CPT code 93356: Strain imaging, speckle-tracking analysis2026 Medicare rate & RVUs in California
Reports echocardiographic speckle-tracking analysis of myocardial deformation, commonly added to a qualifying echocardiogram when strain measurements are obtained and interpreted.
Medicare pays $39.29–$49.82 for 93356 in the office in California, from Chico, CA to San Benito County, CA. 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 93356 covers
This service analyzes echocardiographic images with speckle-tracking software to assess how the heart muscle deforms during the cardiac cycle, including measurements such as longitudinal strain. Cardiologists may use the results when evaluating cardiomyopathy, suspected cardiac amyloidosis, or changes in cardiac function during potentially cardiotoxic treatment. A sonographer typically acquires the images, and a qualified physician interprets the strain findings and includes them in the report.
Report 93356 only with an eligible primary echocardiography procedure; it is not a stand-alone service. The record should support that speckle-tracking strain analysis was performed and interpreted, with the findings documented alongside the primary echocardiogram. CMS treats this as an add-on paid within the primary procedure’s global period. The strain analysis is distinct from the standard measurements and Doppler components of an echocardiogram, so the report should make clear that myocardial strain imaging was performed.
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 93356 pays more and less in California
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
29 payment localities
$39.29 to $49.82
29 of 29 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield, CA | $39.35 | $10.07 |
| Chico, CA | $39.29 | $10.00 |
| El Centro, CA | $39.29 | $10.00 |
| Fresno, CA | $39.29 | $10.00 |
| Hanford, CA | $39.29 | $10.00 |
| Los Angeles, CA | $42.03 | $10.42 |
| Madera, CA | $39.29 | $10.00 |
| Marin County, CA | $48.75 | $11.07 |
| Merced, CA | $39.29 | $10.00 |
| Modesto, CA | $39.29 | $10.00 |
| Napa, CA | $45.92 | $10.71 |
| Oxnard, CA | $41.87 | $10.29 |
| Redding, CA | $39.29 | $10.00 |
| Rest of California | $39.29 | $10.00 |
| Riverside, CA | $39.51 | $10.22 |
| Sacramento, CA | $41.34 | $10.26 |
| Salinas, CA | $41.18 | $10.21 |
| San Benito County, CA | $49.82 | $11.29 |
| San Diego, CA | $42.23 | $10.27 |
| San Francisco, CA | $48.73 | $11.05 |
| San Luis Obispo, CA | $40.51 | $10.07 |
| Santa Clara County, CA | $49.73 | $11.20 |
| Santa Cruz, CA | $42.70 | $10.23 |
| Santa Maria, CA | $41.36 | $10.20 |
| Santa Rosa, CA | $43.13 | $10.32 |
| Stockton, CA | $39.29 | $10.00 |
| Vallejo, CA | $45.89 | $10.67 |
| Visalia, CA | $39.29 | $10.00 |
| Yuba City, CA | $39.29 | $10.00 |
How the 93356 rate is calculated
Each of 93356’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 · 93356
RVUs × geographic indexes × conversion factor
Work0.23
0.23 RVUs× 1.000 GPCI
Practice expense0.85
0.85 RVUs× 1.000 GPCI
Malpractice0.02
0.02 RVUs× 1.000 GPCI
Adjusted RVUs
1.1000
Conversion factor
$33.4009
Medicare rate
$36.74
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 93356
The CMS indicators that decide how 93356 is paid alongside other services.
CMS payment indicators · 93356
Strain imaging, speckle-tracking analysis
| 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 | 0 | Physician service: no professional/technical split. |
93356 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 93306Echocardiogram (TTE)Complete, with spectral and color Doppler
- 93306 reports a complete transthoracic echocardiogram with Doppler; 93356 is added only when speckle-tracking myocardial strain analysis is also performed and interpreted.
- 93308EchocardiogramFollow-up or limited study
- 93308 reports a limited or follow-up transthoracic echocardiogram. It does not by itself describe speckle-tracking strain analysis.
- 93325Color flow DopplerAdd-on to echocardiography
- 93325 describes color-flow Doppler mapping, while 93356 describes speckle-tracking analysis of myocardial deformation.
93356 billing questions
Can 93356 be billed by itself?
No. It is an add-on and must be reported with an eligible primary echocardiography procedure.
Is 93356 included in a complete transthoracic echocardiogram?
The code represents a separate speckle-tracking strain analysis, not the standard measurements of a complete echocardiogram. Report it only when that analysis is performed and interpreted.
What documentation supports reporting 93356?
The echocardiography record should show that speckle-tracking strain analysis was performed, and the interpreting report should document the strain findings.
Does 93356 replace Doppler imaging?
No. Speckle-tracking strain analysis assesses myocardial deformation; it is distinct from Doppler evaluation of blood flow.
How is 93356 paid in relation to the primary echocardiogram?
CMS classifies it as an add-on and pays it within the primary procedure’s global period. It must be billed together with the primary procedure.
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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