Transthoracic echocardiography for congenital cardiac anomalies; complete

CPT 93303 is the billing code for "Transthoracic echocardiography for congenital cardiac anomalies; complete". For complete transthoracic echocardiography to evaluate cardiac structure and function

Medicare pays approximately $208.63 for CPT 93303 (national average). Actual payment varies by geographic location due to GPCI adjustments. Hospital and commercial insurance rates are typically 2-4x higher than Medicare rates.

CPT 93303 has a total RVU of 7.55, broken down as: Work RVU 2.50, Practice Expense RVU 4.80, and Malpractice RVU 0.25. RVUs (Relative Value Units) determine Medicare reimbursement rates.

Key documentation requirements for CPT 93303 include: Indication for echocardiography; Complete cardiac structure assessment; Left ventricular function and wall motion; Valvular function assessment. Missing or incomplete documentation is a leading cause of claim denials for this code.

Bundling considerations for CPT 93303: Includes complete echocardiography. Includes M-mode, 2D, and Doppler imaging Use an NCCI bundling checker to verify specific code combinations before billing.

Common modifiers for CPT 93303 include: 26 (Professional component only (interpretation)), TC (Technical component only (equipment/staff)), 59 (Distinct procedural service if performed separately). Modifiers indicate special circumstances and can affect reimbursement or prevent claim denials.

The typical time requirement for CPT 93303 is 30-45 minutes typical procedure time. Time-based codes require documentation of the actual time spent providing the service.