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

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, 2026One payment locality1.4K Medicare services in 2024

In North Carolina, Medicare pays $144.59 for 93304 in the office.

$144.59Office (non-facility)
Not available in this settingHospital or facility
−5.9%vs the national office rate ($153.64)

Check a contract rate as a % of Medicare · 93304 nationwide

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

We’ll open 93304 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in North Carolina
  2. What 93304 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. 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.

How North Carolina compares for 93304

Across 109 of 109 payment localities, the office rate for 93304 runs from $134.96 in Arkansas to $212.25 in San Benito County, CA. North Carolina pays $144.59. The RVUs are the same everywhere; the geographic indexes change the dollars.

93304 in North Carolina vs other payment areas
  1. North Carolina · this page$144.59
  2. Los Angeles, CA · California$177.61+$33.02
  3. Washington, DC area · District of Columbia$177.88+$33.29
  4. Miami, FL · Florida$160.93+$16.34
  5. Chicago, IL · Illinois$156.18+$11.59
  6. Manhattan, NY · New York$176.71+$32.12
  7. Alaska · Alaska$173.55+$28.96

Other areas in North Carolina first, then benchmark localities. Bars start at $0.

Every other payment area

93304 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$137.07—
ArkansasArkansas$134.96—
ArizonaArizona$149.49—
Bakersfield, CACalifornia$165.87—
Chico, CACalifornia$165.72—
El Centro, CACalifornia$165.73—
Fresno, CACalifornia$165.72—
Hanford, CACalifornia$165.72—

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

See 93304 in every payment locality

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.

The exact North Carolina inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

12,043

Code
93304
Physician work
0.73
Practice expense
3.83
Malpractice
0.04

GPCI2026.csv

83

Locality
North Carolina
Physician work
1.000
Practice expense
0.933
Malpractice
0.639
Office calculation for 93304 in North Carolina
ComponentRVULocality factorAdjusted
Physician work0.73× 1.0000.7300
Practice expense3.83× 0.9333.5734
Malpractice0.04× 0.6390.0256
Total RVUs4.3289
Conversion factor× 33.4009

Office rate, North Carolina$144.59

Office: (0.73 × 1 + 3.83 × 0.933 + 0.04 × 0.639) × $33.4009 = $144.59

Open 93304 in the RVU calculator

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

How 93304 has changed in North Carolina

93304 · Office / nonfacility

$144.59

Effective 2026-10-01

The base rate is $7.15 higher than on 2025-10-01, moving from $137.44 to $144.59 (5.2%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release
  1. January 1, 2026

    RVU26A

    $137.44changed to$144.59

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 0.75 changed to 0.73
    • Practice expense RVU 3.75 changed to 3.83
    • Practice expense GPCI 0.926 changed to 0.933
    • Malpractice GPCI 0.665 changed to 0.639

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $145.05changed to$137.44

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 3.86 changed to 3.75
    • Malpractice RVU 0.05 changed to 0.04

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $142.69changed to$145.05

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $147.55changed to$142.69

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 3.84 changed to 3.86
    • Malpractice RVU 0.06 changed to 0.05
    • Practice expense GPCI 0.927 changed to 0.926
    • Malpractice GPCI 0.742 changed to 0.665
  5. January 1, 2023

    RVU23A

    $152.90changed to$147.55

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 3.90 changed to 3.84
    • Practice expense GPCI 0.928 changed to 0.927
    • Malpractice GPCI 0.819 changed to 0.742

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $156.44changed to$152.90

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 3.97 changed to 3.90

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $153.29changed to$156.44

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 3.72 changed to 3.97
    • Malpractice RVU 0.05 changed to 0.06
    • Practice expense GPCI 0.930 changed to 0.928
    • Malpractice GPCI 0.757 changed to 0.819

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $153.52changed to$153.29

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 3.74 changed to 3.72
    • Malpractice RVU 0.04 changed to 0.05
    • Practice expense GPCI 0.931 changed to 0.930
    • Malpractice GPCI 0.695 changed to 0.757

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $154.35changed to$153.52

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 3.77 changed to 3.74

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $148.25changed to$154.35

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 3.60 changed to 3.77
    • Malpractice GPCI 0.732 changed to 0.695

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $148.16changed to$148.25

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 3.61 changed to 3.60
    • Practice expense GPCI 0.930 changed to 0.931
    • Malpractice GPCI 0.768 changed to 0.732

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $147.42changed to$148.16

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 3.58 changed to 3.61
    • Malpractice RVU 0.03 changed to 0.04

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $146.68changed to$147.42

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $149.05changed to$146.68

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 3.64 changed to 3.58
    • Malpractice RVU 0.04 changed to 0.03
    • Practice expense GPCI 0.929 changed to 0.930
    • Malpractice GPCI 0.732 changed to 0.768

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $123.29changed to$149.05

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 3.07 changed to 3.64
    • Practice expense GPCI 0.927 changed to 0.929
    • Malpractice GPCI 0.695 changed to 0.732

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $123.29

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$144.59Not available in this settingRVU26D
2026-07-01$144.59Not available in this settingRVU26C
2026-04-01$144.59Not available in this settingRVU26B
2026-01-01$144.59Not available in this settingRVU26A
2025-10-01$137.44Not available in this settingRVU25D
2025-07-01$137.44Not available in this settingRVU25C
2025-04-01$137.44Not available in this settingRVU25B
2025-01-01$137.44Not available in this settingRVU25A
2024-10-01$145.05Not available in this settingRVU24D
2024-07-01$145.05Not available in this settingRVU24C
2024-04-01$145.05Not available in this settingRVU24B
2024-03-09$145.05Not available in this settingRVU24AR
2024-01-01$142.69Not available in this settingRVU24A
2023-10-01$147.55Not available in this settingRVU23D
2023-07-01$147.55Not available in this settingRVU23C
2023-04-01$147.55Not available in this settingRVU23B
2023-01-01$147.55Not available in this settingRVU23A
2022-10-01$152.90Not available in this settingRVU22D
2022-07-01$152.90Not available in this settingRVU22C
2022-04-01$152.90Not available in this settingRVU22B
2022-01-01$152.90Not available in this settingRVU22A
2021-10-01$156.44Not available in this settingRVU21D
2021-07-01$156.44Not available in this settingRVU21C
2021-04-01$156.44Not available in this settingRVU21B
2021-01-01$156.44Not available in this settingRVU21A
2020-10-01$153.29Not available in this settingRVU20D
2020-07-01$153.29Not available in this settingRVU20C
2020-04-01$153.29Not available in this settingRVU20B
2020-01-01$153.29Not available in this settingRVU20A
2019-10-01$153.52Not available in this settingRVU19D
2019-07-01$153.52Not available in this settingRVU19C
2019-04-01$153.52Not available in this settingRVU19B
2019-01-01$153.52Not available in this settingRVU19A
2018-10-01$154.35Not available in this settingRVU18D
2018-07-01$154.35Not available in this settingRVU18C
2018-04-01$154.35Not available in this settingRVU18B
2018-01-01$154.35Not available in this settingRVU18AR1
2017-10-01$148.25Not available in this settingRVU17D
2017-07-01$148.25Not available in this settingRVU17C
2017-04-01$148.25Not available in this settingRVU17B
2017-01-01$148.25Not available in this settingRVU17A
2016-10-01$148.16Not available in this settingRVU16D
2016-07-01$148.16Not available in this settingRVU16C
2016-04-01$148.16Not available in this settingRVU16B
2016-01-01$148.16Not available in this settingRVU16A
2015-10-01$147.42Not available in this settingRVU15D
2015-07-01$147.42Not available in this settingRVU15C
2015-04-01$146.68Not available in this settingRVU15B
2015-01-01$146.68Not available in this settingRVU15A
2014-10-01$149.05Not available in this settingRVU14D
2014-07-01$149.05Not available in this settingRVU14C
2014-04-01$149.05Not available in this settingRVU14B
2014-01-01$149.05Not available in this settingRVU14A
2013-10-01$123.29Not available in this settingRVU13D
2013-07-01$123.29Not available in this settingRVU13C
2013-04-01$123.29Not available in this settingRVU13B
2013-01-01$123.29Not available in this settingRVU13AR

Price 93304 for an earlier date of service

Where the North Carolina rate applies

North Carolina is a Medicare payment area, not a city. Our Census mapping connects it to 785 cities and communities in North Carolina. Some span more than one payment area; confirm with the service ZIP.

  • Aberdeen
  • Advance
  • Ahoskie
  • Alamance
  • Albemarle
  • Alexis
  • Alliance
  • Altamahaw

Browse all communities in North Carolina

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)
Geographic factors for North CarolinaGPCI2026.csv, line 83 (RVU26D)

Open CMS sourceHow we calculate rates

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