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CPT code 93351: Stress echocardiogram, ECG monitoring included2026 Medicare rate & RVUs in Washington, DC area

Reports a complete transthoracic echocardiogram performed at rest and during exercise or pharmacologic stress, with ECG monitoring and physician supervision.

CMS RVU26DEffective Oct 1, 2026One payment locality165K Medicare services in 2024

In Washington, DC area, Medicare pays $267.73 for 93351 in the office.

$267.73Office (non-facility)
Not available in this settingHospital or facility
+14.7%vs the national office rate ($233.47)

Check a contract rate as a % of Medicare · 93351 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 93351 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Washington, DC area
  2. What 93351 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 93351 covers

A stress echocardiogram captures cardiac ultrasound images at rest and during treadmill or bicycle exercise, or after pharmacologic stress, so the interpreting physician can assess how cardiac function changes under stress. A sonographer commonly acquires the images in a cardiology office, hospital, or outpatient imaging department; the physician supervises the stress portion and interprets the study. Continuous ECG monitoring is part of this service.

Report one unit for the complete study, supported by documentation of the stress method, image acquisition, ECG monitoring, supervision, and interpretation. The code includes the resting and stress imaging; do not separately report a resting echocardiogram or a stress ECG service for those same components. Billing without a component modifier represents the global service. Modifier 26 identifies the interpretation, while modifier TC identifies the equipment and staff. When multiple cardiovascular diagnostic procedures are performed, the multiple procedure reduction applies to this code’s technical component.

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 Washington, DC area compares for 93351

Across 109 of 109 payment localities, the office rate for 93351 runs from $207.46 in Arkansas to $314.68 in San Benito County, CA. Washington, DC area pays $267.73. The RVUs are the same everywhere; the geographic indexes change the dollars.

93351 in Washington, DC area vs other payment areas
  1. Washington, DC area · this page$267.73
  2. Los Angeles, CA · California$266.35−$1.38
  3. Miami, FL · Florida$245.67−$22.06
  4. Chicago, IL · Illinois$239.06−$28.67
  5. Manhattan, NY · New York$267.11−$0.62
  6. Alaska · Alaska$271.78+$4.05
  7. Alabama · Alabama$210.40−$57.33

Other areas in District of Columbia first, then benchmark localities. Bars start at $0.

Every other payment area

93351 in every other Medicare payment locality
Payment localityOfficeFacility
ArkansasArkansas$207.46—
ArizonaArizona$227.63—
Bakersfield, CACalifornia$249.86—
Chico, CACalifornia$249.50—
El Centro, CACalifornia$249.52—
Fresno, CACalifornia$249.50—
Hanford, CACalifornia$249.50—
Madera, CACalifornia$249.50—

93351 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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.

$207.46

$282.09

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

View every state and territory as a table
93351 office rate range by state
State / territoryOffice rate rangeLocalities
AK$271.781
AL$210.401
AR$207.461
AZ$227.631
CA$249.50–$314.6829
CO$244.501
CT$248.641
DC$267.731
DE$231.341
FL$227.54–$245.673
GA$215.43–$237.082
GU$255.771
HI$255.771
IA$216.751
ID$217.871
IL$220.30–$241.124
IN$219.131
KS$215.211
KY$213.981
LA$213.44–$223.722
MA$242.88–$269.012
MD$235.85–$267.733
ME$218.37–$230.682
MI$218.85–$229.712
MN$236.141
MO$209.51–$225.173
MS$208.551
MT$233.471
NC$220.671
ND$231.491
NE$218.071
NH$240.151
NJ$252.00–$264.982
NM$219.781
NV$233.091
NY$223.83–$272.695
OH$218.451
OK$214.211
OR$231.79–$252.742
PA$219.10–$242.242
PR$235.331
RI$239.911
SC$219.821
SD$231.251
TN$216.181
TX$217.66–$243.248
UT$222.751
VA$229.55–$267.732
VI$235.331
VT$230.091
WA$242.59–$274.992
WI$223.891
WV$212.251
WY$232.601

See 93351 in every payment locality

How the 93351 rate is calculated

Each of 93351’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 · 93351

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.71

1.71 RVUs× 1.000 GPCI

Practice expense5.18

5.18 RVUs× 1.000 GPCI

Malpractice0.10

0.10 RVUs× 1.000 GPCI

Adjusted RVUs

6.9900

Conversion factor

$33.4009

Medicare rate

$233.47

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

The exact Washington, DC area inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

12,085

Code
93351
Physician work
1.71
Practice expense
5.18
Malpractice
0.10

GPCI2026.csv

39

Locality
Washington, DC area
Physician work
1.054
Practice expense
1.178
Malpractice
1.113
Office calculation for 93351 in Washington, DC area
ComponentRVULocality factorAdjusted
Physician work1.71× 1.0541.8023
Practice expense5.18× 1.1786.1020
Malpractice0.10× 1.1130.1113
Total RVUs8.0157
Conversion factor× 33.4009

Office rate, Washington, DC area$267.73

Office: (1.71 × 1.054 + 5.18 × 1.178 + 0.1 × 1.113) × $33.4009 = $267.73

Open 93351 in the RVU calculator

Payment rules and modifiers for 93351

The CMS indicators that decide how 93351 is paid alongside other services.

CMS payment indicators · 93351

Stress echocardiogram, ECG monitoring included

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)9The concept doesn’t apply.
Co-surgeons (62)9The concept doesn’t apply.
Team surgery (66)9The concept doesn’t apply.
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

93351 without 26 · national office

$233.47

Stress echocardiogram, ECG monitoring included

93351-26 · Professional component

$81.16

Pays only the interpretation and report.

When to use modifier 26

Codes related to 93351

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 93351
CodeHow it relatesOffice range, Washington, DC area
Used instead
93350Stress echo, echo service onlyStress echo without the continuous ECG monitoring and physician supervision included in 93351.$212.34
93015Cardiac stress test, global: supervision, tracing, interpretationReports cardiovascular stress testing with ECG services when stress echocardiographic imaging is not performed.$83.45
93306Echocardiogram (TTE), complete, with spectral and color DopplerComplete resting transthoracic echocardiography with Doppler, rather than imaging during cardiovascular stress.$225.69
Add-on codes
93352Contrast administration, during stress echocardiographyAdd-on for administration of an echocardiographic contrast agent during stress echocardiography.$41.27

How 93351 has changed in Washington, DC area

93351 · Office / nonfacility

$267.73

Effective 2026-10-01

The base rate is $10.17 higher than on 2025-10-01, moving from $257.56 to $267.73 (3.9%).

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

    $257.56changed to$267.73

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.75 changed to 1.71
    • Practice expense RVU 5.04 changed to 5.18
    • Malpractice RVU 0.09 changed to 0.10
    • Work GPCI 1.057 changed to 1.054
    • Practice expense GPCI 1.192 changed to 1.178
    • Malpractice GPCI 1.168 changed to 1.113

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $268.22changed to$257.56

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 5.11 changed to 5.04
    • Malpractice RVU 0.10 changed to 0.09

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $263.84changed to$268.22

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $275.78changed to$263.84

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 5.08 changed to 5.11
    • Work GPCI 1.056 changed to 1.057
    • Practice expense GPCI 1.214 changed to 1.192
    • Malpractice GPCI 1.231 changed to 1.168

  5. January 1, 2023

    RVU23A

    $287.76changed to$275.78

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 5.12 changed to 5.08
    • Malpractice RVU 0.11 changed to 0.10
    • Work GPCI 1.054 changed to 1.056
    • Practice expense GPCI 1.236 changed to 1.214
    • Malpractice GPCI 1.294 changed to 1.231

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $289.67changed to$287.76

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 5.13 changed to 5.12
    • Malpractice RVU 0.09 changed to 0.11

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $281.47changed to$289.67

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 4.79 changed to 5.13
    • Work GPCI 1.049 changed to 1.054
    • Practice expense GPCI 1.221 changed to 1.236
    • Malpractice GPCI 1.277 changed to 1.294

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $275.39changed to$281.47

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 4.74 changed to 4.79
    • Malpractice RVU 0.08 changed to 0.09
    • Work GPCI 1.045 changed to 1.049
    • Practice expense GPCI 1.205 changed to 1.221
    • Malpractice GPCI 1.261 changed to 1.277

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $278.14changed to$275.39

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 4.80 changed to 4.74
    • Malpractice RVU 0.09 changed to 0.08

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $321.62changed to$278.14

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 5.82 changed to 4.80
    • Work GPCI 1.048 changed to 1.045
    • Malpractice GPCI 1.271 changed to 1.261

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $320.65changed to$321.62

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 5.81 changed to 5.82
    • Work GPCI 1.051 changed to 1.048
    • Malpractice GPCI 1.280 changed to 1.271

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $320.48changed to$320.65

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 5.79 changed to 5.81
    • Malpractice RVU 0.08 changed to 0.09

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $318.88changed to$320.48

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $328.92changed to$318.88

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 6.03 changed to 5.79
    • Work GPCI 1.050 changed to 1.051
    • Practice expense GPCI 1.202 changed to 1.205
    • Malpractice GPCI 1.205 changed to 1.280

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $271.78changed to$328.92

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 5.06 changed to 6.03
    • Work GPCI 1.049 changed to 1.050
    • Practice expense GPCI 1.198 changed to 1.202
    • Malpractice GPCI 1.130 changed to 1.205

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $271.78

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$267.73Not available in this settingRVU26D
2026-07-01$267.73Not available in this settingRVU26C
2026-04-01$267.73Not available in this settingRVU26B
2026-01-01$267.73Not available in this settingRVU26A
2025-10-01$257.56Not available in this settingRVU25D
2025-07-01$257.56Not available in this settingRVU25C
2025-04-01$257.56Not available in this settingRVU25B
2025-01-01$257.56Not available in this settingRVU25A
2024-10-01$268.22Not available in this settingRVU24D
2024-07-01$268.22Not available in this settingRVU24C
2024-04-01$268.22Not available in this settingRVU24B
2024-03-09$268.22Not available in this settingRVU24AR
2024-01-01$263.84Not available in this settingRVU24A
2023-10-01$275.78Not available in this settingRVU23D
2023-07-01$275.78Not available in this settingRVU23C
2023-04-01$275.78Not available in this settingRVU23B
2023-01-01$275.78Not available in this settingRVU23A
2022-10-01$287.76Not available in this settingRVU22D
2022-07-01$287.76Not available in this settingRVU22C
2022-04-01$287.76Not available in this settingRVU22B
2022-01-01$287.76Not available in this settingRVU22A
2021-10-01$289.67Not available in this settingRVU21D
2021-07-01$289.67Not available in this settingRVU21C
2021-04-01$289.67Not available in this settingRVU21B
2021-01-01$289.67Not available in this settingRVU21A
2020-10-01$281.47Not available in this settingRVU20D
2020-07-01$281.47Not available in this settingRVU20C
2020-04-01$281.47Not available in this settingRVU20B
2020-01-01$281.47Not available in this settingRVU20A
2019-10-01$275.39Not available in this settingRVU19D
2019-07-01$275.39Not available in this settingRVU19C
2019-04-01$275.39Not available in this settingRVU19B
2019-01-01$275.39Not available in this settingRVU19A
2018-10-01$278.14Not available in this settingRVU18D
2018-07-01$278.14Not available in this settingRVU18C
2018-04-01$278.14Not available in this settingRVU18B
2018-01-01$278.14Not available in this settingRVU18AR1
2017-10-01$321.62Not available in this settingRVU17D
2017-07-01$321.62Not available in this settingRVU17C
2017-04-01$321.62Not available in this settingRVU17B
2017-01-01$321.62Not available in this settingRVU17A
2016-10-01$320.65Not available in this settingRVU16D
2016-07-01$320.65Not available in this settingRVU16C
2016-04-01$320.65Not available in this settingRVU16B
2016-01-01$320.65Not available in this settingRVU16A
2015-10-01$320.48Not available in this settingRVU15D
2015-07-01$320.48Not available in this settingRVU15C
2015-04-01$318.88Not available in this settingRVU15B
2015-01-01$318.88Not available in this settingRVU15A
2014-10-01$328.92Not available in this settingRVU14D
2014-07-01$328.92Not available in this settingRVU14C
2014-04-01$328.92Not available in this settingRVU14B
2014-01-01$328.92Not available in this settingRVU14A
2013-10-01$271.78Not available in this settingRVU13D
2013-07-01$271.78Not available in this settingRVU13C
2013-04-01$271.78Not available in this settingRVU13B
2013-01-01$271.78Not available in this settingRVU13AR

Price 93351 for an earlier date of service

Where the Washington, DC area rate applies

Washington, DC area is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in District of Columbia. Some span more than one payment area; confirm with the service ZIP.

  • Washington

Browse all communities in District of Columbia

93351 billing questions

How does 93351 differ from 93350?

93351 includes continuous ECG monitoring and physician supervision along with the stress echocardiography. 93350 reports the stress echo without those ECG stress-test services included.

Can a resting echocardiogram be billed separately on the same study?

The resting images are part of the complete stress echocardiogram. Do not separately report a resting echo for those images.

Should a separate cardiovascular stress test code be reported with 93351?

The ECG monitoring and physician supervision for the stress test are included in 93351. Do not report another stress-test service for those same components.

When should modifier 26 or TC be used?

Use modifier 26 for the physician’s interpretation and report, or modifier TC for the technical service, including equipment and staff. Without either modifier, the claim represents the global service.

What documentation supports 93351?

Document the stress method, rest and stress image acquisition, continuous ECG monitoring, physician supervision, and the interpretation and report.

How does the multiple procedure reduction affect 93351?

When the cardiovascular diagnostic multiple procedure reduction applies, it affects the technical component of 93351.

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 93351PPRRVU2026_Oct_nonQPP.csv, line 12,085 (RVU26D)
Geographic factors for Washington, DC areaGPCI2026.csv, line 39 (RVU26D)

Open CMS sourceHow we calculate rates

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