Billing code 93980: Penile vascular studyMedicare rate & RVUs in Texas
A complete penile duplex examination assesses arterial inflow and venous outflow, typically during evaluation of erectile dysfunction with suspected vascular cause.
Medicare pays $113.73–$125.30 for 93980 in the office in Texas, from Beaumont to Austin. 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 93980 covers
Penile duplex vascular imaging evaluates blood flow through the penile arteries and venous drainage, usually during an erectile dysfunction workup when a vascular cause is being assessed. A urologist or imaging clinician performs the ultrasound, often after an intracavernosal vasoactive agent produces a response; the examination records Doppler flow information across the study rather than a single limited observation. It is performed in an office or hospital outpatient imaging setting.
Report 93980 for the complete examination of arterial inflow and venous outflow, rather than a limited penile vascular assessment. The record should support the full scope with the clinical indication, protocol, Doppler findings, images, and interpretation. Bill the professional interpretation with modifier 26, the equipment-and-staff service with TC, or the global service without a component modifier. CMS applies the cardiovascular diagnostic multiple-procedure reduction to the technical component when applicable.
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 93980 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 payment localities
$113.73 to $125.30
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin | $125.30 | Unavailable |
| Beaumont | $113.73 | Unavailable |
| Brazoria | $120.09 | Unavailable |
| Dallas | $120.68 | Unavailable |
| Fort Worth | $119.93 | Unavailable |
| Galveston | $120.35 | Unavailable |
| Houston | $121.44 | Unavailable |
| Rest Of Texas | $116.73 | Unavailable |
How the 93980 rate is calculated
Each of 93980’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 · 93980
RVUs × geographic indexes × conversion factor
Work1.22
1.22 RVUs× 1.000 GPCI
Practice expense2.34
2.34 RVUs× 1.000 GPCI
Malpractice0.06
0.06 RVUs× 1.000 GPCI
Adjusted RVUs
3.6200
Conversion factor
$33.4009
Medicare rate
$120.91
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 93980
The CMS indicators that decide how 93980 is paid alongside other services.
CMS payment indicators · 93980
Penile vascular 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
93980 without 26 · national office
$120.91
Penile vascular study
93980-26 · Professional component
$59.79
Pays only the interpretation and report.
93980 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 93981Penile duplex
- 93980 represents a complete assessment of penile arterial inflow and venous outflow; 93981 is for a limited penile vascular study.
- 54235Penile injection
- 54235 reports an intracavernosal pharmacologic injection, not Doppler imaging of penile blood flow. It may accompany 93980 when both services are performed.
- 76870Scrotal ultrasound
- 76870 examines scrotal contents by ultrasound. Choose 93980 when the service is a penile vascular duplex assessment.
93980 billing questions
When should 93980 be selected instead of 93981?
Use 93980 when the examination evaluates both penile arterial inflow and venous outflow as a complete study. Use 93981 for a limited penile vascular assessment.
Which modifier identifies the interpretation?
Append modifier 26 for the professional interpretation. Modifier TC identifies the equipment-and-staff portion; billing without either component modifier represents the global service.
Can the pharmacologic injection be reported with the study?
Code 54235 describes an intracavernosal pharmacologic injection and may be reported with 93980 when that injection is performed as part of the encounter. Document the injection and the duplex service separately.
What documentation supports the complete study?
Document the indication, examination protocol, Doppler findings for arterial inflow and venous outflow, and the interpreting clinician's assessment. Retain the diagnostic images.
How does the multiple-procedure reduction affect 93980?
CMS applies the cardiovascular diagnostic multiple-procedure reduction to the technical component when applicable. The reduction concerns the technical component, not the professional interpretation.
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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