CPT code 93981: Penile duplex, limited study2026 Medicare rate & RVUs in Michigan
Reports a focused duplex ultrasound assessment of penile blood flow, typically used in evaluating erectile dysfunction when a complete vascular study is not performed.
Medicare pays $68.63–$72.38 for 93981 in the office in Michigan, from Rest of Michigan to Detroit, MI. 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 93981 covers
This service uses duplex ultrasound to assess blood flow in penile vessels, such as when evaluating erectile dysfunction for evidence of impaired arterial inflow or venous outflow. Urologists, radiologists, or vascular laboratory personnel may perform the study, often in an office or imaging setting. A vasoactive medication may be injected into the corpora cavernosa during diagnostic testing, with the ultrasound findings interpreted in that clinical context.
Select the limited-study code when the documented examination is focused or incomplete rather than a complete assessment of penile arterial inflow and venous outflow. The record should identify the indication, the vessels or flow findings assessed, and the reason the study was limited. Report the professional interpretation with modifier 26 and the equipment-and-staff portion with modifier TC; without a modifier, the claim represents the global service. The cardiovascular diagnostic multiple-procedure reduction applies to the 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 93981 pays more and less in Michigan
| Payment locality | Office | Facility |
|---|---|---|
| Detroit, MI | $72.38 | Unavailable |
| Rest of Michigan | $68.63 | Unavailable |
How the 93981 rate is calculated
Each of 93981’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 · 93981
RVUs × geographic indexes × conversion factor
Work0.43
0.43 RVUs× 1.000 GPCI
Practice expense1.73
1.73 RVUs× 1.000 GPCI
Malpractice0.04
0.04 RVUs× 1.000 GPCI
Adjusted RVUs
2.2000
Conversion factor
$33.4009
Medicare rate
$73.48
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 93981
The CMS indicators that decide how 93981 is paid alongside other services.
CMS payment indicators · 93981
Penile duplex, limited study
| 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) | 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
93981 without 26 · national office
$73.48
Penile duplex, limited study
93981-26 · Professional component
$21.04
Pays only the interpretation and report.
93981 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 93980Penile vascular studyComplete inflow and outflow
- Both codes assess penile vascular flow, but 93980 is selected for a complete examination of arterial inflow and venous outflow; 93981 is for a limited study.
- 93975Vascular duplexComplete organ inflow and outflow
- This code concerns a complete duplex assessment of abdominal, pelvic, or scrotal contents. Choose 93981 when the vessels assessed are penile.
- 93976Vascular duplexLimited abdominal, pelvic, or scrotal study
- This code concerns a limited duplex assessment of abdominal, pelvic, or scrotal contents. The penile vessel target distinguishes 93981.
93981 billing questions
How do I choose this code over 93980?
Use 93981 for a limited penile vascular examination. Use 93980 when the documented study is complete, evaluating both arterial inflow and venous outflow.
Can a diagnostic injection be reported with this study?
A diagnostic intracavernosal injection may be separately reported when it is performed and documented as a distinct service. Code 54235 describes that injection service.
How should the professional and technical portions be billed?
Use modifier 26 for the physician’s interpretation and modifier TC for the equipment and staff portion. Billing without either modifier represents the global service.
Which portion is affected by the cardiovascular diagnostic multiple-procedure reduction?
The reduction applies to the technical component. When billing the components separately, it is the TC portion to which this reduction applies.
What documentation supports reporting a limited study?
Document the clinical indication, the scope of the penile vessel assessment, and the findings obtained. The record should support that the examination was limited rather than a complete arterial inflow and venous outflow study.
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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