	$234.89	$183.11	150
Alabama	6,353	$247.64	$210.40	164
Mississippi	5,793	$298.32	$253.34	102
Maryland	5,719	$255.99	$190.59	86
Kansas	5,688	$345.52	$296.30	84
Iowa	4,802	$235.76	$202.25	74
Wisconsin	4,676	$220.01	$185.91	118
Massachusetts	4,667	$243.68	$186.73	107
Nebraska	3,154	$300.38	$254.83	59
Colorado	3,108	$251.62	$197.80	84
Nevada	2,884	$268.94	$215.36	68
Minnesota	2,670	$221.66	$183.27	83
Connecticut	2,656	$254.27	$186.98	69
Oregon	2,614	$327.53	$255.32	73
West Virginia	2,597	$238.77	$184.13	54
New Mexico	1,951	$281.06	$233.95	33
Montana	1,825	$236.19	$186.59	28
South Dakota	1,815	$225.77	$187.61	22
New Hampshire	1,791	$238.80	$188.27	32
Utah	1,761	$220.14	$177.31	45
North Dakota	1,550	$221.70	$183.95	20
Delaware	1,471	$240.55	$189.38	24
Idaho	1,292	$211.06	$180.03	31
Rhode Island	871	$221.62	$173.53	23
Hawaii	662	$224.79	$184.28	15
Maine	612	$240.39	$192.82	21
Alaska	517	$312.90	$184.47	11
District of Columbia	482	$277.37	$200.29	14
Vermont	388	$233.53	$187.23	8
Wyoming	251	$226.03	$173.59	7
Puerto Rico	197	$237.77	$180.03	11
Guam	50	$804.03	$561.05	1

Related codes

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
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.