CPT Code 93308: Limited Echo Description & Billing

Mukesh MakwanaFounder & CEO · Hands-on medical billing & RCM across 11 specialties · Reviewed September 28, 2026

CPT 93308 is the follow-up or limited transthoracic echocardiogram. It is treated as a consolation prize in a lot of practices, which is exactly backwards: 93308 is a correct code, and using it when the documentation calls for it is considerably cheaper than defending a sample of complete studies on post-payment review.

What CPT 93308 covers

93308 is transthoracic echocardiography, real-time with image documentation (2D), including M-mode recording when performed, follow-up or limited study. It describes a focused look that answers a specific question rather than a full structural assessment.

Two very different situations land here:

A genuinely focused study: a re-look at ejection fraction, a pericardial effusion check, a targeted valve question.
A study intended to be complete that the documentation does not support: required structures not addressed, with no reason recorded for the omission.

Reimbursement context

93308 pays less than the complete codes, which is precisely why it gets avoided. The economics only work in favour of upcoding until a payer samples the complete-echo population, at which point the recoupment covers several years of the difference.

2026 Medicare RVUs for CPT 93308

CPT 93308: 2026 Medicare RVUs (national, before GPCI)
Line	Work	PE, non-facility	PE, facility	Malpractice	Total, non-facility	Total, facility
Global (no modifier)	0.52	2.47	NA	0.04	3.03	NA
Professional (modifier 26)	0.52	0.20	0.20	0.02	0.74	0.74
Technical (modifier TC)	0.00	2.27	NA	0.02	2.29	NA

Source: CMS CY 2026 PFS Relative Value File, RVU26D (October release, published 08/26/2026). RVUs are national and unadjusted; commercial payers set their own rates.

In the 2026 CMS relative value file, CPT 93308 carries 0.52 work RVUs and 3.03 total RVUs when billed globally in a non-facility setting. The global line is NA in a facility, because there the physician bills the professional component only and the facility bills the technical side. Its PC/TC indicator is 1: the code splits into a professional component (modifier 26, 0.74 total RVUs) and a technical component (modifier TC, 2.29 total RVUs), and the global line is billed only when one entity does both. Its global indicator is XXX: the surgical global period concept does not apply. Across the transthoracic and stress echo codes, work RVUs run from 0.52 (93308) to 1.71 (93351), so 93308 carries the lowest physician work in its group.

To turn RVUs into payment, each component is multiplied by your locality's geographic practice cost index, the three are added, and the sum is multiplied by the 2026 conversion factor: $33.4009, or $33.5675 for qualifying APM participants (CMS-1832-F; CMS fact sheet). The CMS Physician Fee Schedule Look-Up Tool runs that calculation for your locality.

Documentation requirements

The specific clinical question the study was performed to answer.
The structures actually examined and the findings for each.
Reference to the prior study where this is a follow-up, including what changed.
Where Doppler was performed, findings named as spectral or color flow so add-ons are supportable.
Retained images available for review.
A signed interpretation naming the study performed as limited or follow-up.

Medicare contractor billing articles. Each Medicare Administrative Contractor publishes its own billing and coding articles for this service, and the covered diagnoses differ by jurisdiction. Active examples in the CMS Medicare Coverage Database, checked September 28, 2026: A57306 (Transthoracic Echocardiography (TTE), CGS), A56781 (Transthoracic Echocardiography (TTE), Wellpoint Federal) and A56625 (Echocardiography, Palmetto GBA). Use the article from the contractor that processes your claims.

Common denials and the exact fix

Frequency or duplicate denial on a repeat study

A second echo close behind the first denies unless the record explains why it was needed.

Fix: document the clinical change that prompted the repeat. A scheduled interval re-look without a change in status is difficult to defend.

Billed alongside a complete echo for the same session

One study produces one code. A limited study performed as part of a complete study is not separately reportable.

Fix: report the single code matching what was done.

Limited study billed as complete

The inverse error, and the expensive one. It pays on submission and fails on audit.

Fix: a scrub rule that compares the structures addressed in the report against the complete-study requirements before the claim goes out.

CO-50: diagnosis does not support the study

Limited studies face the same medical-necessity test, and a vague indication draws a denial.

Fix: code the specific question that prompted the study.

Modifier rules

26 / TC: split by setting and equipment ownership.
76 / 77: repeat study by the same or another physician, with a documented clinical trigger. This is the modifier pair that matters most on 93308.
51: not appended to add-on codes.
59 / XE / XP / XS / XU: rarely applicable.

NCCI bundling edits

93308 with 93320 or 93325: separately reportable, because 93308 excludes Doppler.
93308 with 93306 or 93307: one study, one code.
93308 with 93350 or 93351: stress echocardiography includes the echo imaging.
Repeat studies within short intervals are subject to payer frequency policy rather than NCCI alone.

Frequently asked questions

When is 93308 the correct code?

When the study was focused on a specific clinical question rather than a full structural assessment, or when it was a follow-up look at a known finding. If the required structures of a complete study were not examined and no reason was documented for the omission, 93308 is the only defensible code even where the intent was a complete study.

Can I bill 93320 or 93325 with 93308?

Yes. 93308 does not include Doppler, so when spectral or color flow Doppler is separately performed and documented, the add-on codes are separately reportable. 93308 is the transthoracic code these add-ons are reported with: 93306 already includes Doppler, and CPT does not allow the add-ons with 93307.

Why did my repeat echo deny?

A second study close behind the first draws a frequency or duplicate denial unless the record explains the clinical change that prompted it. Documenting the change in status is what makes the repeat payable, and if the repeat was a focused re-look rather than a full restudy then 93308 is also the correct code for it.

Sources

American Medical Association, CPT 2026 Professional Edition.
Centers for Medicare & Medicaid Services, CY 2026 PFS Relative Value File RVU26D (October release): RVUs, PC/TC indicator and global period for CPT 93308.
Centers for Medicare & Medicaid Services, CY 2026 Physician Fee Schedule final rule, CMS-1832-F: conversion factors.
Centers for Medicare & Medicaid Services, National Correct Coding Initiative Policy Manual for Medicare Services and quarterly procedure-to-procedure edit tables.
Medicare Coverage Database billing and coding articles A57306, A56781, A56625.

CPT® is a registered trademark of the American Medical Association. Payer policy and NCCI edits change quarterly, so check your own contractor before submission. How we verify this guidance.

Related codes

CPT 93306. Complete TTE with spectral and color flow Doppler.
CPT 93307. Complete TTE without Doppler.
CPT 93320. Spectral Doppler add-on.

CPT 93308: Transthoracic Echocardiography, Follow-Up or Limited Study