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See a sample rate comparisonCPT 93316 Fee Schedule
Last Verified: October 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
Ultrasound For Heart Condition, A Transesophageal Heart Ultrasound (Echocardiograph) Takes Images Of The Heart By Inserting A Scope Down The Throat. The Procedure Checks For Heart Conditions That Have Been Present Since Birth. A Physician Report Is Included.
| Key Fact | Detail |
|---|---|
| Service Type | Medicine Services and Procedures Cardiovascular Procedures |
| Common Place of Service | 21 - Inpatient Hospital 22 - On Campus Outpatient Hospital |
| Common Modifiers | 59 - Distinct Procedural Service XU - Unusual Non-Overlapping Service |
| Complexity Level | Low |
| Medicare Fee Schedule | $24.38 national non-facility rate (2026) · View Medicare rates for 93316 |
| Medicaid Fee Schedule | $21.705 median of the 8 states in the free preview · View Medicaid rates for 93316 |
National average reimbursement for CPT 93316 by major payers:
$51.00
$46.74
$47.89
$52.23
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CPT 93316
5 of 25 sample ratesHigher to lower in this preview
Lauren Schumacher
$149.74Published rateYu Zhang
Northwestern Memorial Healthcare
$70.15Published rateColleen Buhrfiend
Veterans Assistance Commission C
$52.70Published rateMohammed Homsi
$40.18Published rateAndrew Kulik
Saint Anthony Health Affiliates
$24.12Published rate
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See a sample payer proposalCPT 93316 vs. Other Cardiovascular Procedures Codes
The CPT 93316 code is part of the Medicine Services and Procedures services used for Cardiovascular Procedures. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 93316 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 93312-CPT | Moderate | Echo Transesophageal, Echocardiography Transesophageal Real Time With Image Documentation 2d With Or Without M Mode Recording Including Probe Placement Image Acquisition Interpretation And Report |
| 93313-CPT | Low | Heart Ultrasound With Probe, A Heart Ultrasound (Echocardiograph) Taken By Inserting A Small Probe Down The Throat. A Heart Ultrasound Assesses The Size Shape And Function Of The Heart. |
| 93314-CPT | Moderate | Heart Ultrasound With Scope, A Heart Ultrasound (Echocardiography) Creates An Image Of The Heart Rhythm By Inserting A Scope Down The Throat. The Procedure Includes Physician Interpretation And A Report. |
| 93316-CPT | Low | Ultrasound For Heart Condition, A Transesophageal Heart Ultrasound (Echocardiograph) Takes Images Of The Heart By Inserting A Scope Down The Throat. The Procedure Checks For Heart Conditions That Have Been Present Since Birth. A Physician Report Is Included. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 93316. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 93316 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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