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Ultrasound Reimbursement & CPT Codes |
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2012 Medicare Physicians Fee Schedule |
Unadjusted |
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Unadjusted National Amount |
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Professional |
Technical |
Global |
2012 Medicare Outpatient |
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CPT Code |
Description |
Fee-26 (1) |
Fee-TC (2) |
Fee (3) |
Prospective Payment |
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System (OPPS) (4) |
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93303 |
Transthoracic echocardiography for |
$ 64.33 |
$ 143.64 |
$ 207.97 |
$579.34 |
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congenital cardiac anomolies; complete |
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APC Code: 0270 |
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Status Indicator: S |
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93304 |
Transthoracic echocardiography for |
$ 36.76 |
$ 98.03 |
$ 134.79 |
$392.78 |
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congenital cardiac anomolies; Follow-up |
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APC Code: 0269 |
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or limited study |
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Status Indicator: S |
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93306 |
Echocardiogaphy, transthoracic, real- |
$ 64.67 |
$ 148.40 |
$ 213.08 |
$392.78 |
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time with image documentation (2D), |
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APC Code: 0269 |
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includes M-Mode recording, when |
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Status Indicator: S |
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performed, complete, with spectral |
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Doppler Echocardiography, and with color |
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flow Doppler echocardiography |
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93307 |
Echocardiogaphy, transthoracic, real- |
$ 45.95 |
$ 86.46 |
$ 132.41 |
$392.78 |
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time with image documentation (2D), |
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APC Code: 0269 |
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includes M-Mode recording, when |
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Status Indicator: S |
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performed, complete, without spectral |
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or color Doppler echocardiography |
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93308 |
Echocardiogaphy, transthoracic, real- |
$ 25.87 |
$ 75.90 |
$ 101.77 |
$221.17 |
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time with image documentation (2D), |
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APC Code: 0697 |
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includes M-Mode recording, when |
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Status Indicator: S |
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performed, follow-up or limited study |
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93312 |
Echocardiography, tranesophogeal, |
$ 106.20 |
$ 209.33 |
$ 315.53 |
$579.34 |
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real-time with image documentation (2D) |
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APC Code: 0270 |
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(with or without M-mode recording); |
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Status Indicator: S |
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including probe placement, image |
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acquisition, interpretation and report |
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93313 |
Echocardiography, tranesophogeal, |
N/A |
N/A |
41.87 |
$392.78 |
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real-time with image documentation (2D) |
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APC Code: 0269 |
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(with or without M-mode recording); |
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Status Indicator: S |
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placement of transesophogeal probe only |
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93314 |
Echocardiography, tranesophogeal, |
$ 60.59 |
$ 226.01 |
$ 286.60 |
Status Inicator: N |
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real-time with image documentation (2D) |
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(with or without M-mode recording); |
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image acquisition, interpretation and |
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report only |
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93315 |
Transesophogeal echocardiograhy for |
$ 140.92 |
N/A |
N/A |
$392.78 |
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congental cardiac anomolies; including |
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APC Code: 0269 |
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probe placement, image acquisition, |
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Status Indicator: S |
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interpretation and report |
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93317 |
Transesophogeal echocardiograhy for |
$ 92.58 |
N/A |
N/A |
Status Indicator: N |
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congental cardiac anomolies; image |
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acquisition, interpretation and report only |
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93318 |
Echocardiography, tranesophogeal |
$ 111.98 |
N/A |
N/A |
$579.34 |
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(TEE) for monitoring purposes, including |
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APC Code: 270 |
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probe placement, real time 2-dimensional |
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Status Indicator: S |
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image acquisition and interpretaion |
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leading to ongoing (continuous) |
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assessment of (dynamically changing) |
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cardiac pumping function, and to |
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therapeutic measures on an immediate |
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time basis |
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93320 |
Doppler echocardiography, pulsed wave |
$ 18.72 |
$ 35.40 |
$ 54.12 |
Status Indicator: N |
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and/or continuous wave with spectral |
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display (List separately in addition to |
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codes for echocardiographic imaging); |
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compete |
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93321 |
Doppler echocardiography, pulsed wave |
$ 7.49 |
$ 19.40 |
$ 26.89 |
Status Indicator: N |
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and/or continuous wave with spectral |
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display (List separately in addition to |
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codes for echocardiographic imaging); |
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follow-up or limites study (List separately |
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in addition to codes for echocardiographic |
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imaging) |
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93325 |
Doppler echocardiography color flow |
$ 3.74 |
$ 24.51 |
$ 28.25 |
Status Indicator: N |
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velocity mapping (List separately in |
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addition to codes for echocardiography) |
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93350 |
Echocardiogaphy, transthoracic, real- |
$ 72.84 |
$ 134.79 |
$ 207.63 |
$392.78 |
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time with image documentation (2D), |
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APC Code: 0269 |
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includes M-Mode recording, when |
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Status Indicator: S |
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performed, during rest and cardiovascular |
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stress test using treadmill, bicycle |
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exercise and/or pharmacologically |
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induced stress, with interpretation and |
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report |
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93351 |
Echocardiogaphy, transthoracic, real- |
$ 87.48 |
$ 155.21 |
$ 242.69 |
$579.34 |
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time with image documentation (2D), |
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APC Code: 0270 |
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includes M-Mode recording, when |
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Status Indicator: S |
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performed, during rest and cardiovascular |
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stress test using treadmill, bicycle |
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exercise and/or pharmacologically |
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induced stress, with interpretation and |
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report; including performance of |
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continuous electrocardiographic |
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monitoring, with physician supervision |
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93352 |
Use of echocardiographic contrast agent |
N/A |
N/A |
$ 35.06 |
Status Indicator: M |
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during stress echocardiography (List |
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seaparately in addition to code for primary |
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Procedure |
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Important Notes: |
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Status Indicators: |
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A-Not paid under OPPS. Paid by fiscal intermediaries/MACs under a fee schedule or payment system other than OPPS. |
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B-Not paid under OPPS. |
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-May be paid by fiscal intermediaries/MACs when submitted on a different bill type, for example, 75x (CORF) but |
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not paid under OPPS. |
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-An alternate code that is recognized by OPPS when submitted on an outpatient hospital Part B bill type (12x and 12x) may |
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be available. |
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E-Not paid by medicare when submitted on outpatient claims (any outpatient bill type). |
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N-Paid under OPPS; payment is packaged into payment for other services. Therefore, there is no separate APC |
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Davis Medical Electronics, Inc. provides general reimbursement information related to the diagnosis of peripheral arterial disease as an overview for our customers. It is important to understand that reimbursement is a complex process and requirements are subject to change without notice. It is the responsibility of the healthcare provider to determine and submit appropriate codes, charges and modifiers for services that are rendered. Prior to filing any claims, customers are advised to contact their third-party payers for specific coverage, coding and payment information. Davis Medical Electronics, Inc. makes no promise or guarantee of reimbursement by Medicare or any other third-party payer. |
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Davis Medical Electronics 2441 Cades Way Bldg 200 Vista, CA 92081 888-599-6641 www.davismedical.com |