CPT code 93304: Transthoracic echo, congenital, limited or follow-up2026 Medicare rate & RVUs

Reports a focused or follow-up transthoracic echocardiogram for congenital heart disease when the study does not require a complete congenital examination.

CMS RVU26DEffective Oct 1, 2026109 payment localities1.4K Medicare services in 2024

Medicare pays $153.64 for 93304 nationally in the office. Local office rates run $134.96–$212.25.

Medicare rate · 93304

Transthoracic echo, congenital, limited or follow-up

Office or facility?

Work RVUs
0.73
Total RVUs
4.60
Global days
XXX

National rate · 2026

$153.64

Office setting, before claim adjustments.

See every locality for 93304 →Billed by an NP, PA or therapist? →

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 93304 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 93304 covers

This service uses ultrasound from the chest wall to assess a focused question or follow-up finding in a patient with congenital heart disease. Cardiologists and other qualified imaging professionals commonly perform it in an echocardiography lab, hospital, or outpatient setting. It may support surveillance of a known congenital defect or assessment after an intervention when a limited examination is appropriate; it is not the complete congenital study.

Select 93304 when the documented examination is limited or a follow-up study for congenital cardiac anatomy, rather than a complete congenital study or a limited study for a noncongenital indication. The report should identify the clinical question and the structures or findings assessed. Bill the global service without a component modifier, or use modifier 26 for interpretation or TC for equipment and staff when billing a component. CMS applies the cardiovascular diagnostic multiple-procedure reduction to the technical component, not the professional interpretation.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

Where 93304 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 payment localities

$134.96 to $212.25

$134.96$173.61$212.25
One dot per payment locality, office / nonfacility. Hover a dot to see the locality; select it to open that rate.

109 of 109 payment localities

93304 office and facility rates by payment locality
Payment localityOfficeFacility
Alabama$137.07Unavailable
Alaska$173.55Unavailable
Arizona$149.49Unavailable
Arkansas$134.96Unavailable
Atlanta, GA$156.03Unavailable
Austin, TX$160.96Unavailable
Bakersfield, CA$165.87Unavailable
Baltimore area, MD$163.69Unavailable
Beaumont, TX$142.04Unavailable
Brazoria, TX$152.39Unavailable

93304 rates by state

Office rate range in each state. Select a state to see its payment localities.

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$134.96

$188.99

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
93304 office rate range by state
State / territoryOffice rate rangeLocalities
AK$173.551
AL$137.071
AR$134.961
AZ$149.491
CA$165.72–$212.2529
CO$161.831
CT$164.261
DC$177.881
DE$152.101
FL$148.69–$160.933
GA$140.08–$156.032
GU$170.611
HI$170.611
IA$141.961
ID$142.711
IL$143.27–$158.304
IN$143.621
KS$140.701
KY$139.331
LA$138.88–$146.282
MA$160.54–$179.312
MD$155.31–$177.883
ME$142.91–$152.002
MI$142.69–$150.082
MN$156.411
MO$135.96–$147.513
MS$135.511
MT$153.641
NC$144.591
ND$152.851
NE$142.961
NH$158.721
NJ$166.52–$175.742
NM$143.291
NV$153.551
NY$146.85–$180.535
OH$142.531
OK$139.661
OR$152.74–$167.892
PA$143.08–$159.592
PR$155.031
RI$158.181
SC$143.721
SD$152.761
TN$141.381
TX$142.04–$160.968
UT$145.831
VA$151.08–$177.882
VI$155.031
VT$151.701
WA$160.42–$183.662
WI$147.351
WV$137.461
WY$153.301

How the 93304 rate is calculated

Each of 93304’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 93304

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.73

0.73 RVUs× 1.000 GPCI

Practice expense3.83

3.83 RVUs× 1.000 GPCI

Malpractice0.04

0.04 RVUs× 1.000 GPCI

Adjusted RVUs

4.6000

Conversion factor

$33.4009

Medicare rate

$153.64

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 93304

The CMS indicators that decide how 93304 is paid alongside other services.

CMS payment indicators · 93304

Transthoracic echo, congenital, limited or follow-up

RuleCMS valueWhat it means
Global periodXXXThe global surgery concept doesn’t apply.
Multiple procedures6Diagnostic cardiovascular reduction applies to the technical component.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical1Diagnostic test with separate professional (26) and technical (TC) components.

What modifiers do to the payment

Modifier 26 · payment effect

With and without the modifier

93304 without 26 · national office

$153.64

Transthoracic echo, congenital, limited or follow-up

93304-26 · Professional component

$34.74

Pays only the interpretation and report.

When to use modifier 26

93304 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 93304

    Transthoracic echo, congenital, limited or follow-up0.73 wRVU

    $153.64

  • 93303

    Congenital echo, complete transthoracic study1.27 wRVU

    $220.45+$66.81

  • 93308

    Echocardiogram, follow-up or limited study0.52 wRVU

    $101.20−$52.44

  • 93306

    Echocardiogram (TTE), complete, with spectral and color Doppler1.42 wRVU

    $196.73+$43.09

How to choose

93303Congenital echoComplete transthoracic study
Both address congenital cardiac anomalies by transthoracic imaging. Choose 93303 for a complete examination and 93304 for a limited or follow-up study.
93308EchocardiogramFollow-up or limited study
Both describe limited or follow-up transthoracic imaging, but 93304 is for congenital cardiac anomalies; 93308 belongs to the general series.
93306Echocardiogram (TTE)Complete, with spectral and color Doppler
93306 is a complete transthoracic study with Doppler. 93304 is selected for a limited or follow-up congenital study.

93304 billing questions

When should 93304 be chosen over 93303?

Use 93304 for a limited or follow-up transthoracic study addressing congenital heart disease. Use 93303 when the congenital examination is complete.

How does 93304 differ from 93308?

93304 identifies a limited or follow-up study for congenital cardiac anomalies. 93308 is the corresponding limited or follow-up transthoracic study in the general, noncongenital series.

Can the professional and technical portions be billed separately?

Yes. Report modifier 26 for the interpretation and report, or modifier TC for the equipment and staff. Billing without either modifier represents the global service.

Does the multiple-procedure reduction affect both components?

CMS applies the cardiovascular diagnostic multiple-procedure reduction to the technical component. It does not apply to the professional interpretation.

What documentation supports reporting 93304?

Document the congenital heart condition, the reason for the focused or follow-up examination, and the findings or structures evaluated. The record should support a limited study rather than a complete congenital examination.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 93304PPRRVU2026_Oct_nonQPP.csv, line 12,043 (RVU26D)

Open CMS sourceHow we calculate rates

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