CPT 93356Cardiology

Myocrd strain img spckl trck

CPT 93356 covers myocardial strain imaging using speckle tracking technology, an advanced echocardiography technique that measures how well heart muscle segments are contracting and relaxing. This add-on analysis helps doctors detect early heart muscle damage that traditional echocardiography might miss.

Showing rates for

National Average

Base Medicare rate

$35.26

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

0.24

PE RVU (NF)

0.83

MP RVU

0.02

Total RVU

1.09

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

NCCI bundling edits

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Billing tips

Always bill 93356 as an add-on to a primary echocardiography code (93303, 93304, 93306, 93307, 93308, 93350, or 93351) - never alone
Impact: Billing without primary code results in 100% denial; proper pairing ensures full $35.26 reimbursement
Document the specific clinical indication requiring strain analysis beyond standard echocardiography, such as chemotherapy cardiotoxicity monitoring or early cardiomyopathy detection
Impact: Specific medical necessity documentation reduces denial rates by 60-70% and supports the $35.26 payment
Bill non-facility rate ($35.26) only when performed in physician office with owned equipment; use facility rate ($11.32) for hospital outpatient settings
Impact: Incorrect place of service coding can trigger $23.94 overpayment recoupment during audits
Ensure physician report explicitly mentions speckle tracking methodology, strain values (GLS, circumferential, radial), and clinical correlation
Impact: Vague documentation like 'strain analysis performed' increases audit vulnerability and denial risk by 40%
Verify payer-specific policies as some commercial insurers consider 93356 investigational for certain indications and may deny coverage
Impact: Pre-authorization for non-covered indications can prevent write-offs averaging $35-150 depending on contract rates
When billing with 3D echocardiography codes (93319, 93320, 93321), document why both advanced techniques were medically necessary
Impact: Dual advanced imaging billing without justification triggers bundling edits resulting in $35.26 denial for the add-on code

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Frequently asked questions

What is CPT code 93356 used for?

CPT 93356 is used for myocardial strain imaging using speckle tracking echocardiography, an advanced analysis technique that measures heart muscle deformation to detect early cardiac dysfunction. It's billed as an add-on to primary echocardiography codes when this specialized analysis is performed.

How much does Medicare pay for CPT 93356 in 2025?

Medicare pays $35.26 for CPT 93356 in non-facility settings (physician offices) and $11.32 in facility settings (hospital outpatient departments) based on 2025 national average rates. The code carries 1.09 total RVUs with a work RVU of 0.24.

Can CPT 93356 be billed alone?

No, CPT 93356 cannot be billed alone. It is an add-on code that must be billed with a primary echocardiography procedure code such as 93303, 93304, 93306, 93307, 93308, 93350, or 93351. Billing it without a primary code will result in denial.

What modifiers are used with CPT 93356?

Common modifiers for 93356 include modifier 26 (professional component only), TC (technical component only), 59 (distinct procedural service), and 76 (repeat procedure by same physician). The appropriate modifier depends on practice setting and billing circumstances.

What documentation is required for CPT 93356?

Documentation must explicitly state speckle tracking was performed, identify the software used, include quantitative strain measurements (especially global longitudinal strain), specify cardiac segments analyzed, provide clinical indication, and include interpretation correlating findings with patient condition. Generic statements are insufficient.

Is CPT 93356 covered by all insurance companies?

Coverage varies by payer. Medicare covers 93356 when medically necessary and properly documented. Many commercial insurers cover it for established indications like chemotherapy cardiotoxicity monitoring, but some consider it investigational for other uses. Always verify payer-specific policies before performing the service.

What are common denial reasons for CPT 93356?

Common denials include billing without an appropriate primary echocardiography code, lack of medical necessity documentation, insufficient detail in the physician report about speckle tracking methodology, bundling with the primary echo code, and payer policies considering it experimental for certain clinical indications.