How much does Medicare pay for CPT 93459?

Medicare allowed an average of $296.47 per service and paid $234.04 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $1835.97, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 93459?

Insertion of tube in left lower heart chamber, coronary artery and bypass graft for diagnosis with review by radiologist. It was billed 25,446 times to 24,735 Medicare beneficiaries by 1,388 providers in 2024.

Does 93459 pay differently in an office than a hospital?

Yes. The allowed amount averaged $422.64 in an office setting and $295.96 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 93459 most?

Interventional Cardiology, with 12,857 services from 710 clinicians. Next are Cardiology, Ambulatory Surgical Center, Internal Medicine.

CPT 93459

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

$296.47Medicare-allowed amount per service, averaged across 25,446 services

Providers submitted

$1835.97

Asking price, not received

Medicare allowed

$296.47

The fee schedule figure

Medicare paid

$234.04

Balance is patient coinsurance

Providers submitted an average of $1835.97 for this code and Medicare allowed $296.47 — 6.2× 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 $234.04 (79%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $422.64
Hospital / facility: $295.96

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. 103 services were billed in an office setting and 25,343 in a facility.

Services: 25,446
Beneficiaries: 24,735
Providers billing it: 1,388
Total allowed: $7,543,976

What Medicare pays for CPT 93459

Across 25,446 services billed by 1,388 providers to 24,735 beneficiaries, Medicare allowed an average of $296.47 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 93459

Specialty	Services	Beneficiaries	Avg allowed	Providers
Interventional Cardiology	12,857	12,513	$259.58	710
Cardiology	11,038	10,691	$258.42	601
Ambulatory Surgical Center	843	836	$1386.35	34
Internal Medicine	562	551	$259.31	33
Clinical Cardiac Electrophysiology	49	49	$287.61	3
Peripheral Vascular Disease	35	33	$279.23	2
Interventional Radiology	14	14	$264.64	1
Vascular Surgery	13	13	$191.54	1
Cardiac Surgery	12	12	$272.51	1
Undefined Physician type	12	12	$288.07	1
Hospitalist	11	11	$257.47	1

93459 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	2,674	$349.52	$272.11	137
Texas	2,199	$358.27	$291.32	132
Arkansas	1,366	$261.01	$223.15	59
New York	1,144	$283.70	$197.01	54
California	1,140	$261.61	$204.45	63
Georgia	1,018	$261.37	$204.52	53
Tennessee	1,006	$244.61	$209.20	53
Ohio	970	$261.91	$208.87	54
Missouri	909	$272.65	$219.95	50
Mississippi	892	$346.05	$298.09	44
Oklahoma	883	$324.64	$270.81	43
South Carolina	846	$253.54	$205.85	50
North Carolina	775	$247.02	$203.96	41
Louisiana	771	$337.57	$273.46	41
Indiana	713	$248.45	$213.26	41
Kansas	666	$433.39	$373.90	28
Illinois	657	$277.04	$205.59	41
Alabama	629	$232.40	$196.88	34
Kentucky	575	$256.54	$201.94	33
Virginia	504	$248.80	$197.98	32
Arizona	469	$548.61	$442.65	28
Maryland	449	$269.02	$200.44	20
Pennsylvania	406	$276.33	$216.84	30
Michigan	393	$268.76	$205.41	27
New Jersey	339	$285.74	$209.46	21
Wisconsin	328	$243.86	$209.08	18
West Virginia	320	$249.54	$191.05	18
Iowa	307	$265.69	$230.26	17
Washington	300	$240.88	$193.90	20
North Dakota	189	$243.72	$199.23	10
Nebraska	187	$332.03	$282.17	12
Delaware	179	$287.29	$227.37	10
Massachusetts	179	$267.42	$207.83	9
Montana	177	$255.18	$202.32	10
South Dakota	134	$238.85	$203.95	6
Nevada	122	$225.30	$181.79	8
New Mexico	114	$249.40	$196.36	6
Oregon	97	$444.50	$349.64	7
New Hampshire	92	$264.71	$210.38	6
Utah	79	$230.67	$191.40	5
Connecticut	75	$284.15	$216.24	4
Minnesota	55	$258.03	$210.59	4
Idaho	39	$230.79	$201.52	3
Rhode Island	25	$261.87	$199.90	2
Hawaii	23	$283.16	$231.49	2
District of Columbia	21	$304.76	$229.43	1
Maine	11	$277.66	$230.47	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
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.