CPT 93320Cardiology

Doppler echo complete

CPT code 93320 covers a complete Doppler echocardiogram, an ultrasound test that examines blood flow through the heart's chambers and valves using sound waves. This diagnostic procedure helps detect heart valve problems, blood flow abnormalities, and other cardiovascular conditions.

Showing rates for

National Average

Base Medicare rate

$48.52

This calculator gives a typical-case estimate using standard Medicare modifier rules. Actual payment depends on payer policies, documentation, code-specific CMS status indicators, and locality. Verify before billing.

RVU breakdown

Work RVU

0.38

PE RVU (NF)

1.1

MP RVU

0.02

Total RVU

1.5

Conversion factor: 32.3465 · Source: CMS MPFS RVU25A · Confidence: High

NCCI bundling edits

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Billing tips

Always verify whether 93320 is bundled into your primary echo code (93303-93308 series) before billing separately
Impact: Prevents 100% denial for duplicate/bundled services and reduces audit risk
Document all Doppler modalities used: pulsed-wave, continuous-wave, and color flow for all four valves and chambers
Impact: Ensures medical necessity is established and prevents downcoding to limited Doppler studies (93321)
Bill 93320 globally without modifiers when practice owns equipment and employs interpreting physician
Impact: Captures full $48.52 Medicare payment versus split technical/professional payments
For split billing arrangements, verify contractual arrangements between technical and professional providers before submitting claims
Impact: Prevents duplicate billing and ensures correct modifier 26/TC usage, avoiding recoupment demands
Check payer-specific bundling edits as many commercial payers bundle 93320 into comprehensive echo codes unlike Medicare
Impact: Can affect 30-50% of claims if commercial payer policies differ from Medicare's separate reimbursement model
When billing with stress echo codes, verify that 93320 represents Doppler performed at rest separately from stress imaging
Impact: Prevents denial for services already included in stress echo global codes (93350-93352)

Common denials

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Frequently asked questions

What is the Medicare reimbursement rate for CPT code 93320 in 2025?

The 2025 Medicare national average reimbursement rate for CPT 93320 is $48.52 for both facility and non-facility settings. This is based on 1.5 total RVUs (0.38 work RVU, 1.1 PE RVU, 0.02 MP RVU) multiplied by the 2025 conversion factor of 32.3465.

Can CPT 93320 be billed separately with a complete echocardiogram?

It depends on the payer and specific echo code. Medicare allows separate billing of 93320 with certain echo codes when not bundled by NCCI edits, but many comprehensive echo codes (93303-93308) already include complete Doppler and should not be billed separately. Always check current NCCI edits and payer-specific policies before billing both codes together.

What is the difference between CPT 93320 and 93321?

CPT 93320 represents a complete Doppler echocardiographic examination including spectral and color flow Doppler of all cardiac structures, while 93321 is a follow-up or limited Doppler study. The complete study (93320) requires documentation of pulsed-wave, continuous-wave, and color Doppler for all valves and chambers, whereas 93321 involves focused reassessment of specific structures.

How many RVUs is CPT code 93320 worth?

CPT 93320 has a total of 1.5 RVUs for 2025, consisting of 0.38 work RVUs, 1.1 practice expense RVUs (both facility and non-facility), and 0.02 malpractice RVUs according to the CMS Medicare Physician Fee Schedule RVU25A released December 23, 2024.

Do I need modifier 26 or TC when billing 93320?

Use modifier 26 when billing only the professional component (physician interpretation) and modifier TC when billing only the technical component (equipment, sonographer). Bill 93320 without modifiers only when your practice provides both components. Split billing requires clear contractual arrangements to avoid duplicate payment issues.

What documentation is required to bill CPT 93320?

Required documentation includes evidence of complete Doppler interrogation using pulsed-wave, continuous-wave, and color flow techniques for all four cardiac valves and chambers, quantitative measurements of velocities and gradients, permanent image storage, medical necessity justification, and a signed physician interpretation report detailing all Doppler findings.

Is CPT 93320 bundled with stress echocardiography codes?

Generally, 93320 should not be billed separately with stress echo codes (93350-93352) as complete Doppler assessment is typically included in the stress study. However, if a separate resting complete Doppler is medically necessary and performed distinctly from the stress protocol, documentation must clearly support the separate service with appropriate modifiers to prevent denial.