CPT code 93321: Doppler echo, limited or follow-up2026 Medicare rate & RVUs in Pennsylvania
Reports limited or follow-up spectral Doppler assessment performed with echocardiographic imaging, such as focused evaluation of blood flow or pressure gradients.
Medicare pays $23.72–$26.36 for 93321 in the office in Pennsylvania, from Rest of Pennsylvania to Metropolitan Philadelphia, PA. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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What 93321 covers
This add-on covers a limited or follow-up spectral Doppler assessment during an echocardiographic examination, using pulsed-wave and/or continuous-wave Doppler to evaluate blood-flow patterns or velocities. It may help assess a focused hemodynamic question, such as a valve gradient, rather than provide the broader Doppler assessment of a complete study. A cardiac sonographer typically acquires the images, and a qualified physician interprets the findings in an outpatient imaging setting or hospital.
Report 93321 only with an eligible primary echocardiographic procedure; a limited transthoracic study such as 93308 is a common pairing. The record should support the focused Doppler service and its medical purpose. CMS treats it as an add-on paid within the primary procedure’s global period. Modifier 26 identifies the interpretation, modifier TC identifies the equipment and staff, and reporting without either modifier represents the global service.
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 93321 pays more and less in Pennsylvania
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Philadelphia, PA | $26.36 | Unavailable |
| Rest of Pennsylvania | $23.72 | Unavailable |
How the 93321 rate is calculated
Each of 93321’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 · 93321
RVUs × geographic indexes × conversion factor
Work0.15
0.15 RVUs× 1.000 GPCI
Practice expense0.60
0.60 RVUs× 1.000 GPCI
Malpractice0.01
0.01 RVUs× 1.000 GPCI
Adjusted RVUs
0.7600
Conversion factor
$33.4009
Medicare rate
$25.38
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 93321
The CMS indicators that decide how 93321 is paid alongside other services.
CMS payment indicators · 93321
Doppler echo, limited or follow-up
| Rule | CMS value | What it means |
|---|---|---|
| Global period | ZZZ | Add-on code: falls within the primary procedure’s global period. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 1 | Diagnostic test with separate professional (26) and technical (TC) components. |
What modifiers do to the payment
Modifier 26 · payment effect
With and without the modifier
93321 without 26 · national office
$25.38
Doppler echo, limited or follow-up
93321-26 · Professional component
$7.35
Pays only the interpretation and report.
93321 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 93320Spectral DopplerComplete assessment
- 93320 is for complete spectral Doppler assessment; 93321 is for limited or follow-up Doppler assessment.
- 93308EchocardiogramFollow-up or limited study
- 93308 reports limited or follow-up transthoracic imaging. 93321 is the add-on for a qualifying limited Doppler service, not the imaging study itself.
- 93306Echocardiogram (TTE)Complete, with spectral and color Doppler
- 93306 reports a complete transthoracic study that includes spectral Doppler. 93321 is used with an eligible primary study for a limited or follow-up Doppler service.
93321 billing questions
When should 93321 be selected instead of 93320?
Use 93321 for limited or follow-up Doppler assessment. Use 93320 when the Doppler assessment is complete.
Can 93321 be billed by itself?
No. It is an add-on and must be reported with an eligible primary echocardiographic procedure, such as a limited study reported with 93308.
Does a complete study reported with 93306 also need 93321?
93306 includes spectral Doppler as part of the complete transthoracic study. Do not add 93321 merely to report that included Doppler work.
How do modifiers 26 and TC apply?
Use modifier 26 for the physician’s interpretation or TC for the technical service. Without either modifier, the claim represents the global service.
What documentation supports limited Doppler reporting?
Document the focused or follow-up Doppler assessment, its clinical purpose, and the findings interpreted. The record should distinguish this work from a complete Doppler 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
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