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CPT code 93990: Dialysis access scan, existing access evaluation2026 Medicare rate & RVUs

Duplex evaluation of an established hemodialysis access assesses blood flow through the access when dysfunction or a complication is suspected.

CMS RVU26DEffective Oct 1, 2026109 payment localities91.9K Medicare services in 2024

Medicare pays $144.29 for 93990 nationally in the office.

Medicare rate · 93990

Dialysis access scan, existing access evaluation

Office or facility?

Work RVUs
0.49
Total RVUs
4.32
Global days
XXX

National rate · 2026

$144.29

Office setting, before claim adjustments.

See every locality for 93990 →Billed by an NP, PA or therapist? →

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

Your location

Medicare pays by the payment locality where the service is performed.

On this page 10 sections
  1. Medicare rate
  2. What 93990 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 93990 covers

This study uses ultrasound and Doppler assessment to evaluate blood flow through an established hemodialysis access, including arterial inflow, the access conduit, and venous outflow. It is commonly performed in a vascular laboratory or imaging department for a patient with an arteriovenous fistula or graft. Clinical concerns may include poor dialysis flow, difficult cannulation, prolonged bleeding after needle removal, or suspected access stenosis or thrombosis. The study differs from preoperative mapping of vessels to plan a new access.

Report the study supported by the order and findings; document the access examined, clinical indication, results, and interpretation. A physician may report the professional interpretation with modifier 26, the technical service with modifier TC, or the global service without either modifier. CMS separately prices the 26 and TC components. When multiple cardiovascular diagnostic procedures are performed, the 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 93990 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

93990 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailableUnavailable
AlaskaUnavailableUnavailable
ArizonaUnavailableUnavailable
ArkansasUnavailableUnavailable
Atlanta, GAUnavailableUnavailable
Austin, TXUnavailableUnavailable
Bakersfield, CAUnavailableUnavailable
Baltimore area, MDUnavailableUnavailable
Beaumont, TXUnavailableUnavailable
Brazoria, TXUnavailableUnavailable

93990 rates by state

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

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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.

View every state and territory as a table
93990 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 93990 rate is calculated

Each of 93990’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 · 93990

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.49

0.49 RVUs× 1.000 GPCI

Practice expense3.73

3.73 RVUs× 1.000 GPCI

Malpractice0.10

0.10 RVUs× 1.000 GPCI

Adjusted RVUs

4.3200

Conversion factor

$33.4009

Medicare rate

$144.29

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

Payment rules and modifiers for 93990

The CMS indicators that decide how 93990 is paid alongside other services.

CMS payment indicators · 93990

Dialysis access scan, existing access evaluation

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)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
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

93990 without 26 · national office

$144.29

Dialysis access scan, existing access evaluation

93990-26 · Professional component

$22.38

Pays only the interpretation and report.

When to use modifier 26

93990 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 93990

    Dialysis access scan, existing access evaluation0.49 wRVU

    $144.29

  • 93985

    Dialysis access mapping, complete bilateral study0.78 wRVU

    $249.17+$104.88

  • 93986

    Access mapping, complete unilateral study0.49 wRVU

    $148.30+$4.01

  • 36901

    Circuit angiography, diagnostic only3.28 wRVU

    $686.39+$542.10

How to choose

93985Dialysis access mappingComplete bilateral study
93985 describes complete bilateral upper-extremity vessel mapping before access creation; 93990 evaluates an established hemodialysis access.
93986Access mappingComplete unilateral study
93986 describes complete unilateral upper-extremity vessel mapping before access creation; 93990 evaluates an established hemodialysis access.
36901Circuit angiographyDiagnostic only
36901 reports invasive diagnostic angiography of the dialysis circuit. Choose 93990 for noninvasive duplex evaluation of access flow.

Codes related to 93990

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

Codes related to 93990
CodeHow it relatesNational office range
Used instead
93985Dialysis access mapping, complete bilateral studyComplete bilateral preoperative vessel mapping, rather than evaluation of an established access.$215.76–$345.51
93986Access mapping, complete unilateral studyComplete unilateral preoperative vessel mapping, rather than evaluation of an established access.No office rate
36901Circuit angiography, diagnostic onlyAngiographic evaluation of a dialysis circuit is an invasive alternative to duplex assessment.$599.20–$937.97

93990 billing questions

When should this code be chosen instead of 93985 or 93986?

Use 93990 for duplex evaluation of an established hemodialysis access. Codes 93985 and 93986 describe complete preoperative vessel mapping, with the applicable code depending on whether mapping is bilateral or unilateral.

Does this code cover the entire access circuit?

The evaluation includes the access inflow, conduit, and venous outflow. Document the portions examined and the findings rather than reporting separate access-segment services under this code.

How are the professional and technical services billed?

Modifier 26 identifies the professional interpretation, and modifier TC identifies the technical service. Report the global service without either modifier when billing both components together.

Does the multiple-procedure reduction affect the interpretation?

CMS applies the cardiovascular diagnostic multiple-procedure reduction to the technical component when multiple cardiovascular diagnostic procedures are performed.

What documentation supports reporting this study?

Document the clinical concern prompting evaluation, the hemodialysis access studied, the duplex findings, and the interpretation. Relevant concerns include poor dialysis flow, difficult cannulation, and suspected access narrowing.

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

Open CMS sourceHow we calculate rates

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