CPT 93460 covers a combined right and left heart catheterization performed with coronary angiography. It is the code that resolves one of the most common cath lab billing errors, where a right heart study and a left heart study with angiography are submitted as two separate lines.
What CPT 93460 covers
93460 is catheter placement for coronary angiography, including intraprocedural injections, imaging supervision and interpretation, with right and left heart catheterization including injection(s) for left ventriculography when performed.
One code covers all of it: the right-sided pressures and saturations, the left-sided study, the ventriculogram and the coronary angiography.
Where 93460 sits in the cath family
93460 is coronary angiography with right and left heart catheterization. If bypass grafts were also imaged it becomes 93461; if only one side of the heart was catheterized it is 93456 (right) or 93458 (left). Both catheterizations are inside 93460, so 93451 and 93452 are never added to it for the same session. See the complete 93451 to 93461 code map on the CPT 93458 guide.
Reimbursement context
93460 splits into professional and technical components, and the setting decides which you may report.
2026 Medicare RVUs for CPT 93460
| CPT 93460: 2026 Medicare RVUs (national, before GPCI) | ||||||
|---|---|---|---|---|---|---|
| Line | Work | PE, non-facility | PE, facility | Malpractice | Total, non-facility | Total, facility |
| Global (no modifier) | 6.92 | 27.78 | NA | 1.40 | 36.10 | NA |
| Professional (modifier 26) | 6.92 | 2.63 | 2.63 | 1.34 | 10.89 | 10.89 |
| Technical (modifier TC) | 0.00 | 25.15 | NA | 0.06 | 25.21 | NA |
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 93460 carries 6.92 work RVUs and 36.10 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, 10.89 total RVUs) and a technical component (modifier TC, 25.21 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); 93460 sits at 6.92.
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
93451 and 93458 billed as two lines
This is the error 93460 exists to prevent. Two lines describing a single combined study will have one of them stripped.
Fix: replace both with 93460.
CO-97: 93454 billed alongside 93460
Coronary angiography is already inside 93460.
Fix: remove the 93454 line.
93451 billed alongside 93460
The right heart catheterization is already inside the combined code.
Fix: remove the 93451 line.
Bypass grafts imaged but 93460 reported
Graft angiography is not inside 93460.
Fix: report 93461.
Right heart findings not documented
Billing the combined code requires evidence the right heart study actually happened: pressures, saturations, cardiac output where measured.
Fix: document the right-sided data rather than relying on the procedure title.
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.Two add-ons are separately reportable with 93460 when genuinely performed and documented: 93567 for supravalvular aortography and 93568 for pulmonary artery angiography.
Modifier rules
- 26 / TC: 93460 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 93460.
- 59 / XE / XP / XS / XU: only for a genuinely distinct service in a separate session, site or encounter. 93460 already contains 93451 to 93454, 93456 and 93458, so none of them is added with a modifier.
- 51: multiple procedures; most payers apply it automatically.
- 22: increased procedural services on 93460 is rare, needs a narrative and goes to manual review.
- LC, LD, RC, RI, LM: vessel modifiers belong on intervention codes, not on 93460.
NCCI bundling edits
- 93451 and 93454 are both components of 93460. Neither is separately reportable alongside it.
- 93452 and 93458 describe left-sided work already inside 93460.
- 93460 and 93461 are mutually exclusive for one session.
- Access, closure, guidance and angiographic injections are included.
- 93567 and 93568: both separately reportable with 93460 where genuinely performed and documented.
Frequently asked questions
When is CPT 93460 the correct code?
Can I bill 93451 with 93460?
What if bypass grafts were also imaged?
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 93460.
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 93451. Right heart catheterization.
- CPT 93458. Left heart cath with coronary angiography.
- CPT 93461. Right and left heart cath with coronary and graft angiography.
More cardiology code guides
- CPT 93306. Complete TTE with spectral and color flow Doppler.
- CPT 93307. Complete TTE without Doppler.
- CPT 93308. Limited or follow-up echo.
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.
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