Tte w/doppler complete
CPT code 93306 represents a complete ultrasound examination of the heart (transthoracic echocardiogram) that includes Doppler measurements to assess blood flow through the heart's chambers and valves.
RVU breakdown
Conversion factor: 32.3465 · Source: CMS MPFS RVU25A · Confidence: High
Billing tips
Bill 93306 only when ALL required components are performed and documented: 2D imaging, M-mode, spectral Doppler, and color flow Doppler of all chambers and valves
Impact: Incomplete studies may be downcoded to limited echo codes (93307-93308), reducing reimbursement by $50-$100
Never bill 93306 with add-on Doppler codes 93320-93321 on the same date of service
Impact: These are bundled into 93306; attempting to bill separately will result in denial and potential audit flags
Ensure the written report includes quantitative measurements (EF%, chamber dimensions, valve gradients, valve areas) not just qualitative descriptions
Impact: Lack of quantitative data is a primary audit trigger and can result in full denial of the $187.93 payment
When billing globally (not using 26/TC modifiers), verify your practice owns or leases the equipment and employs the sonographer
Impact: Incorrect global billing when you should bill professional component only can trigger overpayment recovery actions
Document medical necessity clearly in the order and report; routine screening or patient request alone is insufficient
Impact: Medical necessity denials are the most common reason for 93306 rejections, affecting 15-20% of claims without proper documentation
Verify patient did not have a complete echo (93306 or 93350) within 30 days unless clinical status has significantly changed
Impact: Repeat studies within 30 days without documented clinical change face high denial rates (60-70%) and recoupment risk
Common denials
Medical necessity not established - insufficient documentation of signs, symptoms, or clinical indication
How to appeal: Submit appeal with detailed clinical notes documenting specific symptoms (dyspnea, chest pain, new murmur), abnormal EKG findings, or relevant diagnosis requiring cardiac assessment. Include treatment plan changes based on echo results.
Frequency limitation - study performed too soon after previous complete echocardiogram
How to appeal: Provide documentation of significant clinical change, new symptoms, medication changes, or acute event (hospitalization, arrhythmia) that necessitated repeat evaluation. Compare clinical status at time of prior study versus current study.
Incomplete documentation - report lacks required quantitative measurements or complete assessment of all cardiac structures
How to appeal: Submit complete amended report including all required elements: LV dimensions and EF%, all four valves assessed with gradients/areas where applicable, RV size and function, pericardium, and interpretation of all Doppler studies. May require study review and addendum by interpreting physician.
Bundling/CCI edit violation - billed with mutually exclusive or component codes
How to appeal: If services were truly distinct and separate, provide detailed documentation with timeline showing procedures were performed at different sessions or anatomically distinct. Consider whether correct code is 93306 or if limited study code (93308) is more appropriate. Remove bundled codes from claim if not separately reimbursable.
Frequently asked questions
What is the Medicare reimbursement rate for CPT 93306 in 2025?
The 2025 Medicare national average reimbursement for CPT 93306 is $187.93 for both facility and non-facility settings, based on 5.81 total RVUs and the 2025 conversion factor of 32.3465.
What is the difference between CPT 93306 and 93307?
CPT 93306 is a complete transthoracic echocardiogram including Doppler and color flow, while 93307 is a complete echo without spectral or color Doppler. Code 93306 requires comprehensive Doppler assessment of all valves and flow patterns, making it more thorough and higher reimbursed than 93307.
Can I bill CPT 93306 with modifier 26 for interpretation only?
Yes, modifier 26 can be appended when billing only the professional component (physician interpretation) separately from the technical component. However, for 93306, the facility and non-facility rates are identical ($187.93), which is unusual and should be verified with your MAC for proper component billing.
How often can CPT 93306 be billed for the same patient?
There is no absolute Medicare frequency limit for 93306, but repeat studies within 30 days face heightened scrutiny and require clear documentation of significant clinical change, new symptoms, or acute events. Routine surveillance without clinical indication will be denied for medical necessity.
What documentation is required to bill CPT 93306?
Required documentation includes complete 2D and M-mode imaging, spectral and color flow Doppler of all four valves, quantitative measurements (EF%, chamber dimensions, valve gradients), assessment of ventricular function, a medical indication, and a complete written interpretation signed by a qualified physician.
Can CPT 93306 and 93320 be billed together?
No, CPT 93320 (Doppler echocardiography) is bundled into 93306 and cannot be billed separately on the same date of service. Code 93306 already includes all Doppler components, so billing 93320 separately would be considered unbundling and will be denied.
What are the RVUs for CPT code 93306 in 2025?
The 2025 RVUs for CPT 93306 are: Work RVU 1.46, Practice Expense RVU 4.28 (both facility and non-facility), Malpractice RVU 0.07, for a total of 5.81 RVUs. These values are from the CMS Medicare Physician Fee Schedule RVU25A released December 23, 2024.