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Percutaneous transcatheter heart balloon drug infusion costs range from $3,333 to $5,702 depending on facility type, making bill verification essential given this potential $2,369 price difference.
About the analyst
Kevin Nyk analyzes hospital pricing data at BillRazor Research. He specializes in Medicare reimbursement patterns and chargemaster pricing across U.S. hospitals. Expertise: hospital pricing, Medicare rates, chargemaster analysis.
This procedure involves inserting a specialized balloon catheter through the skin into heart vessels to deliver targeted medication directly to cardiac tissue. Patients with specific heart conditions requiring localized drug therapy typically receive this treatment. Code 0913T is a Category III (temporary) CPT code, meaning reimbursement policies vary significantly between payers and documentation requirements are often more stringent.
Non-facility rate
$99
Office setting benchmark
Data sources
4
23 data points
Key insights for CPT 0913T
ASC vs hospital outpatient savings
$2,369Having this done at an ambulatory surgery center costs $3,333 vs $5,702 at a hospital outpatient
What this procedure costs across different settings
The same procedure can cost very different amounts depending on where it's performed. These are the Medicare-allowed amounts — what hospitals actually charge can be 3-10x higher.
| Setting | Medicare rate | vs lowest |
|---|---|---|
| Non-facility (office) | $99 | Lowest |
| Outpatient (APC) | $5,702 | +5659% |
| Ambulatory surgery (ASC) | $3,333 | +3267% |
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About this data
Rates shown are from the 2026 Medicare Physician Fee Schedule, Hospital Outpatient Prospective Payment System (OPPS), Ambulatory Surgery Center Payment System, Clinical Laboratory Fee Schedule, Durable Medical Equipment Fee Schedule, and CMS Inpatient Prospective Payment System (DRG weights). Regional adjustments use CMS Geographic Practice Cost Indices (GPCI). Hospital charges are from CMS Hospital Price Transparency machine-readable files. All data is publicly available under federal law (45 CFR Part 180).
This data is for informational purposes only and does not constitute medical or financial advice. Actual costs depend on insurance coverage, negotiated rates, and individual circumstances.
Data: Medicare Physician Fee Schedule, CMS Inpatient PPS (IPPS), Outpatient PPS (OPPS), ASC Payment System, Clinical Lab Fee Schedule (CLFS), National Average Drug Acquisition Cost (NADAC). FY 2024 data. All publicly available from CMS.
Methodology: Facility rate applies when the procedure is performed in a hospital or ASC. Non-facility rate applies in a physician office. GPCI adjustments reflect regional cost-of-living differences.
This information is for educational purposes only and is not medical, financial, or legal advice. Actual costs depend on your insurance and provider. We recommend verifying costs directly with your provider. Full methodology · Terms of use