93308 — Ultrasound of heart, follow-up

What the market charges

Across 31,538 negotiated rates, the middle 80% fall between $31 and $211, with a median of $104.

What Medicare pays

Medicare allowed an average of $31 for this code, across 490,430 services billed by 12,148 providers. At the median, the market charges 3.4 times what Medicare pays for this code.

Where this is billed, and what it costs there

The states billing 93308 most, by Medicare service volume, each compared against the national average of $31. Each links to the providers Mishe lists there.

  • California — 1,021 providers billed it, Medicare allowed $36 — 16% above the national average
  • Florida — 876 providers billed it, Medicare allowed $36 — 16% above the national average
  • Pennsylvania — 719 providers billed it, Medicare allowed $27 — 13% below the national average
  • Ohio — 591 providers billed it, Medicare allowed $26 — 16% below the national average
  • New York — 638 providers billed it, Medicare allowed $36 — 16% above the national average
  • Texas — 643 providers billed it, Medicare allowed $38 — 23% above the national average
  • Illinois — 532 providers billed it, Medicare allowed $29 — 6% below the national average
  • Virginia — 348 providers billed it, Medicare allowed $27 — 13% below the national average

Claim-editing rules

These are National Correct Coding Initiative procedure-to-procedure edits — the rules a payer applies when deciding whether two codes billed together are both payable.

Codes this one absorbs

Billed together, 93308 is the payable code and these are not separately payable. 22 pairs in total.

  • 33017 — a modifier may allow both to be paid
  • 33018 — a modifier may allow both to be paid
  • 33019 — a modifier may allow both to be paid
  • 36000 — a modifier may allow both to be paid
  • 36005 — a modifier may allow both to be paid
  • 36410 — a modifier may allow both to be paid
  • 36591 — no modifier can override this edit
  • 36592 — no modifier can override this edit
  • 76998 — a modifier may allow both to be paid
  • 93040 — a modifier may allow both to be paid
  • 93041 — a modifier may allow both to be paid
  • 93042 — a modifier may allow both to be paid

Codes that absorb this one

Billed alongside any of these, 93308 is not separately payable. 322 pairs in total.

  • 33016 — a modifier may allow both to be paid
  • 33017 — a modifier may allow both to be paid
  • 33018 — a modifier may allow both to be paid
  • 33019 — a modifier may allow both to be paid
  • 33361 — a modifier may allow both to be paid
  • 33362 — a modifier may allow both to be paid
  • 33363 — a modifier may allow both to be paid
  • 33364 — a modifier may allow both to be paid
  • 33365 — a modifier may allow both to be paid
  • 33366 — a modifier may allow both to be paid
  • 33367 — a modifier may allow both to be paid
  • 33368 — a modifier may allow both to be paid

Deploy this for your team

Every figure on this page came from published payer and Medicare data, assembled by Mishe. The same pricing, claim-editing and care-pathway intelligence runs underneath the plans Mishe operates.

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