CPT 93998 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 | • Medicine Services and Procedures • Non-Invasive Vascular Diagnostic Studies |
| Common Place of Service | • 11 - Office • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • 26 - Professional component • TC - Technical component |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 93998 |
National average reimbursement for CPT 93998 by major payers:
$41.55
$60.07
$90.48
$47.11
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 93998 | ||||||
United | 93998 | $53.02 | 1336378132 - ROTHMAN ORTHOPAEDIC SPECIALTY HOSPITAL, LLC, BUCKS COUNTY SPECIALTY HOSPITAL, LLC | 270260289 - (PA) ROTHMAN ORTHOPAEDIC SPECIALTY HOSPITAL LLC | PA | General Acute Care Hospital (282N00000X) |
United | 93998 | $111.80 | 1841746948 - PRISMA HEALTH-UPSTATE, PRISMA HEALTH CANCER INST-GREER | 811723202 - PRISMA HEALTH - UPSTATE | SC | General Acute Care Hospital (282N00000X) |
United | 93998 | $40.09 | 1225450588 - PARISH HOSPITAL SERVICE DISTRICT FOR THE PARISH OF ORLEANS, NEW ORLEANS EAST HOSPITAL | 273335876 | LA | General Acute Care Hospital (282N00000X) |
United | 93998 | $79.11 | 1306825997 - WILLIAM BEAUMONT HOSPITAL, BEAUMONT HOSPITAL, TROY | 381459362 - WILLIAM BEAUMONT HOSPITAL | MI | General Acute Care Hospital (282N00000X) |
United | 93998 | $36.84 | 1487651857 - OKLAHOMA SURGICAL HOSPITAL, LLC | 731573733 - (OK) OKLAHOMA SURGICAL HOSPITAL LLC | OK | General Acute Care Hospital (282N00000X) |
United | 93998 | $82.94 | 1306992151 - SWEDISH HEALTH SERVICES, SWEDISH MEDICAL CENTER | 910433740 - (WA) SWEDISH HEALTH SERVICES | WA | General Acute Care Hospital (282N00000X) |
United | 93998 | $69.76 | 1962408203 - ONEIDA HEALTH SYSTEMS, INC, ONEIDA HEALTHCARE CENTER | 161492011 - (NY) ONEIDA HEALTHCARE SYSTEMS INC | NY | General Acute Care Hospital (282N00000X) |
United | 93998 | $25.54 | 1619057155 - SABINE MEDICAL CENTER | 262074318 | LA | General Acute Care Hospital (282N00000X) |
United | 93998 | $71.41 | 1215598156 - AHN EMERUS WESTMORELAND LLC, AHN BRENTWOOD NEIGHBORHOOD HOSPITAL | 823697883 - (PA) AHN EMERUS WESTMORELAND LLC | PA | General Acute Care Hospital (282N00000X) |
United | 93998 | $111.80 | 1417505694 - PRISMA HEALTH-UPSTATE, PRISMA HEALTH HILLCREST HOSPITAL VASCULAR LAB | 811723202 - PRISMA HEALTH - UPSTATE | SC | General Acute Care Hospital (282N00000X) |
United | 93998 | $87.61 | 1689672693 - SAINT CLARE HOSPITAL, ST. CLARE HOSPITAL | 911487485 | WA | General Acute Care Hospital (282N00000X) |
United | 93998 | $36.04 | 1316047632 - TRINITY MEDICAL CENTER, TRINITY ROCK ISLAND | 362739299 - TRINITY MEDICAL CENTER | IL | General Acute Care Hospital (282N00000X) |
United | 93998 | $86.80 | 1790734127 - SAINT FRANCIS MEDICAL CENTER, CHILDREN'S HOSPITAL OF ILLINOIS | 370662569 - (IL) SAINT FRANCIS MEDICAL CENTER | IL | Children's Hospital (282NC2000X) |
United | 93998 | $78.55 | 1194744805 - WEST PENN ALLEGHENY HEALTH SYSTEM INC, THE WESTERN PENNSYLVANIA HOSPITAL | 250969492 - (PA) HIGHMARK HEALTH | PA | General Acute Care Hospital (282N00000X) |
United | 93998 | $51.09 | 1730730490 - US HEALTH PARTNERS, LLC | 843119330 - (TX) US HEALTH PARTNERS LLC | TX | General Acute Care Hospital (282N00000X) |
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 93998 vs. Other Non-Invasive Vascular Diagnostic Studies Codes
The CPT 93998 code is part of the Medicine Services and Procedures 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 93998 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 |
|---|---|---|
| 93922-CPT | Low | Limited Bilateral Noninvasive Physiologic Studies Of Upper Or Lower Extremity Arteries (Er For Lower Extremity Ankle/Brachial Indices At Sital 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/Dorasalis Pedis Arteries Plus Volume Pletheysmography At 1-2 Levels Or Ankle/Brachial Indices At Distal Posterior Tibial And Anterior Tibail/Dor |
| 93926-CPT | Low | Duplex Scn Low Ext Art/Grft;F/U Ltd |
| 93985-CPT | Moderate | Duplex Scan Of Arterial Inflow And Venous Outflow For Preoperative Vessel Assessment Prior To Creation Of Hemodialysis Access; Complete Bilateral Study |
| 93998-CPT | Low | Unlisted Noninvasive Vascular Diagnostic Study |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 93998. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 93998 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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