Echo transesophageal
CPT code 93314 covers a transesophageal echocardiogram (TEE), a specialized ultrasound test where a probe is inserted through the esophagus to get detailed images of the heart's structure and function.
RVU breakdown
Conversion factor: 32.3465 · Source: CMS MPFS RVU25A · Confidence: High
Billing tips
Separate professional and technical components appropriately - hospitals typically bill TC while physicians bill 26 modifier
Impact: Prevents duplicate billing denials and ensures correct payment split between facility ($215.75 global) and professional components
Document medical necessity clearly, especially when performed within 30 days of transthoracic echo
Impact: Reduces denial rate by 40-60% when clear clinical indication explains why standard echo was insufficient
Do not bill 93314 with intraoperative TEE codes (93355) - these are separate services with different indications
Impact: Prevents bundling denials and potential compliance issues; intraoperative codes reimburse separately at different rates
Include sedation time and monitoring in documentation but bill conscious sedation separately with 99151-99153 when criteria met
Impact: Can add $75-150 in additional reimbursement when sedation meets time and documentation requirements
Verify place of service code matches actual location (22 for outpatient hospital, 24 for ASC, 21 for inpatient)
Impact: Both facility and non-facility rates are $215.75 for 93314, but incorrect POS triggers audit flags
For Medicare patients, ensure ordering physician documents indication and signs order before procedure
Impact: Missing signed orders account for 25% of TEE denials; retroactive orders not accepted for payment
Common denials
Medical necessity not established - payer requires prior transthoracic echo or specific clinical indication
How to appeal: Submit appeal with documentation showing: (1) specific clinical question requiring TEE, (2) prior TTE results if performed with limitations noted, (3) peer-reviewed guidelines supporting TEE for the indication, (4) how TEE findings altered management
Bundled with other cardiovascular procedures performed same day without appropriate modifier
How to appeal: Resubmit with modifier 59 and detailed operative report showing TEE was separate, medically necessary procedure not included in primary procedure's global package; cite CCI edits and modifier guidelines
Incomplete documentation - missing probe insertion note, image interpretation, or measurements
How to appeal: Provide complete TEE report including: indication, patient preparation, sedation details, probe insertion documentation, systematic image acquisition protocol, complete measurements, interpretation, and impression with clinical correlation
Duplicate billing with professional component already paid to another provider
How to appeal: Submit documentation clarifying which provider performed and interpreted study; correct billing with appropriate modifier (26 or TC) and refund any overpayment; establish clear billing protocols to prevent recurrence
Frequently asked questions
What is the Medicare reimbursement rate for CPT 93314 in 2025?
The 2025 Medicare national average payment for CPT 93314 is $215.75 for both facility and non-facility settings. This is based on 6.67 total RVUs multiplied by the conversion factor of 32.3465. Actual payment may vary by geographic location based on GPCI adjustments.
How many RVUs is CPT code 93314 worth?
CPT 93314 has 6.67 total RVUs in 2025, consisting of 1.85 work RVUs, 4.63 practice expense RVUs, and 0.19 malpractice RVUs. The practice expense RVU is the same for both facility and non-facility settings.
Can you bill CPT 93314 and 93306 together on the same day?
Yes, 93314 (TEE) and 93306 (complete transthoracic echo) can be billed together when both are medically necessary and address different clinical questions. Use modifier 59 on 93314 to indicate a distinct procedural service. Documentation must clearly justify why both studies were required.
What modifier should I use for professional component billing of 93314?
Use modifier 26 when billing only the professional component (interpretation) of CPT 93314. This is common when the procedure is performed at a hospital or facility that owns the equipment and bills the technical component separately with modifier TC.
Does CPT 93314 include probe manipulation or is that billed separately?
CPT 93314 is the complete transesophageal echocardiography code that includes probe insertion, image acquisition, manipulation, and interpretation. Probe manipulation is not billed separately. This code represents the global service for diagnostic TEE.
What documentation is required to bill 93314 to Medicare?
Required documentation includes: medical necessity/indication, informed consent, sedation details, probe insertion documentation, systematic image acquisition across standard TEE views, quantitative measurements, complete interpretation addressing the clinical indication, and attending physician signature. Missing any element risks denial.
Is prior authorization required for CPT 93314?
Prior authorization requirements vary by payer. Most Medicare Advantage plans require prior authorization for TEE. Traditional Medicare does not require prior auth but does require medical necessity documentation. Commercial payers commonly require authorization, especially for outpatient settings. Always verify with the specific payer before scheduling.