CPT Code 93350: The Stress Echocardiogram CPT Code, 2026 Rates, and Billing Rules

CPT Code 93350 at a Glance

• 93350 reports a transthoracic stress echo: 2D images at rest and under stress, M-mode when performed, and the physician’s interpretation and report.
• Continuous ECG monitoring and supervision of the stress test aren’t part of 93350; 93351 adds them.
• Stress test work by another clinician goes on the claim as 93016, 93017, and 93018. Codes 93015 and 93351 stay off a 93350 claim.
• Medicare’s 2026 national rates for 93350 are $185.37 global, $67.47 with modifier 26, and $117.91 with modifier TC, at the non-QP conversion factor.
• Add-on codes that travel with 93350 are 93352 for contrast; 93320, 93321, and 93325 for Doppler; and 93356 for strain imaging.
• Hospitals report C8928 in place of 93350 on contrast studies, and Medicare doesn’t pay 93352 separately under OPPS.
• Noridian retired billing article A57184 on October 16, 2025, so stress echo coverage now follows your MAC’s current article.

What Is CPT Code 93350?

CPT code 93350 is the AMA CPT code for a transthoracic stress echocardiogram. It covers 2D images of the heart, plus M-mode when performed, taken at rest and during treadmill, bicycle, or pharmacologic stress. The physician’s interpretation and report come with it. Continuous ECG monitoring and stress test supervision aren’t part of the code.

Look up the CPT code for stress echocardiogram imaging, and two codes come back. The 93350 CPT code is the procedure code for stress echo when the work is split. One physician reads the images. A colleague runs the treadmill or the dobutamine infusion, and that stress test work goes on the claim as 93016 to 93018.

A stress echo compares heart wall motion at rest and under stress. If a segment moves well at rest but weakens at peak stress, the cardiologist reads it as ischemia, usually from coronary artery disease. Cardiologists also order it to see how a narrowed valve behaves under load.

The stress echocardiogram CPT code sits in the echocardiography range of the cardiology CPT codes. Resting transthoracic studies use 93306, 93307, and 93308, and congenital studies use 93303 and 93304. Transesophageal studies run from 93312 to 93318. A resting echo can’t go out as 93350, because the code requires images under stress.

What the 93350 CPT Code Description Includes and What It Leaves Out

The AMA’s CPT Editorial Panel maintains the official 93350 CPT code description, and payers read claims for the code against this exact wording:

“Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed, during rest and cardiovascular stress test using treadmill, bicycle exercise and/or pharmacologically induced stress, with interpretation and report.”

In plain terms, CPT code 93350 is the CPT code for echocardiogram stress test images and their reading. ECG tracing and the stress drug belong to other codes, and so does the clinician who supervises the treadmill. Each piece has its own line.

Table: What 93350 includes and what you bill separately

Is 93350 a stress test code? No, it’s the imaging code. Stress test work goes on the claim as 93016 to 93018, or as 93015 when nobody takes echo images. Coders mix them up because the stress echocardiogram CPT line and the stress test lines often land on the same claim.

Exercise, Treadmill, and Dobutamine: One Stress Echo Test CPT Code

Changing the stress method doesn’t change the code. Coders report 93350 or 93351 for treadmill, bicycle, and dobutamine protocols alike. That makes the exercise stress echo CPT code and the treadmill stress echo CPT code the same number.

The CPT code for exercise stress echo differs from the treadmill stress test CPT code. Codes 93015 to 93018 cover the ECG-only version. Add images at rest and under stress, and the echo portion moves to 93350 or 93351.

A dobutamine stress echo CPT code is still 93350 or 93351. Dobutamine itself goes on its own line as J1250 (“Injection, dobutamine hydrochloride, per 250 mg”), and the practice that bought the drug bills it. Record the total dose in the report, since J1250 units count in 250 mg increments.

CPT Code 93350 vs 93351: The One Question That Picks the Code

The deciding question is who ran the stress test. If the physician who read the echo also supervised the stress test and provided continuous ECG monitoring, the code is 93351. Any other setup gets 93350 for the echo physician. Stress test components go on the claim as 93016, 93017, and 93018.

The two descriptors match word for word until the end. There, 93351 adds “including performance of continuous electrocardiographic monitoring, with supervision by a physician or other qualified health care professional.” That clause is the whole difference in the CPT stress echocardiogram pair. It’s why 93351 exists, for the clinician who handles the echo and the stress test together.

Picking the wrong code costs money either way. A 93350 claim for work that supports 93351 leaves the ECG and supervision unpaid. Billing 93351 when a colleague ran the treadmill charges for work the reading physician didn’t do, and Medicare can recoup that overpayment.

Most charge tickets don’t show who stood at the treadmill, so cardiology specialty billing teams read the report before picking the stress echo CPT code. For a typical group, the CPT for stress echo comes down to one line in the report: who supervised the stress portion.

Table: CPT 93350 vs 93351 in 2026

Our CPT code 93351 billing guide covers the ECG monitoring documentation payers look for once you’ve decided 93351 is the right call for a study.

Can 93350 and 93351 Be Billed Together?

No. CPT guidance says 93350 and the stress test codes 93015 to 93018 aren’t reported with 93351, because 93351 already contains that work (CPT Assistant, January 2010). Report one stress echo code per study, and let the documentation decide which one. Payers deny a claim that carries both for one study.

How to Bill 93350 in the Office, the Hospital, and Split-Physician Cases

Two facts set the lines on a stress echo claim: the place of service and who performed each part of the test. They also decide the CPT code for stress echo imaging. The table maps the five common setups.

Table: How to bill a stress echo by setting (2026)

Office, One Physician Does Everything: Bill 93351

A cardiologist who runs the stress portion and reads the echo in the office bills 93351 as a global service. Reporting 93350 here would leave the stress test work unbilled. Add 93352 only when the report documents contrast use, and bill the agent’s Q-code only if the practice bought the agent.

Office, Two Physicians Share the Test: 93350 Plus 93016 to 93018

Say Dr. A reads the echo images while Dr. B, a partner in the same group, supervises the treadmill and interprets the stress ECG. The group owns the equipment. Dr. A’s line is 93350, and Dr. B bills 93016 for supervision and 93018 for the ECG interpretation. The group adds 93017 for the tracing.

The global stress test code, 93015, stays off this claim. It bundles supervision, tracing, and interpretation into one line, so CPT 93350 pairs with the three component codes instead. The report has to name each clinician and the part each one performed, or a reviewer can’t tie the lines to people.

Hospital Outpatient Professional Claims: 93350-26 or 93351-26

Hospital claims separate the professional work from the technical work, so the physician’s echo line carries modifier 26. CPT guidance, as quoted in the AAPC Cardiology Coding Alert on August 24, 2018, settles the single-physician case:

“When only the professional components of a complete stress test and a stress echocardiogram are provided by the same physician, you should report 93351 with modifier 26.”

Split the professional work between physicians, and CPT code 93350 with modifier 26 goes to the echo reader. The supervising physician bills 93016, and the physician who interprets the stress ECG bills 93018. Both are professional-only codes, so neither takes modifier 26. Our modifier 26 professional component guide explains how payers read that split.

Forums still argue about this because older guidance said otherwise. CPT Assistant in January 2010 said facility stress echo work always used 93350. The current CPT guideline text allows 93351-26. Follow the current guideline.

Hospital Facility Claims: 93017 and the Contrast C-Codes

The hospital bills the technical side on a UB-04. With contrast, Medicare wants C8928, the contrast version of 93350, or C8930, the contrast version of 93351, plus the agent’s Q-code. Medicare doesn’t pay 93352 separately under OPPS, and the NCCI Policy Manual bars reporting a C-code with its matching CPT code for the same encounter.

The hospital’s ECG tracing goes on the facility claim as CPT code 93017. Coding guidance for the non-contrast facility claim has conflicted over the years, so follow your compliance team’s written policy. Across the rest of the hospital outpatient revenue cycle, the same rule holds: the UB-04 code has to match what the technologist and the report show.

The Split-Billing Pattern That Draws Audits

A single cardiologist does all the professional work, yet the claim goes out as 93350-26, 93016, and 93018. CPT directs 93351-26 for that situation, and the three-line version pays more at 2026 national Medicare rates.

Table: Same work, two ways to bill it (2026 national Medicare, non-QP)

A repeated $20.71 gap per study under one NPI is the kind of pattern a coding review flags. Set a charge capture rule that prompts for 93351-26 when one physician documents all the professional work.

If your cardiologists read stress echos in the hospital and nobody’s checked whether those claims should’ve gone out as 93351-26, it’s worth a look. We can review a batch of your stress echo claims and show you where the codes and the work don’t line up. A stress echo claim audit is the place to start.

Companion and Add-On CPT Codes for Stress Echo Claims

Stress echo is one of three stress test types, next to the exercise ECG test (93015 to 93018) and the nuclear stress test (78451 to 78454). The CPT for stress echocardiogram claims is 93350 or 93351, and CPT code 93350 usually shares the claim with other lines. Our stress test CPT codes guide covers all three types.

Stress Test Components: 93016, 93017, and 93018, Not 93015

A search for the CPT code for cardiac stress test, or the CPT code for stress test, usually lands on 93015. That 93015 CPT code is the ECG stress test CPT code for the complete test in one line. It stays off any claim that carries 93350. Its component codes go on instead.

Table: Stress test component codes that pair with 93350

CPT code 93016 pays $20.71 at the 2026 national rate, and CPT code 93018 pays $13.69. The tracing code, 93017, pays $39.08 and goes to whoever owns the equipment, which is the practice in an office and the hospital in a facility.

Contrast: +93352, the Q-Codes, and C8928

Add-on code 93352 reports echo contrast use during a stress echo. Physicians report it with 93350 or 93351, and it pays $35.74 at the 2026 national rate. The agent goes on its own line, billed by whoever bought it. Q9957 covers perflutren lipid microspheres per ml, and Q9950, Q9955, and Q9956 cover other agents (ASE contrast coding guidance).

Hospitals report C8928 or C8930 plus the Q-code instead, and Medicare doesn’t pay 93352 separately under OPPS (Medicare NCCI Policy Manual). Neither the IV start (36000) nor the injection (96374) is separately reportable. The report should say why the images needed contrast, usually poor endocardial border definition without it.

Doppler Add-Ons: 93320, 93321, and 93325

Doppler can go on a stress echo claim when it’s clinically indicated and documented on its own. CPT code 93320 covers a complete spectral Doppler study, and CPT 93321 covers a limited or follow-up study. The 93325 CPT code covers color flow mapping.

CPT Assistant’s January 2010 issue allows all three with 93350 and 93351. In 2026, the national global amounts are $51.44 for 93320, $25.38 for 93321, and $23.71 for 93325. Your report needs actual Doppler findings, since “Doppler performed” alone won’t hold up.

CPT Code 93356: Strain Imaging With a Stress Echo

Add-on 93356 reports myocardial strain imaging. The 93356 CPT code description reads: “Myocardial strain imaging using speckle tracking derived assessment of myocardial mechanics (List separately in addition to codes for echocardiography imaging).” At 2026 national rates, it pays $36.74 in the office and $10.02 in a facility.

ASE’s coding FAQ lists the primary codes as 93303, 93304, 93306, 93307, 93308, 93350, and 93351, with the add-on reported once per imaging session (ASE echocardiography coding FAQ). So yes, the 93356 CPT code can go with 93308.

Coverage varies by payer. Some commercial policies set clinical criteria for strain imaging, so check the plan’s 93356 CPT rules before the study. Medicare pays 93356 under the fee schedule, but a commercial plan can still deny it as not medically necessary.

93350 Reimbursement in 2026: Medicare Rates, RVUs, and Modifier 26

In 2026, Medicare’s national rate for CPT code 93350 is $185.37 for the global service, $67.47 with modifier 26, and $117.91 with modifier TC. Those figures use the non-QP conversion factor of $33.4009 from the CMS October 2026 RVU file. Your actual payment moves with your locality’s geographic adjustment.

Table: 2026 national Medicare rates for stress echo claim lines (non-QP)

Source: CMS PFS relative value file RVU26D, October 2026 release dated August 26, 2026. National amounts equal total RVUs multiplied by the non-QP conversion factor of $33.4009, before geographic adjustment.

The 93350 CPT code carries 1.42 work RVUs in 2026, down from 1.46 in 2025, and 93351 went from 1.75 to 1.71. Both drops match the 2.5% efficiency adjustment CMS applied to work RVUs for non-time-based services. The global rate for 93350 still rose from $176.94 in 2025.

Why There Are Two 2026 Conversion Factors

CMS finalized two conversion factors for 2026: $33.57 for qualifying APM participants and $33.40 for everyone else (CMS CY 2026 final rule). Unless your group qualified through an Advanced APM, the non-QP amounts above apply. Confirm your QP status before you compare a remittance against these rates.

Commercial Rates and Underpayments

Commercial contracts often price cardiology services as a percentage of Medicare, so the table above works as a baseline for checking your contracted rate. A stress echo paid below contract shows up as a variance in payment posting. Your posting team has to compare the paid amount to the contract to catch it.

That comparison is part of end-to-end revenue cycle management. Without it, an underpaid 93350 can repeat on claim after claim for months before anyone spots the pattern.

NCCI Bundling Rules for CPT 93350

Four bundling rules decide whether a 93350 claim pays. It can’t go out with 93351, and it can’t pair with the global stress test code 93015. A same-day resting TTE needs its own clinical reason and a modifier, and nobody bills the contrast injection separately.

93350 With 93351 or 93015

Code 93351 already contains the work of 93350 plus the stress test, so the two can’t share a claim for one study. Since 93015 bundles the whole stress test, CPT code 93350 pairs with its three component codes instead. For Medicare claims, confirm each pair and its modifier indicator in the NCCI PTP file effective October 1, 2026.

Can You Bill a Resting Echo (93306) on the Same Day?

Not for the same study. The resting images are part of 93350, so payers deny a separate complete TTE code 93306 for the same session. A resting TTE qualifies on its own only when it answers a different clinical question, like a valve evaluation ordered before the stress protocol.

Document each order and indication on its own. Then add modifier 59 to the TTE line, or the more specific XE for a separate encounter or XU for an unusual non-overlapping service. Leave 93350 unmodified. The same logic applies to 93351 and 93306 on one date.

How to Check an Edit Before You Submit

1. Pull the NCCI PTP table for the current quarter; the Q4 2026 file takes effect October 1, 2026.
2. Find 93350 in column one or column two against each other code on the claim.
3. Read the modifier indicator: 0 means no modifier bypasses the edit, 1 means one can with supporting documentation, and 9 means the edit is inactive.
4. Check the MUE for units, and remember that CMS doesn’t publish every MUE value.

Denials from these edits usually come back as CO-236 or CO-97. Our guide to CO-236 NCCI edit denials covers the appeal side, including the documentation a reviewer expects when you use a modifier.

Payable Diagnoses and Coverage for CPT Code 93350

Medicare has no single national diagnosis list for 93350. Each Medicare Administrative Contractor publishes its own billing and coding article, and the ICD-10-CM code on the claim has to match a covered indication in that article. It also has to match the ordering provider’s note.

The Stress Testing Article Many Guides Still Cite Was Retired

Noridian retired LCD L36889 and billing article A57184 effective October 16, 2025 (Noridian retirement notice). Plenty of billing content still quotes A57184’s documentation rules as if they were current. If you bill in Noridian’s JF region, search the Medicare Coverage Database by code and state to see what applies now.

What a Current MAC Article Looks Like

CGS article A57306 for Kentucky and Ohio makes a good model. Revision R28 took effect April 16, 2026, and its ICD-10 Group 4 applies to 93350, 93351, 93352, C8928, and C8930 (CGS billing article A57306). Use it to learn how a MAC lays out coverage for the stress echo CPT code, then pull your own contractor’s version.

Common Diagnosis Codes Behind a Stress Echo Order

Table: Common ICD-10-CM codes for stress echo orders (check each one against your MAC’s current article)

A diagnosis outside the MAC’s list usually comes back as CO-50, and our guide to CO-50 medical necessity denials explains how to appeal one. Don’t recode to chase payment. The FY2027 ICD-10-CM code set takes effect October 1, 2026, so recheck each code in this table for dates of service from that day on.

Commercial Plans and Prior Authorization

UnitedHealthcare requires prior authorization for stress echocardiograms in office and outpatient settings for its Commercial and Exchange plans (UnitedHealthcare cardiology prior authorization). Other commercial payers run their own imaging authorization programs. Request stress echo prior authorization at scheduling, because some plans won’t approve it after the fact.

CPT 93350 Documentation Requirements

A 93350 claim holds up in review when the record covers the order, the stress method, rest and stress images, a signed interpretation, and who did each part. That last item separates 93350 from 93351 on paper. Medicare also requires the treating practitioner to order the test under 42 CFR 410.32(a).

1. Order details from the treating practitioner, including the date and the clinical question the test should answer.
2. Stress method and protocol, with the exercise stages reached, or the pharmacologic agent and dose plus the reason the patient couldn’t exercise.
3. Rest and stress images, with a wall motion comparison and the ejection fraction.
4. Names of the clinicians who supervised the stress test, monitored the ECG, interpreted the ECG, and read the echo.
5. Contrast details when used, with the agent and amount and the reason the images needed it.
6. Doppler or strain findings for any add-on code on the claim.
7. Final report, signed and dated by the interpreting physician.

ASE’s 2020 guideline on stress echocardiography in ischemic heart disease sets the clinical standard for performing and reporting the study. Pull five recent CPT code 93350 reports and check each against the list. If two or more miss the same item, a documentation and coding audit shows how far the gap runs across your stress echo volume.

Common CPT Code 93350 Denials and How to Fix Them

Stress echo denials usually come from four causes: a bundling edit, a wrong or missing modifier, a diagnosis the payer doesn’t cover, and a missing authorization or record. A correct CPT code for stress echo work won’t prevent the last two. Each arrives on the 835 as a claim adjustment reason code, sometimes with a remark code.

Table: 93350 denial codes and fixes

A stress echo denial that repeats every month usually means nobody fixed the step that caused it. That step might sit in scheduling or in charge entry. Our cardiology denial management team traces each denial back to its source and fixes the process there, so your staff stops reworking the same claim.

What Other 93350 Guides Get Wrong

A handful of claims about CPT code 93350 show up again and again in billing forums and code lookup pages. Each row below pairs one of those claims with the current rule and its source, so you can check it yourself.

Table: Common 93350 misconceptions, corrected

What Changed for 93350 in 2026 and What to Watch in 2027

The items below changed in 2025 or 2026, or take effect before January 1, 2027. Each one carries its effective date, so you can match it to the dates of service on your claims.

• Starting January 1, 2026, Medicare uses two conversion factors: $33.57 for qualifying APM participants and $33.40 for everyone else.
• Virtual direct supervision through real-time audio and video became permanent for diagnostic tests on January 1, 2026, which covers the stress portion billed as 93016.
• Noridian retired LCD L36889 and billing article A57184 effective October 16, 2025.
• NCCI’s Q4 2026 edit files carry an October 1, 2026 effective date, so recheck 93350 pairs against them.
• ICD-10-CM FY2027 codes apply to dates of service from October 1, 2026.
• The AMA released CPT 2027 on September 9, 2026, with 299 new codes, 74 revisions, and 80 deletions, effective January 1, 2027.

The AMA’s published highlights for CPT 2027 don’t mention stress echo. Even so, check CPT code 93350 against the full CPT 2027 changes list before January 1, 2027, since the highlights don’t cover every revision. New Medicare rates arrive with the CY 2027 final rule, which CMS usually publishes around November 1.

CPT Code 93350 FAQs

What Is the Procedure Code for Stress Echocardiogram Testing?

It’s 93350 or 93351, depending on who ran the stress portion. The stress echocardiogram CPT code is 93351 when the same physician supervised the stress test with continuous ECG monitoring and read the echo. Otherwise it’s 93350, and the stress test work goes out as component codes 93016 to 93018.

Can a Nurse Practitioner or Physician Assistant Supervise the Stress Portion?

Yes, where scope of practice and state law allow it. Medicare’s diagnostic test rule at 42 CFR 410.32(b)(1) lets NPs, PAs, clinical nurse specialists, CRNAs, and certified nurse-midwives supervise diagnostic tests. The 93351 descriptor also says “physician or other qualified health care professional.” Commercial payers can set stricter rules, so check the contract.

How Many Units of 93350 Can You Bill in a Day?

One unit per stress echo study. If a second, separately ordered stress echo happens the same day, document its own indication. Check the current MUE and PTP files before billing it, because a second line usually draws an edit.

What Is the CPT Code for Stress Echocardiography With Contrast in a Hospital?

The physician reports 93350-26 or 93351-26 plus add-on 93352. On the facility claim, the hospital reports C8928 or C8930 with the contrast agent’s Q-code. It leaves 93352 off, because Medicare doesn’t pay that code separately under OPPS.

What If the Stress Test Stops Early?

Bill what the team performed and document why the test stopped. CPT modifier 52 describes a service reduced at the physician’s discretion, and modifier 53 describes one discontinued for the patient’s safety. Payer rules on both differ for imaging, so check the policy before you add either one.

Which Costs More, a Stress Echo or an ECG?

A stress echo pays far more. In 2026, Medicare’s national global rate for 93350 is $185.37, while a routine 12-lead ECG, 93000, pays $15.36. That’s about 12 times as much. The difference covers the echo equipment and sonographer time, plus the physician’s read of rest and stress images.

Does Medicare Cover a Stress Echo for Screening?

No. Medicare pays for diagnostic tests the treating practitioner orders to answer a clinical question. A stress echo for a patient with no symptoms or covered indication, coded with a screening code such as Z13.6, usually comes back denied as not medically necessary.

Is CPT 93350 Still Valid in 2026?

Yes. CMS lists the 93350 CPT code with status indicator A, active and separately payable, in its October 2026 relative value file. For 2027, confirm its status in the AMA’s CPT 2027 changes list and watch the CY 2027 fee schedule for its new rate.

Getting Stress Echo Claims Paid the First Time

Before a CPT code 93350 claim goes out, run four checks. The CPT code for stress echocardiogram work comes first, because it decides which other lines belong on the claim. Next, make sure those lines fit the place of service. Then match the diagnosis to your MAC’s current article and confirm any authorization the plan requires.

If your team would rather hand stress echo claims to specialty-matched cardiology coders, we can take them on and work each one from charge entry through final payment. Our full-service billing at 3% of collections covers coding, claims, denials, and follow-up, with nothing added on.