Transcath closure of vsd
Percutaneous transcatheter closure of ventricular septal defect (heart hole repair) shows a potential difference of $16,805 depending on care setting, making bill verification essential before treatment.
About the analyst
David Park researches procedure pricing and insurance reimbursement patterns at BillRazor Research. He specializes in cost comparison across care settings and metropolitan areas. Expertise: procedure pricing, insurance reimbursement, cost comparison.
This procedure uses a catheter inserted through the skin to close an abnormal hole between the heart's lower chambers without open surgery. Patients are typically infants or children born with this heart defect, though some adults may also receive this treatment. The procedure code 93581 charges approximately 8.2x the Medicare reimbursement rate of $1,247, with potential billing differences of $4,500 depending on the facility type.
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Facility rate
$1,151
National Medicare benchmark
Non-facility rate
$99
Office setting benchmark
Data sources
3
23 data points
Key insights for CPT 93581
Facility vs office setting
$1,052 differenceNon-facility setting is less expensive for this procedure
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 |
|---|---|---|
| Facility (physician office) | $1,151 | +1063% |
| Non-facility (office) | $99 | Lowest |
| Outpatient (APC) | $17,957 | +18038% |
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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.
Related procedures
Related pricing data
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