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93350

Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or pharmacologically induced stress, with interpretation and report

Cardiology Diagnostic Testing 12.12 Total RVUs
Quick Reference
For stress echocardiography with exercise or pharmacologic stress

Audit Defense & Denial Intelligence

Research-based denial patterns from OrbDoc Bill Analyzer

High overall risk
Top issues: Echocardiogram billed as complete when limited views obtained

1. Echocardiogram billed as complete when limited views obtained

Very Common

93350 (echocardiogram transthoracic complete) requires 2D imaging with M-mode and Doppler of: LV size/function, RV, LA, RA, aortic valve, mitral valve, tricuspid valve, pulmonic valve, pericardium, and Doppler assessment. Denied when limited study performed (focused views), when technical quality prevents complete evaluation, or when follow-up echo on known single issue.

Common Causes

  • Report documents LV function only - that's limited 93308, not complete 93350
  • Study for pre-op clearance focused on LV - limited exam even if multiple views obtained
  • Poor acoustic windows prevent full valve assessment but billed as complete

Resolution Strategy

Document complete exam: 'Complete transthoracic echocardiogram. 2D imaging: LV size normal, EF 55-60%, no wall motion abnormalities. RV normal size/function. LA mildly dilated. RA normal. M-mode measurements: LVIDd 4.8cm, LVIDs 3.2cm. Doppler: Aortic valve trileaflet, trace AI, peak velocity 1.2 m/s. Mitral valve normal, mild MR. Tricuspid valve normal, trace TR, RVSP 28 mmHg. Pulmonic valve normal. No pericardial effusion.' Must document: all four chambers, all four valves, pericardium, both 2D and Doppler. If any component missing, bill limited 93308. Appeal only if complete exam actually performed but inadequately documented. Success rate moderate if amended report shows all components.

Appeal Success: Medium
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Relative Value Units (RVUs)

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Work RVU
4.20
Physician effort
PE RVU
7.50
Practice expense
MP RVU
0.42
Malpractice
Total RVU
12.12
Combined value
Dollar reimbursement rates vary by locality and payer. RVUs shown for relative comparison only.
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Clinical Information

When to Use

For stress echocardiography with exercise or pharmacologic stress

Time Requirement
60-90 minutes typical procedure time

Common Scenarios

Evaluation of coronary artery disease
Assessment of myocardial ischemia
Evaluation of exercise capacity
Assessment of valvular function during stress
Evaluation of left ventricular function during stress

Documentation Requirements

  • Indication for stress echocardiography
  • Type of stress used (exercise vs pharmacologic)
  • Rest and stress images
  • Wall motion assessment
  • Interpretation and report

Coding Guidelines

Common Modifiers

26 Professional component only (interpretation)
TC Technical component only (equipment/staff)
59 Distinct procedural service if performed separately
52 Reduced services if procedure not completed

Bundling Rules

  • Includes rest and stress echocardiography
  • Includes stress testing
  • Includes interpretation
  • Baseline echocardiography coded separately
  • Transesophageal echocardiography coded separately

Exclusions

  • 93303 (transthoracic echocardiography, rest only)
  • 93306 (complete transthoracic echocardiography)
  • 93307 (complete transthoracic echocardiography without Doppler)
  • 93015 (cardiovascular stress test)

Coding Notes

No global period - diagnostic procedure
Includes rest and stress imaging
Document type of stress used
Professional and technical components may be separate

Clinical scenarios

Evaluation of coronary artery disease
Evaluation of coronary artery disease
When to use:For stress echocardiography with exercise or pharmacologic stress
  • Indication for stress echocardiography
  • Type of stress used (exercise vs pharmacologic)
  • Rest and stress images
Pitfalls:Echocardiogram billed as complete when limited views obtained
Assessment of myocardial ischemia
Assessment of myocardial ischemia
When to use:For stress echocardiography with exercise or pharmacologic stress
  • Indication for stress echocardiography
  • Type of stress used (exercise vs pharmacologic)
  • Rest and stress images
Pitfalls:Echocardiogram billed as complete when limited views obtained
Evaluation of exercise capacity
Evaluation of exercise capacity
When to use:For stress echocardiography with exercise or pharmacologic stress
  • Indication for stress echocardiography
  • Type of stress used (exercise vs pharmacologic)
  • Rest and stress images
Pitfalls:Echocardiogram billed as complete when limited views obtained

Who are you?

Code Details

Code 93350
Category Cardiology
Subcategory Diagnostic Testing
Total RVUs 12.12

Medicare Pricing

PFS
2025 National Rate
$176.94
Facility
$176.94
Non-Facility
$176.94
RVU Breakdown
Work RVU:1.46PE RVU:3.95MP RVU:0.06Total RVU:5.47CF:$32.3465Global Days:XXX
OPPS Details
APC:5524Status:SCopayment:
Physician Fee Schedule: Medicare pays physicians based on Relative Value Units (RVUs) multiplied by a conversion factor.

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Frequently Asked Questions

What is CPT code 93350?

CPT 93350 is the billing code for "Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or pharmacologically induced stress, with interpretation and report". For stress echocardiography with exercise or pharmacologic stress

How much does Medicare pay for CPT 93350?

Medicare pays approximately $176.94 for CPT 93350 (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.

What are the RVUs for CPT 93350?

CPT 93350 has a total RVU of 12.12, broken down as: Work RVU 4.20, Practice Expense RVU 7.50, and Malpractice RVU 0.42. RVUs (Relative Value Units) determine Medicare reimbursement rates.

Why was my 93350 claim denied?

The most common denial reason for CPT 93350 is "Echocardiogram billed as complete when limited views obtained". 93350 (echocardiogram transthoracic complete) requires 2D imaging with M-mode and Doppler of: LV size/function, RV, LA, RA, aortic valve, mitral valve, tricuspid valve, pulmonic valve, pericardium, and Doppler assessment. Denied when limited study performed (focused views), when technical quality prevents complete evaluation, or when follow-up echo on known single issue. Common causes include: Report documents LV function only - that's limited 93308, not complete 93350; Study for pre-op clearance focused on LV - limited exam even if multiple views obtained. Appeal success rate is approximately 40-60%.

What documentation is required for CPT 93350?

Key documentation requirements for CPT 93350 include: Indication for stress echocardiography; Type of stress used (exercise vs pharmacologic); Rest and stress images; Wall motion assessment. Missing or incomplete documentation is a leading cause of claim denials for this code.

Can CPT 93350 be billed with other codes?

Bundling considerations for CPT 93350: Includes rest and stress echocardiography. Includes stress testing Use an NCCI bundling checker to verify specific code combinations before billing.

What modifiers are commonly used with CPT 93350?

Common modifiers for CPT 93350 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.

What is the time requirement for CPT 93350?

The typical time requirement for CPT 93350 is 60-90 minutes typical procedure time. Time-based codes require documentation of the actual time spent providing the service.

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