CPT 93307 Billing: Complete TTE Without Doppler

CPT 93307 is the complete transthoracic echocardiogram performed without spectral or color flow Doppler. It is the least understood member of the echo family. It is the correct code only when Doppler was not done, and it is still routinely paired with Doppler add-on codes that CPT does not allow alongside it.

93307 plus 93320 or 93325 is not a valid combination. A complete study with spectral and color flow Doppler is 93306, the single code that replaced that combination in 2009.

What CPT 93307 covers

93307 is transthoracic echocardiography, real-time with image documentation (2D), including M-mode recording when performed, complete, without spectral or color flow Doppler.

The word doing the work is "complete". The structural requirements are the same as 93306: an attempted evaluation of the left and right atria, the left and right ventricles, the aortic, mitral and tricuspid valves, the pericardium and the adjacent portions of the aorta. The only difference is the absence of Doppler.

93307 is not a downgrade of 93306 for a weak report. A study that failed to examine the required structures is 93308, not 93307.

Reimbursement context

93307 pays less than 93306 because it excludes the Doppler work. When Doppler genuinely was performed on a complete study, the answer is 93306, not 93307 plus add-on codes. Payment follows the CMS Physician Fee Schedule and varies by locality.

Documentation requirements

An indication explaining why the study was ordered, coded specifically.
Findings for each required structure, or an explicit statement of why one could not be adequately visualised.
Chamber dimensions, wall motion and ejection fraction with the method used.
An explicit statement that Doppler was not performed, so the choice of 93307 over 93306 is visible in the record.
Retained images available for review.
A signed interpretation naming the study performed.

Common denials and the exact fix

Doppler add-ons billed with 93307

CPT instructs that 93307 is not reported with 93320, 93321 or 93325, so those lines deny. This is a code-selection error, not a bundling edit a modifier can fix.

Fix: where both spectral and color flow Doppler were performed and documented on a complete study, recode to 93306 and remove the add-on lines.

Under-reporting: 93307 billed when Doppler was performed

This does not deny, which is why it persists for years. Every affected study loses the Doppler value.

Fix: if spectral and color flow Doppler were performed as part of a complete study, the correct code is 93306. Adding Doppler add-ons to 93307 is not an alternative, because CPT does not allow that combination. What is not defensible is billing 93307, with or without add-ons, when a complete study with Doppler was done.

93307 used as a fallback for a weak complete report

An incomplete structural exam is 93308. Using 93307 to soften a documentation gap misstates what was performed.

Fix: code the study the report supports. If required structures were not addressed and no reason was given, that is a limited study.

Missing or mismatched 26 / TC

The same split-billing rule applies as on 93306. A global code from a facility place of service denies.

Fix: align modifier, place of service and equipment ownership.

CO-50: diagnosis does not support the echo

Screening-flavoured indications draw medical-necessity denials, and most MACs publish an echocardiography LCD.

Fix: code the specific cardiac indication and check the applicable LCD before appealing.

Modifier rules

26 / TC: split by setting, equipment ownership and place of service.
Doppler add-ons: 93320, 93321 and 93325 are not reported with 93307, and no modifier changes that.
76 / 77: repeat study with a documented clinical trigger.
59 / XE / XP / XS / XU: rarely applicable on a diagnostic echo, and never a route to billing Doppler add-ons with 93307.

NCCI bundling edits

93307 with 93320, 93321 or 93325: not reported together per CPT. A complete study with Doppler is 93306.
93307 with 93306: one study, one code.
93307 with 93308: one study, one code.
93307 with 93350 or 93351: stress echocardiography includes the echo imaging for that study.

Frequently asked questions

When is 93307 correct instead of 93306?

When a complete structural study was performed but spectral and color flow Doppler were not performed or not documented. 93307 is about the absence of Doppler, not about an incomplete exam. If the structural study itself was limited or focused, the correct code is 93308 regardless of whether Doppler was used.

Can I bill 93320 and 93325 with 93307?

No. CPT instructs that 93307 is not reported with 93320, 93321 or 93325. Since 2009, a complete transthoracic study that includes spectral and color flow Doppler has been reported with the single code 93306, which replaced the old combination of 93307 plus the Doppler add-ons. If Doppler was performed on a complete study, report 93306.

Is 93307 paid less than 93306?

Yes, because it excludes the Doppler work. That is why systematically defaulting to 93307 when Doppler was genuinely performed and documented quietly under-reports the service. Code to what the report supports rather than to a habit in either direction.

Sources

American Medical Association, CPT 2026 Professional Edition.
Centers for Medicare & Medicaid Services, National Correct Coding Initiative Policy Manual and quarterly edit tables, cms.gov.
Centers for Medicare & Medicaid Services, Physician Fee Schedule Look-Up Tool, cms.gov.
American College of Cardiology, acc.org. AAPC coding resources, aapc.com.

CPT® is a registered trademark of the American Medical Association. Code descriptors are summarised here for billing guidance and are not a substitute for the current CPT codebook. Payer rules and NCCI edits change quarterly; verify against your own payer policy before submission.

Related codes

CPT 93306. Complete TTE with spectral and color flow Doppler.
CPT 93308. Limited or follow-up echo.
CPT 93320. Spectral Doppler add-on.

CPT 93307: Transthoracic Echocardiography, Complete Without Doppler