$196.04
93306 reports a complete transthoracic echocardiogram with Doppler; 93356 is added only when speckle-tracking myocardial strain analysis is also performed and interpreted.
On this page
CMS RVU26D · Effective 2026-10-01
93356 Strain imaging Medicare reimbursement rates in Wyoming
Reports echocardiographic speckle-tracking analysis of myocardial deformation, commonly added to a qualifying echocardiogram when strain measurements are obtained and interpreted. Compare 93356 office and facility rates across CMS payment localities in Wyoming.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 93356 in Wyoming?
Wyoming has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$36.57
1 of 1 localities have a supported rate.
Payment area: Wyoming**
One mapped payment locality.
Facility setting
$9.85
1 of 1 localities have a supported rate.
Payment area: Wyoming**
One mapped payment locality.
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Cardiac imaging
About 93356: Myocardial strain imaging by speckle tracking
Reports echocardiographic speckle-tracking analysis of myocardial deformation, commonly added to a qualifying echocardiogram when strain measurements are obtained and interpreted.
This service analyzes echocardiographic images with speckle-tracking software to assess how the heart muscle deforms during the cardiac cycle, including measurements such as longitudinal strain. Cardiologists may use the results when evaluating cardiomyopathy, suspected cardiac amyloidosis, or changes in cardiac function during potentially cardiotoxic treatment. A sonographer typically acquires the images, and a qualified physician interprets the strain findings and includes them in the report.
Report 93356 only with an eligible primary echocardiography procedure; it is not a stand-alone service. The record should support that speckle-tracking strain analysis was performed and interpreted, with the findings documented alongside the primary echocardiogram. CMS treats this as an add-on paid within the primary procedure’s global period. The strain analysis is distinct from the standard measurements and Doppler components of an echocardiogram, so the report should make clear that myocardial strain imaging was performed.
CMS billing rules for 93356
- Global period
- Add-on code: billed only together with a primary procedure and paid within that procedure's global period.
Where the value comes from
- Work RVU0.23 · 21%
- Practice expense (office) RVU0.85 · 77%
- Malpractice RVU0.02 · 2%
472.2K
Medicare services in 2024 · #236 by national volume
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.
93356 compared with similar codes
Office rates for Wyoming, from the same CMS release.
$100.86
93308 reports a limited or follow-up transthoracic echocardiogram. It does not by itself describe speckle-tracking strain analysis.
$23.71
93325 describes color-flow Doppler mapping, while 93356 describes speckle-tracking analysis of myocardial deformation.
Compare 93356 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Wyoming** →
Office / nonfacility
$36.57
Facility
$9.85
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 93356 in Wyoming**.
PPRRVU2026_Oct_nonQPP.csv
12,090
- Code
- 93356
- Physician work
- 0.23
- Practice expense
- 0.85
- Malpractice
- 0.02
GPCI2026.csv
112
- Locality
- Wyoming**
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.740
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.23 | × 1.000 | 0.2300 |
| Practice expense | 0.85 | × 1.000 | 0.8500 |
| Malpractice | 0.02 | × 0.740 | 0.0148 |
| Total RVUs | 1.0948 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Wyoming**$36.57
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.23 | 1 |
| Practice expense | 0.85 | 1 |
| Malpractice | 0.02 | 0.74 |
(0.23 × 1 + 0.85 × 1 + 0.02 × 0.74) × $33.4009 = $36.57
Facility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.23 | 1 |
| Practice expense | 0.05 | 1 |
| Malpractice | 0.02 | 0.74 |
(0.23 × 1 + 0.05 × 1 + 0.02 × 0.74) × $33.4009 = $9.85
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
93356 billing questions
Can 93356 be billed by itself?
No. It is an add-on and must be reported with an eligible primary echocardiography procedure.
Is 93356 included in a complete transthoracic echocardiogram?
The code represents a separate speckle-tracking strain analysis, not the standard measurements of a complete echocardiogram. Report it only when that analysis is performed and interpreted.
What documentation supports reporting 93356?
The echocardiography record should show that speckle-tracking strain analysis was performed, and the interpreting report should document the strain findings.
Does 93356 replace Doppler imaging?
No. Speckle-tracking strain analysis assesses myocardial deformation; it is distinct from Doppler evaluation of blood flow.
How is 93356 paid in relation to the primary echocardiogram?
CMS classifies it as an add-on and pays it within the primary procedure’s global period. It must be billed together with the primary procedure.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
12,08793351,TC,Stress tte complete,A,,0.00,4.52,,4.52,NA,0.04,4.56,4.56,1,XXX,0.00,0.00,0.00,6,0,9,9,9,9,,33.4009,02,0,99,16.57,16.57,0.15
12,08893352,,Admin ecg contrast agent,A,,0.19,0.86,,0.86,NA,0.02,1.07,1.07,0,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,08993355,,Echo transesophageal (tee),A,,4.54,0.87,NA,0.87,,0.34,5.75,5.75,0,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,09093356,,Myocrd strain img spckl trck,A,,0.23,0.85,,0.05,,0.02,1.10,0.30,0,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,09193451,,Right heart cath,A,,2.41,22.66,,22.66,NA,0.42,25.49,25.49,1,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,09293451,26,Right heart cath,A,,2.41,1.03,,1.03,,0.39,3.83,3.83,1,000,0.00,0.00,0.00,2,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
12,09393451,TC,Right heart cath,A,,0.00,21.63,,21.63,NA,0.03,21.66,21.66,1,000,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,03,0,99,0.00,0.00,0.00
10902402,WA,99,REST OF WASHINGTON,1.013,1.053,0.761
11011402,WV,16,WEST VIRGINIA,1.000,0.869,1.431
11106302,WI,00,WISCONSIN,1.000,0.958,0.308
11203602,WY,21,WYOMING**,1.000,1.000,0.740
113"MAC Assignments as of November 22, 2023",,,,,,
114,,,,,,
115*Work GPCI reflects a 1.5 floor in Alaska established by the MIPPA.,,,,,,