CPT Code 93350: Stress Echo Description & Billing

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

CPT 93350 is stress echocardiography: echo imaging at rest and with stress, interpreted and reported. The defining feature is what it leaves out. Unlike 93351, it does not include the continuous ECG monitoring and physician supervision, which is why the stress test codes stay separately reportable alongside it.

What CPT 93350 covers

93350 is echocardiography, transthoracic, real-time with image documentation (2D), including M-mode recording when performed, during rest and cardiovascular stress using treadmill, bicycle exercise and/or pharmacologically induced stress, with interpretation and report.

It covers the imaging side of a stress echo. The stress test itself, meaning the supervision, the continuous ECG tracing and its interpretation, is separate work reported with the 93015 family as appropriate to the setting.

93350 excludes ECG monitoring and supervision. 93351 includes them. Everything about how you pair these codes follows from that one distinction.

Reimbursement context

93350 splits into professional and technical components, and the setting determines which you may report.

2026 Medicare RVUs for CPT 93350

CPT 93350: 2026 Medicare RVUs (national, before GPCI)
Line	Work	PE, non-facility	PE, facility	Malpractice	Total, non-facility	Total, facility
Global (no modifier)	1.42	4.06	NA	0.07	5.55	NA
Professional (modifier 26)	1.42	0.55	0.55	0.05	2.02	2.02
Technical (modifier TC)	0.00	3.51	NA	0.02	3.53	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 93350 carries 1.42 work RVUs and 5.55 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, 2.02 total RVUs) and a technical component (modifier TC, 3.53 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); 93350 sits at 1.42.

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 cardiac indication that justified a stress study rather than a resting echo.
Rest images and stress images, both retained and both addressed in the report.
Wall motion assessment at rest and at peak stress, segment by segment.
The stress method used, including agent and dose where pharmacological.
Heart rate achieved against target, and reason for termination.
Where contrast was used, the agent and the reason it was needed.
A signed interpretation with a conclusion answering the clinical question.

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: A57183 (Cardiovascular Stress Testing, Including Exercise and/or Pharmacological Stress and Stress Echocardiography, Noridian), A56423 (Cardiology Non-emergent Outpatient Stress Testing, Novitas) and A56952 (Cardiology Non-emergent Outpatient Stress Testing, First Coast). Use the article from the contractor that processes your claims.

Common denials and the exact fix

Stress test components omitted when they were reportable

This is an under-reporting problem rather than a denial. Because 93350 excludes supervision and ECG monitoring, practices that treat it like 93351 leave the stress test component unbilled on every study.

Fix: where your practice supervised the test and interpreted the tracing, report the appropriate stress test component codes alongside 93350.

Resting echo billed on the same day

The rest imaging is already inside 93350.

Fix: report the stress echo alone unless a genuinely separate indication is documented for an additional study.

Missing or mismatched 26 / TC

A global code from a facility place of service denies where the facility bills the technical component.

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

CO-50: indication does not justify a stress study

A stress echo ordered without a documented reason that a resting study would not answer draws a medical-necessity denial.

Fix: record the clinical question in the order and the report, and code it specifically.

Modifier rules

26 / TC: split by setting and equipment ownership.
51: not appended to add-on codes reported with the study.
76 / 77: repeat study with a documented clinical trigger.
59 / XE / XP / XS / XU: rarely applicable; not a route to separately billing imaging already inside the code.

NCCI bundling edits

93350 with 93015 to 93018: separately reportable, because 93350 excludes supervision and ECG monitoring.
93350 with 93306, 93307 or 93308: the rest imaging is included in the stress study.
93350 with 93351: mutually exclusive. One stress echo, one code.
93352: contrast use during the stress study is reported with this add-on where genuinely administered, and the agent itself is reported under its own HCPCS code.

Frequently asked questions

What is the difference between CPT 93350 and 93351?

93351 includes the performance of continuous electrocardiographic monitoring with physician supervision, while 93350 does not. That single difference decides everything downstream: with 93351 the stress test codes 93015 to 93018 are not separately reportable, whereas with 93350 the appropriate stress test component codes remain separately reportable.

Can I bill a resting echo on the same day as 93350?

Not routinely. 93350 already includes the rest imaging performed as part of the stress study. A separate complete echo on the same day needs documentation of a distinct clinical indication that the stress study did not address, and it draws scrutiny even then.

Is contrast separately reportable with stress echocardiography?

Yes. When an echocardiographic contrast agent is used during the stress study, the add-on code 93352 reports that use, with 93350 or 93351. Report it only where the agent was genuinely administered and documented, and note that the agent itself may be billed separately depending on the setting and payer.

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 93350.
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 A57183, A56423, A56952.

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 93351. Stress echo including ECG monitoring and supervision.
CPT 93306. Complete TTE with spectral and color flow Doppler.
CPT 93308. Limited or follow-up echo.

More cardiology code guides

CPT 78452. Myocardial perfusion SPECT, multiple studies.

CPT 93350: Stress Echocardiography, Rest and Stress Imaging