CPT 93926 Fee Schedule
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.
| Key Fact | Detail |
|---|---|
| Service Type | Non-Invasive Extremity Arterial Studies (Including Digits) Non-Invasive Vascular Diagnostic Studies |
| Common Place of Service | 11 - Office 21 - Inpatient Hospital |
| Common Modifiers | None 26 - Professional component RT - Right side of body |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 93926 |
National average reimbursement for CPT 93926 by major payers:
$168.11
$207.08
$181.80
$239.67
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
United | 93926 | $58.72 | 1790936540 - SRISHTI NANGIA | 131623978 | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 93926 | $240.82 | 1780651588 - PATRICIA MUMBY | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | IL | Psychiatry Physician (2084P0800X) |
United | 93926 | $285.16 | 1740201425 - JOSEPH DIVINCENZO | 364015560 - LOYOLA UNIVERSITY MEDICAL CENTER | IL | Psychiatry Physician (2084P0800X) |
United | 93926 | $255.13 | 1982870317 - LUDA SORIN | 383852646 - OSF MULTI-SPECIALTY GROUP | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 93926 | $241.66 | 1992980379 - JANICE KOWALSKI | 363738206 - NORTHSHORE UNIVERSITY HEALTHSYSTEM FACULTY PRACTICE ASSOCIATES | IL | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 93926 | $226.58 | 1376581413 - MARK SINIBALDI | 363149833 - NORTHWESTERN MEMORIAL HEALTHCARE | IL | Psychiatry Physician (2084P0800X) |
United | 93926 | $251.61 | 1184815870 - RYAN COATES | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 93926 | $258.11 | 1275911067 - ELIZABETH HARARI | 911780160 | IL | Psychiatry Physician (2084P0800X) |
United | 93926 | $239.05 | 1730263617 - MARK ALTER | 811324691 | VA | Child & Adolescent Psychiatry Physician (2084P0804X) |
United | 93926 | $21.51 | 1245360411 - ANDREW KULIK | 364340137 - (IL) SAINT ANTHONY HEALTH AFFILIATES | IL | Psychiatry Physician (2084P0800X) |
United | 93926 | $48.02 | 1376063370 - ABBY FREDRICKSON | 910844563 | IL | Psychiatry Physician (2084P0800X) |
United | 93926 | $28.97 | 1881012235 - LAUREN PREST | 910843135 | IL | Psychiatry Physician (2084P0800X) |
United | 93926 | $27.43 | 1851376230 - ANITA PAIRITZ | 351913875 - INDIANA UNIVERSITY HEALTH SOUTHERN INDIANA PHYSICIANS | IL | Psychiatry Physician (2084P0800X) |
United | 93926 | $222.10 | 1255478004 - CHRISTOPHER RAIO | 111888924 - GOOD SAMARITAN HOSPTIAL MEDICAL CENTER | NY | Emergency Medicine Physician (207P00000X) |
United | 93926 | $217.88 | 1679515951 - EUGENE SCHNITZLER | 364035455 | IL | Neurology with Special Qualifications in Child Neurology Physician (2084N0402X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 93926 vs. Other Non-Invasive Vascular Diagnostic Studies Codes
The CPT 93926 code is part of the Non-Invasive Extremity Arterial Studies (Including Digits) services used for Non-Invasive Vascular Diagnostic Studies. 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 93926 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 |
|---|---|---|
| 93895-CPT | Low | Assessment Of Artery Blockage, Ultrasound Of The Carotid Artery (Large Blood Vessel Located In The Neck) To Assess Blockage Associated With Atherosclerosis (Clogged Arteries) Or Coronary Heart Disease. |
| 93922-CPT | Low | Upr L Xtremity Art 2 Levels, Limited Bilateral Noninvasive Physiologic Studies Of Upper Or Lower Extremity Arteries Eg For Lower Extremity Ankle Brachial Indices At Distal Posterior Tibial And Anterior Tibial Dorsalis Pedis Arteries Plus Bidirectional Doppler Waveform Recording And Analysis At 1 2 Levels Or Ankle Brachial Indices At Distal Posterior Tibial And Anterior Tibial Dorsalis Pedis Arteries Plus Volume Plethysmography At 1 2 Levels Or Ankle Brachial Indices At Distal Posterior Tibial And Anterior Tibial Dorsalis Pedis Arteries With Transcutaneous Oxygen Tension Measurement At 1 2 Levels |
| 93925-CPT | Moderate | Ultrasound Arteries In Legs, Ultrasound To Determine If Blood Flow Is Adequate Through Arteries Or Bypass Grafts. The Procedure Is Performed On Both Legs Or On A Section Or Single Leg. |
| 93926-CPT | Low | Ultrasound Arteries In Legs, Ultrasound To Determine If Blood Flow Is Adequate Through Arteries Or Bypass Grafts. The Procedure Is Performed On Both Legs Or On A Section Or Single Leg. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 93926. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 93926 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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