Billing code 93975: Vascular duplexMedicare rate & RVUs in Delaware
Reports a complete duplex evaluation of arterial inflow and venous outflow serving abdominal, pelvic, scrotal, or retroperitoneal structures.
Medicare pays $256.34 for 93975 in the office in Delaware (Delaware). 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.
On this page 9 sections
What 93975 covers
This study uses ultrasound and Doppler to assess blood flow into and out of abdominal, pelvic, scrotal, or retroperitoneal structures. It may be performed for suspected renal vascular disease, portal or hepatic flow concerns, mesenteric vascular disease, or scrotal vascular conditions. A sonographer typically acquires the images, and a qualified physician interprets the study. The examination must support a complete assessment of the relevant arterial inflow and venous outflow, rather than a limited evaluation.
Report 93975 for the complete study; use the documented anatomy, vessels examined, Doppler findings, and interpretation to support that level rather than a limited study. Bill globally without a component modifier when one claim includes both the professional interpretation and technical service. Modifier 26 identifies the professional interpretation, while modifier TC identifies equipment and staff. 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.
93975 in Delaware
| Payment locality | Office | Facility |
|---|---|---|
| Delaware | $256.34 | Unavailable |
How the 93975 rate is calculated
Each of 93975’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 · 93975
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 1.13Practice expense 6.50Malpractice 0.13
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 93975
The CMS indicators that decide how 93975 is paid alongside other services.
CMS payment indicators · 93975
Vascular duplex
| 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
93975 without 26 · national office
$259.19
Vascular duplex
93975-26 · Professional component
$53.11
Pays only the interpretation and report.
93975 compared with similar codes
Compare codes
93975 vs 93976 vs 93978 vs 93979: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 93976Vascular study
- 93976 is for a limited examination of the relevant organ-related vessels; 93975 is for the complete arterial inflow and venous outflow study.
- 93978Vascular duplex
- 93978 evaluates the aorta, inferior vena cava, or iliac vasculature as its target. Choose 93975 for the complete vascular evaluation of abdominal, pelvic, scrotal, or retroperitoneal structures.
- 93979Vascular duplex
- 93979 is the limited aortoiliac study. It differs from 93975 both in the vascular territory examined and in the extent of the study.
93975 billing questions
How does 93975 differ from 93976?
93975 represents a complete evaluation of arterial inflow and venous outflow for the relevant abdominal, pelvic, scrotal, or retroperitoneal structures. Use 93976 when the documented examination is limited.
When should modifier 26 or TC be reported?
Use modifier 26 for the physician's professional interpretation and modifier TC for the technical service, including equipment and staff. Report without either modifier when billing the global service.
What documentation supports the complete study?
Document the structures and vessels examined, the arterial inflow and venous outflow assessment, Doppler findings, and the interpreting provider's conclusions. The record should show why the examination was complete rather than limited.
Does the multiple procedure reduction affect the interpretation?
The CMS cardiovascular diagnostic multiple procedure reduction applies to the technical component. It is relevant to the TC portion when multiple cardiovascular diagnostic procedures are performed.
Is 93975 the right code for an aortoiliac duplex?
Select the code based on the anatomy and vessels studied. A study directed at the aorta, inferior vena cava, or iliac vasculature is distinguished from 93975's evaluation of organ-related arterial inflow and venous outflow.
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
Show the CMS file lines behind this rate
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