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    v1.0.28
    OpenPayerBilling CodesIntracardiac Electrophysiological Procedures/StudiesCPT cpt-93631-epicardial-endocardial-mapping-pacing-open-heart-surgery
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    CPT 93631: Epicardial and Endocardial Pacing and Mapping, Open Heart

    Medicare pays $403 on average nationally for this procedure.

    CPT code 93631 describes intraoperative epicardial and endocardial pacing and mapping performed during open heart surgery to identify tachycardia- or arrhythmia-generating foci; service type: intraoperative cardiac electrophysiology mapping and pacing; typical site of service: operating room during open cardiac surgery.

    For related coverage guidance, see recent payer policy updates: Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use Disorders, Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use Disorders, Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use Disorders.

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    Clinical & Coding Specifications

    Clinical Context

    A 63-year-old male with ischemic cardiomyopathy is scheduled for open-heart surgery for coronary artery bypass grafting and concurrent evaluation of recurrent intraoperative atrial tachyarrhythmias. During the median sternotomy and cardiopulmonary bypass, the cardiac electrophysiology team performs epicardial and endocardial pacing and mapping to localize tachycardia and arrhythmogenic foci that are contributing to hemodynamically significant arrhythmias. The workflow includes preoperative review of prior electrocardiography and telemetry, intraoperative placement of epicardial pacing/sensing wires on the surface of the heart, transvenous access for endocardial mapping catheters as indicated, programmed stimulation and pacing protocols to induce and characterize arrhythmia, recording of activation sequences, and documentation of targeted sites for possible surgical ablation or modification. Post-mapping, findings are communicated to the surgical team to guide lesion placement or adjunctive therapy, and mapping data are included in the operative report and billing documentation for code 93631.

    Related CPT Codes

    CPT CodeDescriptionRelationship to This Procedure
    33405Cardiopulmonary bypass, with pump oxygenator; initiation and managementOften performed during open-heart surgery providing circulatory support while epicardial/endocardial mapping is performed.
    33430Open heart procedure, valve repair or replacement (separate specific code as applicable)Cardiac surgical procedures during which intraoperative mapping may be performed concurrently to address arrhythmias.
    93650Intracardiac electrophysiologic (EP) study, without catheter ablation including insertion and repositioning of electrode cathetersPerformed when endocardial catheter mapping and stimulation are done; portions of EP study techniques overlap with intraoperative mapping.
    93653Mapping for catheter ablation, electroanatomic mapping for complex arrhythmias, including intra-procedural catheter movement and computer-assisted mappingWhen detailed electroanatomic mapping is performed in conjunction with ablation procedures; complements surgical mapping data.
    33210Insertion of temporary transvenous pacing electrode, emergency procedureTemporary pacing may be placed before, during, or after mapping to manage bradyarrhythmias or as part of programmed stimulation protocols.
    33426Pericardial window creation or related pericardial proceduresSometimes performed in the same operative setting when epicardial access or visualization is required for mapping.

    Related Modifiers

    9 rows

    ModifierDescriptionWhen to Use
    62Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
    22Modifier –22 (Increased Procedural Services) is used when a reported procedure is substantially more extensive than normally required. The CPT Manual and CMS state it may be appended only when the…- When to use: Append modifier -22 to a procedural CPT code when the service performed is substantially more extensive than the usual service described by that code — i.e., the procedure required…
    26Modifier 26 (Professional Component) identifies and bills only the professional portion of a split service — the physician’s interpretation, report, and medical judgment — when the technical…- Use CPT Modifier -26 when you are billing only the professional component (PC) of a split‑bill eligible service—i.e., you performed the physician interpretation, medical judgment and prepared a…
    50Modifier –50 (Bilateral Procedure) is appended to a CPT code when an identical procedure is performed on paired anatomical structures during the same operative session. The AMA states to add…- Use modifier -50 when the same CPT surgical, diagnostic, or radiology procedure is performed on paired anatomical structures (both sides of the body) during the same operative/session by the same…
    52Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
    53Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
    73Modifier 73 indicates a facility-level outpatient hospital or ASC procedure that was discontinued after the patient was prepared and taken to the procedure/operating room but before any anesthesia…- When to use: Apply CPT modifier 73 on the FACILITY (outpatient hospital or ASC) claim when the patient has been fully prepared and physically taken into the procedure/operating room but the…
    78CPT modifier -78 indicates an unplanned, related return to the operating or procedure room by the same provider during the global postoperative period. It is appended when treatment for a…- Use modifier -78 when an unplanned, related complication during the original procedure’s global postoperative period requires the patient to return to a formal operating or procedure room and the…
    80CPT® Modifier 80 (Assistant Surgeon) is appended to a surgical CPT code when a physician (MD or DO) provides full, continuous assistance throughout the operative procedure. It is intended only for…- Use CPT Modifier -80 when a physician (MD or DO) serves as an assistant surgeon and provides full, continuous assistance throughout the entire operative procedure; append -80 to the surgical CPT…

    Related Provider Taxonomies

    8 rows

    Taxonomy CodeSpecialtyNotes
    208000000XPediatrics PhysicianA pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectru…
    207RH0000XHematology (Internal Medicine) PhysicianAn internist with additional training who specializes in diseases of the blood, spleen and lymph. This specialist treats conditions such as anemia, cl…
    2084P0800XPsychiatry PhysicianA Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, …
    207L00000XAnesthesiology PhysicianAn anesthesiologist is trained to provide pain relief and maintenance, or restoration, of a stable condition during and immediately following an opera…
    246Q00000XPathology Specialist/Technologist(1) An individual educated and trained in clinical chemistry, microbiology or other biological sciences; and in gathering data on the blood, tissues, …
    225600000XDance TherapistThe dance therapist, sometimes called a movement therapist, focuses on rhythmic body movements as a medium of physical and psychological change. Dance…
    261QC0050XCritical Access Hospital Clinic/CenterAn outpatient entity, facility, or distinct part of a facility within or affiliated with a Critical Access Hospital that provides access to primary ca…
    246ZB0500XBiochemistTechnologists, Technicians & Other Technical Service Providers · Specialist/Technologist, Other

    Related Payer Policy Updates

    Specialty: Anesthesiology1 / 3

    9 rows

    PolicyPayerEffective Date
    Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use DisordersPremera Bluecross2026-07-01
    Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use DisordersPremera Bluecross2026-07-01
    Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use DisordersPremera Bluecross2026-07-01
    Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric or Substance Use DisordersPremera Bluecross2026-07-01
    Elective Inpatient Services (for Idaho Only)UnitedHealthcare2026-06-01
    Sites of Servicepriority health2026-06-01
    Coverage for Ambulatory Surgery Unit (ASU)/Outpatient Facility and Anesthesia for Dental Servicesuniverahealthcare2026-05-21
    Mm_0579_Coveragepositioncriteria_Anesthesia_Services_Selected_Nerve_BlocksCigna2026-05-15
    Intravenous Anesthetics for the Treatment of Chronic Pain and Psychiatric DisordersBlue Cross Blue Shield - North Carolina2026-04-01

    Related Codes

    CPT-93600-HIS-BUNDLE-ELECTROGRAM-RECORDING

    CPT 93600: Electrogram Recording of Bundle of His

    CPT-93602-INTRACARDIAC-ATRIAL-ELECTROGRAM-RECORDING

    CPT 93602: Intracardiac Atrial Electrogram Recording

    CPT-93603-INTRACARDIAC-ELECTROGRAM-RECORDING-VENTRICLE

    CPT 93603: Intracardiac Electrogram Recording from Ventricular Chamber

    CPT-93609-ELECTROPHYSIOLOGY-MAPPING-INDUCED-ARRHYTHMIA

    CPT 93609: Electrophysiology Study with Arrhythmia Induction and Mapping

    CPT-93610-ATRIAL-PACING-ELECTROPHYSIOLOGY-EVALUATION

    CPT 93610: Atrial Pacing for Electrophysiology Evaluation

    CPT-93612-VENTRICULAR-PACING-DIAGNOSTIC

    CPT 93612: Ventricular Pacing During Electrophysiology Study

    CPT-93613-ELECTROANATOMIC-MAPPING-WITH-ARRHYTHMIA-INDUCTION

    CPT 93613: Electroanatomic Mapping for Arrhythmia Localization

    CPT-93615-ESOPHAGEAL-ELECTROGRAM-ELECTRODE-PLACEMENT

    CPT 93615: Esophageal Electrogram Recording of Atria

    CPT-93616-ESOPHAGEAL-ELECTROGRAM-PACING-ELECTRODE

    CPT 93616: Esophageal Atrial Pacing and Electrogram Recording

    CPT-93618-CATHETER-INSERTION-TO-INDUCE-ARRHYTHMIA

    CPT 93618: Catheter Insertion to Induce Arrhythmia

    Showing 1–10 of 28

    Frequently Asked Questions

    References

    1. 1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
    2. 2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
    3. 3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.
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