CPT code 93351: Stress echocardiogram, ECG monitoring included2026 Medicare rate & RVUs in Washington
Reports a complete transthoracic echocardiogram performed at rest and during exercise or pharmacologic stress, with ECG monitoring and physician supervision.
Medicare pays $242.59–$274.99 for 93351 in the office in Washington, from Rest of Washington to King County, WA. 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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On this page 9 sections
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.
Where 93351 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| King County, WA | $274.99 | Unavailable |
| Rest of Washington | $242.59 | Unavailable |
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
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.
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
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| Multiple procedures | 6 | Diagnostic cardiovascular reduction applies to the technical component. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 9 | The concept doesn’t apply. |
| Co-surgeons (62) | 9 | The concept doesn’t apply. |
| Team surgery (66) | 9 | The concept doesn’t apply. |
| 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
93351 without 26 · national office
$233.47
Stress echocardiogram, ECG monitoring included
93351-26 · Professional component
$81.16
Pays only the interpretation and report.
93351 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 93350Stress echoEcho service only
- 93351 includes continuous ECG monitoring and physician supervision. 93350 reports the stress echo without those stress-test services included.
- 93306Echocardiogram (TTE)Complete, with spectral and color Doppler
- 93306 is a complete resting transthoracic echo with Doppler. Choose 93351 when images are acquired at rest and during exercise or pharmacologic stress.
- 93015Cardiac stress testGlobal: supervision, tracing, interpretation
- 93015 reports cardiovascular stress testing with ECG services but no echocardiographic imaging. 93351 includes stress echo imaging and its ECG monitoring and physician supervision.
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
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