CPT code 93990: Dialysis access scan, existing access evaluation2026 Medicare rate & RVUs in Missouri
Duplex evaluation of an established hemodialysis access assesses blood flow through the access when dysfunction or a complication is suspected.
CMS doesn’t publish an office rate for 93990 in Missouri.
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 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 in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | Unavailable | Unavailable |
| Metropolitan St. Louis, MO | Unavailable | Unavailable |
| Rest of Missouri | Unavailable | Unavailable |
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
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
| 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
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.
93990 compared with similar codes
Compare codes · National
4 codes, side by side
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.
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
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