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Official Description

Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation;

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

The CPT® Code 93454 refers to the procedure of catheter placement in the coronary arteries for the purpose of conducting coronary angiography. This procedure includes the necessary intraprocedural injections for the angiography, as well as the imaging supervision and interpretation that accompany it. In simpler terms, this involves inserting a catheter into the coronary arteries, which may also include arterial and/or venous coronary bypass grafts, to visualize the blood vessels of the heart. The process begins with the cleansing of the skin at the site where the catheter will be inserted, followed by the administration of a local anesthetic to minimize discomfort. A needle is then used to puncture the artery, and a sheath is placed to facilitate the insertion of a guidewire. This guidewire is carefully threaded through the artery and into the aorta, ultimately reaching the right or left coronary artery or a bypass graft. Once the guidewire is in place, a catheter is advanced over it, and the guidewire is subsequently removed. Contrast media is injected through the catheter to enhance the visibility of the coronary arteries and bypass grafts during imaging. Angiograms are then obtained to assess the condition of these vessels. After the angiography is completed, the catheter is withdrawn, and pressure is applied to the puncture site to prevent bleeding, followed by the application of a compression dressing. Finally, the angiograms are reviewed, and a written interpretation of the findings is generated. It is important to note that CPT® Code 93454 should be used when the catheterization and angiography are performed solely on native coronary arteries, while CPT® Code 93455 is applicable when the procedure involves both native coronary arteries and bypass grafts.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

The procedure described by CPT® Code 93454 is indicated for patients who require evaluation of the coronary arteries to diagnose conditions such as coronary artery disease, assess the severity of blockages, or plan for potential interventions. The following conditions may warrant the use of this procedure:

  • Coronary Artery Disease - A condition characterized by the narrowing or blockage of coronary arteries due to plaque buildup, leading to reduced blood flow to the heart muscle.
  • Chest Pain - Unexplained or atypical chest pain that may suggest underlying cardiac issues necessitating further investigation.
  • Abnormal Stress Test Results - Results from non-invasive stress tests that indicate potential ischemia or other cardiac abnormalities.
  • Preoperative Assessment - Evaluation of coronary artery status prior to non-cardiac surgery in patients with known risk factors for coronary artery disease.

2. Procedure

The procedure for CPT® Code 93454 involves several critical steps to ensure successful catheter placement and angiography. The following outlines the procedural steps:

  • Step 1: Preparation - The patient is positioned comfortably, and the skin over the arterial access site is thoroughly cleansed to reduce the risk of infection. A local anesthetic is administered to numb the area where the catheter will be inserted.
  • Step 2: Arterial Access - A needle is used to puncture the artery, typically in the groin or wrist, and a sheath is placed in the puncture site to facilitate the introduction of the guidewire and catheter.
  • Step 3: Guidewire Insertion - A guidewire is carefully inserted through the sheath and advanced through the artery into the aorta. The guidewire is maneuvered to position it within the right or left coronary artery or an arterial or venous coronary bypass graft.
  • Step 4: Catheter Placement - A catheter is threaded over the guidewire and advanced into the coronary artery. Once the catheter is in place, the guidewire is removed, leaving the catheter in position for the injection of contrast media.
  • Step 5: Contrast Injection and Imaging - Contrast media is injected through the catheter to enhance the visibility of the coronary arteries and bypass grafts. Radiological imaging is performed to obtain angiograms, which visualize the blood vessels.
  • Step 6: Completion of Procedure - After the angiograms are obtained, the catheter is withdrawn from the artery. Pressure is applied to the puncture site to control any bleeding, and a compression dressing is applied to ensure hemostasis.
  • Step 7: Interpretation of Findings - The angiograms are reviewed, and a written interpretation of the findings is documented for further evaluation and management.

3. Post-Procedure

After the completion of the procedure associated with CPT® Code 93454, patients are typically monitored for any complications, such as bleeding or hematoma at the puncture site. The healthcare provider will assess the patient's vital signs and the integrity of the access site. Patients may be advised to rest and avoid strenuous activities for a specified period. Follow-up appointments may be scheduled to discuss the results of the angiography and any necessary further interventions based on the findings. It is essential for patients to report any unusual symptoms, such as increased pain, swelling, or changes in sensation at the access site, to their healthcare provider promptly.

Short Descr CORONARY ARTERY ANGIO S&I
Medium Descr CATH PLACEMENT & NJX CORONARY ART ANGIO IMG S&I
Long Descr Catheter placement in coronary artery(s) for coronary angiography, including intraprocedural injection(s) for coronary angiography, imaging supervision and interpretation;
Status Code Active Code
Global Days 000 - Endoscopic or Minor Procedure
PC/TC Indicator (26, TC) 1 - Diagnostic Tests for Radiology Services
Multiple Procedures (51) 0 - No payment adjustment rules for multiple procedures apply.
Bilateral Surgery (50) 0 - 150% payment adjustment for bilateral procedures does NOT apply.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 0 - Payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62) 0 - Co-surgeons not permitted for this procedure.
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family 99 - Concept Does Not Apply
APC Status Indicator Hospital Part B services paid through a comprehensive APC
ASC Payment Indicator Non office-based surgical procedure added in CY 2008 or later; payment based on OPPS relative payment weight.
Type of Service (TOS) 2 - Surgery
Berenson-Eggers TOS (BETOS) P2F - Major procedure, cardiovascular-Other
MUE 1
CCS Clinical Classification 47 - Diagnostic cardiac catheterization, coronary arteriography

This is a primary code that can be used with these additional add-on codes.

0523T Add-on Code Resequenced Code MPFS Status: Carrier Priced APC N ASC N1 Intraprocedural coronary fractional flow reserve (FFR) with 3D functional mapping of color-coded FFR values for the coronary tree, derived from coronary angiogram data, for real-time review and interpretation of possible atherosclerotic stenosis(es) intervention (List separately in addition to code for primary procedure)
92973 Addon Code Resequenced Code MPFS Status: Active Code APC N CPT Assistant Article Illustration for Code Percutaneous transluminal coronary thrombectomy mechanical (List separately in addition to code for primary procedure)
92974 Addon Code Resequenced Code MPFS Status: Active Code APC N CPT Assistant Article Illustration for Code Transcatheter placement of radiation delivery device for subsequent coronary intravascular brachytherapy (List separately in addition to code for primary procedure)
92978 Addon Code CPT Resequenced MPFS Status: Carrier Priced APC N ASC N1 CPT Assistant Article Illustration for Code Endoluminal imaging of coronary vessel or graft using intravascular ultrasound (IVUS) or optical coherence tomography (OCT) during diagnostic evaluation and/or therapeutic intervention including imaging supervision, interpretation and report; initial vessel (List separately in addition to code for primary procedure)
93567 Addon Code MPFS Status: Active Code APC N ASC N1 Injection procedure during cardiac catheterization including imaging supervision, interpretation, and report; for supravalvular aortography (List separately in addition to code for primary procedure)
93571 Addon Code MPFS Status: Carrier Priced APC N ASC N1 CPT Assistant Article Intravascular Doppler velocity and/or pressure derived coronary flow reserve measurement (coronary vessel or graft) during coronary angiography including pharmacologically induced stress; initial vessel (List separately in addition to code for primary procedure)
93662 Addon Code MPFS Status: Carrier Priced APC N PUB 100 CPT Assistant Article Intracardiac echocardiography during therapeutic/diagnostic intervention, including imaging supervision and interpretation (List separately in addition to code for primary procedure)
G0278 Add-on Code Medicare Coverage: Carrier Priced MPFS Status: Active Code APC N Iliac and/or femoral artery angiography, non-selective, bilateral or ipsilateral to catheter insertion, performed at the same time as cardiac catheterization and/or coronary angiography, includes positioning or placement of the catheter in the distal aorta or ipsilateral femoral or iliac artery, injection of dye, production of permanent images, and radiologic supervision and interpretation (list separately in addition to primary procedure)
26 Professional component: certain procedures are a combination of a physician or other qualified health care professional component and a technical component. when the physician or other qualified health care professional component is reported separately, the service may be identified by adding modifier 26 to the usual procedure number.
59 Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25.
XU Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
GC This service has been performed in part by a resident under the direction of a teaching physician
51 Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d).
TC Technical component; under certain circumstances, a charge may be made for the technical component alone; under those circumstances the technical component charge is identified by adding modifier 'tc' to the usual procedure number; technical component charges are institutional charges and not billed separately by physicians; however, portable x-ray suppliers only bill for technical component and should utilize modifier tc; the charge data from portable x-ray suppliers will then be used to build customary and prevailing profiles
XS Separate structure, a service that is distinct because it was performed on a separate organ/structure
CR Catastrophe/disaster related
GZ Item or service expected to be denied as not reasonable and necessary
AQ Physician providing a service in an unlisted health professional shortage area (hpsa)
80 Assistant surgeon: surgical assistant services may be identified by adding modifier 80 to the usual procedure number(s).
XE Separate encounter, a service that is distinct because it occurred during a separate encounter
AO Alternate payment method declined by provider of service
Q6 Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area
XP Separate practitioner, a service that is distinct because it was performed by a different practitioner
Q1 Routine clinical service provided in a clinical research study that is in an approved clinical research study
22 Increased procedural services: when the work required to provide a service is substantially greater than typically required, it may be identified by adding modifier 22 to the usual procedure code. documentation must support the substantial additional work and the reason for the additional work (ie, increased intensity, time, technical difficulty of procedure, severity of patient's condition, physical and mental effort required). note: this modifier should not be appended to an e/m service.
25 Significant, separately identifiable evaluation and management service by the same physician or other qualified health care professional on the same day of the procedure or other service: it may be necessary to indicate that on the day a procedure or service identified by a cpt code was performed, the patient's condition required a significant, separately identifiable e/m service above and beyond the other service provided or beyond the usual preoperative and postoperative care associated with the procedure that was performed. a significant, separately identifiable e/m service is defined or substantiated by documentation that satisfies the relevant criteria for the respective e/m service to be reported (see evaluation and management services guidelines for instructions on determining level of e/m service). the e/m service may be prompted by the symptom or condition for which the procedure and/or service was provided. as such, different diagnoses are not required for reporting of the e/m services on the same date. this circumstance may be reported by adding modifier 25 to the appropriate level of e/m service. note: this modifier is not used to report an e/m service that resulted in a decision to perform surgery. see modifier 57 for significant, separately identifiable non-e/m services, see modifier 59.
52 Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use).
53 Discontinued procedure: under certain circumstances, the physician or other qualified health care professional may elect to terminate a surgical or diagnostic procedure. due to extenuating circumstances or those that threaten the well being of the patient, it may be necessary to indicate that a surgical or diagnostic procedure was started but discontinued. this circumstance may be reported by adding modifier 53 to the code reported by the individual for the discontinued procedure. note: this modifier is not used to report the elective cancellation of a procedure prior to the patient's anesthesia induction and/or surgical preparation in the operating suite. for outpatient hospital/ambulatory surgery center (asc) reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use).
58 Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78.
62 Two surgeons: when 2 surgeons work together as primary surgeons performing distinct part(s) of a procedure, each surgeon should report his/her distinct operative work by adding modifier 62 to the procedure code and any associated add-on code(s) for that procedure as long as both surgeons continue to work together as primary surgeons. each surgeon should report the co-surgery once using the same procedure code. if additional procedure(s) (including add-on procedure(s) are performed during the same surgical session, separate code(s) may also be reported with modifier 62 added. note: if a co-surgeon acts as an assistant in the performance of additional procedure(s), other than those reported with the modifier 62, during the same surgical session, those services may be reported using separate procedure code(s) with modifier 80 or modifier 82 added, as appropriate.
74 Discontinued out-patient hospital/ambulatory surgery center (asc) procedure after administration of anesthesia: due to extenuating circumstances or those that threaten the well being of the patient, the physician may terminate a surgical or diagnostic procedure after the administration of anesthesia (local, regional block(s), general) or after the procedure was started (incision made, intubation started, scope inserted, etc). under these circumstances, the procedure started but terminated can be reported by its usual procedure number and the addition of modifier 74. note: the elective cancellation of a service prior to the administration of anesthesia and/or surgical preparation of the patient should not be reported. for physician reporting of a discontinued procedure, see modifier 53.
76 Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service.
77 Repeat procedure by another physician or other qualified health care professional: it may be necessary to indicate that a basic procedure or service was repeated by another physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 77 to the repeated procedure or service. note: this modifier should not be appended to an e/m service.
78 Unplanned return to the operating/procedure room by the same physician or other qualified health care professional following initial procedure for a related procedure during the postoperative period: it may be necessary to indicate that another procedure was performed during the postoperative period of the initial procedure (unplanned procedure following initial procedure). when this procedure is related to the first, and requires the use of an operating/procedure room, it may be reported by adding modifier 78 to the related procedure. (for repeat procedures, see modifier 76.)
79 Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.)
82 Assistant surgeon (when qualified resident surgeon not available): the unavailability of a qualified resident surgeon is a prerequisite for use of modifier 82 appended to the usual procedure code number(s).
95 Synchronous telemedicine service rendered via a real-time interactive audio and video telecommunications system: synchronous telemedicine service is defined as a real-time interaction between a physician or other qualified health care professional and a patient who is located at a distant site from the physician or other qualified health care professional. the totality of the communication of information exchanged between the physician or other qualified health care professional and the patient during the course of the synchronous telemedicine service must be of an amount and nature that would be sufficient to meet the key components and/or requirements of the same service when rendered via a face-to-face interaction. modifier 95 may only be appended to the services listed in appendix p. appendix p is the list of cpt codes for services that are typically performed face-to-face, but may be rendered via a real-time (synchronous) interactive audio and video telecommunications system.
AG Primary physician
AS Physician assistant, nurse practitioner, or clinical nurse specialist services for assistant at surgery
CC Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed)
CG Policy criteria applied
ET Emergency services
GV Attending physician not employed or paid under arrangement by the patient's hospice provider
GW Service not related to the hospice patient's terminal condition
KX Requirements specified in the medical policy have been met
LC Left circumflex coronary artery
LD Left anterior descending coronary artery
LM Left main coronary artery
LT Left side (used to identify procedures performed on the left side of the body)
PD Diagnostic or related non diagnostic item or service provided in a wholly owned or operated entity to a patient who is admitted as an inpatient within 3 days
Q0 Investigational clinical service provided in a clinical research study that is in an approved clinical research study
RC Right coronary artery
RT Right side (used to identify procedures performed on the right side of the body)
SG Ambulatory surgical center (asc) facility service
SU Procedure performed in physician's office (to denote use of facility and equipment)
TG Complex/high tech level of care
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2017-01-01 Changed Moderate (Conscious) Sedation flag removed. See new Moderate Sedation category.
2011-01-01 Added Added
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