CPT 93458: what Medicare pays in 2026
Heart test or procedure
Medicare's 2026 national amount for 93458 is $1,010.04 when a doctor's office or clinic bills it. Across Medicare's 109 payment localities the office amount runs from $880.36 in Arkansas to $1,361.74 in San Jose-Sunnyvale-Santa Clara (San Benito County), CA.
CPT descriptions are copyrighted by the American Medical Association, so this page shows the code number only. The description printed on your bill, or the provider, will tell you what the code covers.
Medicare amounts for 93458 in 2026
- Doctor's office or clinic, national
- $1,010.04
- Professional part only (modifier 26), office, national
- $287.25
- Technical part only (modifier TC), office, national
- $722.80
- Hospital outpatient rate, national (APC 5191)
- $3,312.15
- Hospital outpatient status J1
- comprehensive rate (covers most other services on the same hospital claim)
Same-day global period: routine care on the day of the procedure is included. Hospital outpatient rates are national figures before Medicare's wage adjustment, which moves about 60% of the rate up or down with local hospital wages.
What providers charged Medicare for 93458 in 2024
From CMS's national utilization file (the most recent full year published). The charge is the provider's list price, the same kind of figure an uninsured patient is usually billed.
| Setting | Services | Average charge | Medicare allowed | Charge vs allowed |
|---|---|---|---|---|
| In an office or other non-facility setting | 4,296 | $3,013.60 | $600.35 | 5.0× |
| In a facility setting | 387,434 | $1,582.75 | $269.39 | 5.9× |
How Medicare builds the 93458 amount
Each physician fee schedule amount is three relative value units (RVUs), each multiplied by the locality's cost index, added up and multiplied by the 2026 conversion factor of $33.4009.
- Work RVU
- 5.46
- Practice expense RVU, office
- 23.65
- Malpractice RVU
- 1.13
93458 in every Medicare locality
The office amount is lowest in Arkansas and highest in San Jose-Sunnyvale-Santa Clara (San Benito County), CA.
| State | Locality | Office | Facility |
|---|---|---|---|
| AK | Alaska | $1,135.63 | none |
| AL | Alabama | $894.92 | none |
| AR | Arkansas | $880.36 | none |
| AZ | Arizona | $980.12 | none |
| CA | Bakersfield | $1,074.58 | none |
| CA | Chico | $1,071.46 | none |
| CA | El Centro | $1,071.65 | none |
| CA | Fresno | $1,071.46 | none |
| CA | Hanford-Corcoran | $1,071.46 | none |
| CA | Los Angeles-Long Beach-Anaheim (Los Angeles/Orange County) | $1,149.40 | none |
| CA | Madera | $1,071.46 | none |
| CA | Merced | $1,071.46 | none |
| CA | Modesto | $1,071.46 | none |
| CA | Napa | $1,254.16 | none |
| CA | Oxnard-Thousand Oaks-Ventura | $1,144.69 | none |
| CA | Redding | $1,071.46 | none |
| CA | Rest of California | $1,071.46 | none |
| CA | Riverside-San Bernardino-Ontario | $1,083.61 | none |
| CA | Sacramento-Roseville-Folsom | $1,127.85 | none |
| CA | Salinas | $1,123.78 | none |
| CA | San Diego-Chula Vista-Carlsbad | $1,153.05 | none |
| CA | San Francisco-Oakland-Berkeley (Marin County) | $1,330.82 | none |
| CA | San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa County) | $1,329.54 | none |
| CA | San Jose-Sunnyvale-Santa Clara (San Benito County) | $1,361.74 | none |
| CA | San Jose-Sunnyvale-Santa Clara (Santa Clara County) | $1,356.49 | none |
| CA | San Luis Obispo-Paso Robles | $1,105.43 | none |
| CA | Santa Cruz-Watsonville | $1,166.20 | none |
| CA | Santa Maria-Santa Barbara | $1,128.77 | none |
| CA | Santa Rosa-Petaluma | $1,178.11 | none |
| CA | Stockton | $1,071.46 | none |
| CA | Vallejo | $1,252.31 | none |
| CA | Visalia | $1,071.46 | none |
| CA | Yuba City | $1,071.46 | none |
| CO | Colorado | $1,054.52 | none |
| CT | Connecticut | $1,082.44 | none |
| DC | DC + MD/VA Suburbs | $1,164.76 | none |
| DE | Delaware | $997.66 | none |
| FL | Fort Lauderdale | $1,050.81 | none |
| FL | Miami | $1,100.14 | none |
| FL | Rest of Florida | $994.27 | none |
| GA | Atlanta | $1,030.82 | none |
| GA | Rest of Georgia | $931.98 | none |
| HI | Hawaii, Guam | $1,102.37 | none |
| IA | Iowa | $920.14 | none |
| ID | Idaho | $926.96 | none |
| IL | Chicago | $1,064.15 | none |
| IL | East St. Louis | $985.12 | none |
| IL | Rest of Illinois | $962.57 | none |
| IL | Suburban Chicago | $1,061.79 | none |
| IN | Indiana | $932.98 | none |
| KS | Kansas | $915.49 | none |
| KY | Kentucky | $919.15 | none |
| LA | New Orleans | $968.57 | none |
| LA | Rest of Louisiana | $917.62 | none |
| MA | Metropolitan Boston | $1,166.62 | none |
| MA | Rest of Massachusetts | $1,047.17 | none |
| MD | Baltimore/Surrounding Counties | $1,079.57 | none |
| MD | Rest of Maryland | $1,018.25 | none |
| ME | Rest of Maine | $932.58 | none |
| ME | Southern Maine | $989.01 | none |
| MI | Detroit | $1,008.29 | none |
| MI | Rest of Michigan | $946.19 | none |
| MN | Minnesota | $1,006.38 | none |
| MO | Metropolitan Kansas City | $960.99 | none |
| MO | Metropolitan St. Louis | $972.20 | none |
| MO | Rest of Missouri | $900.05 | none |
| MS | Mississippi | $890.39 | none |
| MT | Montana | $1,009.97 | none |
| NC | North Carolina | $943.49 | none |
| ND | North Dakota | $987.62 | none |
| NE | Nebraska | $925.74 | none |
| NH | New Hampshire | $1,037.71 | none |
| NJ | Northern NJ | $1,150.49 | none |
| NJ | Rest of New Jersey | $1,093.67 | none |
| NM | New Mexico | $952.07 | none |
| NV | Nevada | $1,004.53 | none |
| NY | Manhattan | $1,171.80 | none |
| NY | NYC Suburbs/Long Island | $1,203.36 | none |
| NY | Poughkeepsie/Northern NYC Suburbs | $1,101.22 | none |
| NY | Queens | $1,182.16 | none |
| NY | Rest of New York | $959.34 | none |
| OH | Ohio | $941.62 | none |
| OK | Oklahoma | $917.10 | none |
| OR | Portland | $1,090.98 | none |
| OR | Rest of Oregon | $995.67 | none |
| PA | Metropolitan Philadelphia | $1,053.00 | none |
| PA | Rest of Pennsylvania | $943.19 | none |
| PR | Puerto Rico | $1,018.17 | none |
| RI | Rhode Island | $1,035.50 | none |
| SC | South Carolina | $944.35 | none |
| SD | South Dakota | $984.98 | none |
| TN | Tennessee | $920.68 | none |
| TX | Austin | $1,051.92 | none |
| TX | Beaumont | $936.27 | none |
| TX | Brazoria | $996.09 | none |
| TX | Dallas | $1,003.17 | none |
| TX | Fort Worth | $995.76 | none |
| TX | Galveston | $999.48 | none |
| TX | Houston | $1,020.16 | none |
| TX | Rest of Texas | $966.10 | none |
| UT | Utah | $958.80 | none |
| VA | Virginia | $985.52 | none |
| VI | Virgin Islands | $1,018.17 | none |
| VT | Vermont | $983.50 | none |
| WA | Rest of Washington | $1,045.26 | none |
| WA | Seattle (King County) | $1,191.57 | none |
| WI | Wisconsin | $950.75 | none |
| WV | West Virginia | $922.83 | none |
| WY | Wyoming | $1,000.23 | none |