CPT 93452: Left Heart Catheterization With Ventriculography

Mukesh MakwanaFounder & CEO · Hands-on medical billing & RCM across 11 specialties · Reviewed September 28, 2026

CPT 93452 covers a left heart catheterization with left ventriculography and no coronary angiography. It is a narrow code, and the most frequent error is reporting it alongside a coronary angiography code when a single combined code already describes that study.

What CPT 93452 covers

93452 is left heart catheterization including intraprocedural injection(s) for left ventriculography, imaging supervision and interpretation, when performed. It covers left-sided pressures and the ventriculogram.

What it does not include is coronary angiography. That is the distinction that drives its denial profile: if the coronaries were imaged in the same session, 93452 is the wrong code.

Where 93452 sits in the cath family

93452 is left heart catheterization with ventriculography and no coronary angiography. Image the coronaries in the same session and it becomes 93458, or 93459 with bypass grafts. Add right heart catheterization without coronaries and it becomes 93453; with coronaries, 93460 or 93461. See the complete 93451 to 93461 code map on the CPT 93458 guide.

Reimbursement context

93452 splits into professional and technical components, and the setting decides which you may report.

2026 Medicare RVUs for CPT 93452

Source: CMS CY 2026 PFS Relative Value File, RVU26D (October release, published 08/26/2026). RVUs are national and unadjusted; commercial payers set their own rates.

In the 2026 CMS relative value file, CPT 93452 carries 4.39 work RVUs and 26.23 total RVUs when billed globally in a non-facility setting. The global line is NA in a facility, because there the physician bills the professional component only and the facility bills the technical side. Its PC/TC indicator is 1: the code splits into a professional component (modifier 26, 6.92 total RVUs) and a technical component (modifier TC, 19.31 total RVUs), and the global line is billed only when one entity does both. Its global period is 000: related work on the day of the procedure is included, with no postoperative days. Across the diagnostic catheterization family, work RVUs run from 2.41 (93451) to 7.65 (93461); 93452 sits at 4.39.

To turn RVUs into payment, each component is multiplied by your locality's geographic practice cost index, the three are added, and the sum is multiplied by the 2026 conversion factor: $33.4009, or $33.5675 for qualifying APM participants (CMS-1832-F; CMS fact sheet). The CMS Physician Fee Schedule Look-Up Tool runs that calculation for your locality.

Documentation requirements

• The cardiac indication that justified the study, coded specifically.
• Access site, sheath and each catheter used.
• Every vessel or chamber selectively engaged, with findings.
• Hemodynamic measurements obtained, including pressures, gradients and saturations where applicable.
• Contrast volume and fluoroscopy time.
• A signed interpretation naming the study actually performed.
• Where an intervention followed in the same session, why the diagnostic study was necessary and not already available.

Medicare contractor billing articles. Each Medicare Administrative Contractor publishes its own billing and coding articles for this service, and the covered diagnoses differ by jurisdiction. Active examples in the CMS Medicare Coverage Database, checked September 28, 2026: A52850 (Cardiac Catheterization and Coronary Angiography, Wellpoint Federal) and A56500 (Cardiac Catheterization and Coronary Angiography, CGS). Use the article from the contractor that processes your claims.

Common denials and the exact fix

What is already inside these codes

• Vascular access and sheath placement through the same access.
• Fluoroscopic guidance and roadmapping.
• Closure devices.
• The intraprocedural injections for the angiography described by the code.
• Imaging supervision and interpretation.

Billing any of these separately on the professional claim produces a CO-236 unbundling denial. Hospitals may still report closure device placement with HCPCS G0269, but it is packaged into the procedure rather than paid separately.One add-on is separately reportable with 93452 when genuinely performed and documented: 93567 for supravalvular aortography. Pulmonary artery angiography, 93568, pairs only with codes that include a right heart catheterization, so it is not reported with 93452.

Modifier rules

• 26 / TC: 93452 splits by setting. In a hospital the physician bills modifier 26 and the facility reports the technical side; the global line is only for one entity furnishing both. A modifier that contradicts the place of service is the most common modifier denial on 93452.
• 59 / XE / XP / XS / XU: only for a genuinely distinct service in a separate session, site or encounter. Left heart catheterization with ventriculography is already inside 93453 and 93458 to 93461, so no modifier rescues a 93452 line billed next to any of them for the same session.
• 51: multiple procedures; most payers apply it automatically.
• 22: increased procedural services on 93452 is rare, needs a narrative and goes to manual review.
• LC, LD, RC, RI, LM: vessel modifiers belong on intervention codes, not on 93452.

NCCI bundling edits

• 93452 with 93454: resolves to 93458.
• 93452 with 93451: resolves to 93453, or 93460 where coronary angiography was performed.
• Access, closure, guidance and the ventriculography injections are included.
• 93567: separately reportable where genuinely performed. 93568: not reported with 93452, because it pairs only with codes that include right heart catheterization.

Frequently asked questions

Sources

American Medical Association, CPT 2026 Professional Edition.
Centers for Medicare & Medicaid Services, CY 2026 PFS Relative Value File RVU26D (October release): RVUs, PC/TC indicator and global period for CPT 93452.
Centers for Medicare & Medicaid Services, CY 2026 Physician Fee Schedule final rule, CMS-1832-F: conversion factors.
Centers for Medicare & Medicaid Services, National Correct Coding Initiative Policy Manual for Medicare Services and quarterly procedure-to-procedure edit tables.
Medicare Coverage Database billing and coding articles A52850, A56500.

CPT® is a registered trademark of the American Medical Association. Payer policy and NCCI edits change quarterly, so check your own contractor before submission. How we verify this guidance.

Related codes

• CPT 93458. Left heart cath with coronary angiography.
• CPT 93451. Right heart catheterization.
• CPT 93460. Right and left heart cath with coronary angiography.

More cardiology code guides

• CPT 93325. Color flow Doppler add-on.
• CPT 93350. Stress echo, imaging only.
• CPT 93351. Stress echo including ECG monitoring and supervision.

Related reading

• Cardiology billing & RCM. How we scrub cardiology claims across diagnostics, cath lab, EP and remote monitoring.
• Cardiac cath billing: NCCI bundling and modifier 59. Where cath lab bundling edits bite, and when a distinct-service modifier is genuinely earned.
• TC/26 modifier errors in cardiology. The split-billing mistakes that cost diagnostic practices the most.