Transthoracic echocardiography (TTE) is one of the core diagnostic tools used across cardiology, internal medicine, and family medicine. While many providers are familiar with CPT 93306—the complete echo with spectral and color Doppler—there is often confusion around CPT 93307, which represents a complete echo without Doppler. Strengthen documentation and avoid denials with our expert CPT 93306 Complete Echocardiogram Billing Guide written specifically for cardiology practices.
Billing this code correctly requires understanding what qualifies as a “complete” exam, what must not be included, how it differs from Doppler studies, and how payers evaluate documentation and medical necessity.
If your practice performs diagnostic ultrasound of the heart, this guide breaks down everything you need to know about CPT 93307, including correct usage, documentation requirements, payer rules, modifier usage, and common mistakes leading to denials.
What Is CPT Code 93307?
The official CPT definition states:
“Echocardiography, transthoracic, real-time with image documentation (2D), includes M-mode recording, when performed; complete, without spectral or color flow Doppler echocardiography.”
In simpler terms:
CPT 93307 = Complete 2D transthoracic echo + M-mode (optional) WITHOUT Doppler.
This means:
✔ All required cardiac structures must be evaluated
✔ M-mode may be included
✔ No spectral Doppler
✔ No color Doppler
If any Doppler study is performed, you cannot bill 93307—you must bill 93306 instead.
93307 vs. 93306 vs. 93308 (Key Differences)
Many billing errors happen because practices confuse these three codes.
Here is the correct distinction:
| CPT Code | Description | Doppler Included? | Exam Type |
| 93306 | Complete TTE with spectral + color Doppler | Yes | Complete |
| 93307 | Complete TTE without Doppler | No | Complete |
| 93308 | Limited or follow-up TTE | Only if Doppler add-on codes used | Limited |
Quick rule:
- If BOTH spectral + color Doppler → 93306
- If NO Doppler → 93307
- If exam is NOT complete → 93308. Reduce audit risk by reviewing our practical CPT 93308 Limited Echocardiogram Billing Guide designed for real-world cardiology documentation needs.
When Should You Use CPT 93307?
Use 93307 when:
✓ A complete echocardiogram is performed
This means all major cardiac structures are examined:
- Left ventricle (LV)
- Right ventricle (RV)
- Left atrium (LA)
- Right atrium (RA)
- Aortic valve
- Mitral valve
- Tricuspid valve
- Pulmonic valve (as indicated)
- Aortic root and ascending aorta
- Pericardium and great vessels
✓ No Doppler is performed
This is the #1 rule.
✓ There is documented medical necessity, such as:
- I10 (Hypertension)
- R06.02 (Shortness of breath)
- R07.9 (Chest pain)
- I50.9 (Heart failure, unspecified)
- I48.91 (Atrial fibrillation)
- R00.2 (Palpitations)
- Abnormal ECG findings
- Murmurs (R01.1)
✓ A full interpretation is provided
A complete, signed physician report is required.
When NOT to Use 93307
Do not bill 93307 when:
❌ Spectral OR color Doppler is used (bill 93306 instead)
❌ Only limited structures are evaluated (bill 93308)
❌ Echo is for screening or administrative purposes
❌ No formal interpretation is documented
❌ The study is a repeat echo without medical justification
Documentation Requirements for CPT 93307
To support 93307, documentation must include:
1. Required Cardiac Structures (Complete Exam)
The provider must evaluate:
Left Ventricle
- Size
- Wall motion
- Ejection fraction estimate (LVEF)
Right Ventricle
- Size and systolic function
Atria
- LA and RA dimensions
Valves
- Aortic
- Mitral
- Tricuspid
- Pulmonic (documented when clinically indicated)
Great vessels
- Aortic root measurement
- Ascending aorta
Pericardium
- Presence or absence of effusion
2. Image Documentation
Actual 2D images must be stored or archived.
3. Written Interpretation & Impression
A compliant report includes:
- Measurements (LV dimensions, wall thickness, etc.)
- Description of valve structure/motion
- Pericardial assessment
- Comparison with prior studies
- Final impression summarizing findings
- Physician signature + credentials
4. Statement confirming NO Doppler performed
This isn’t required by CPT, but including it helps prevent downcoding or audit questions. Avoid stress-test denials and understand payer variations with our CPT 93015 Cardiac Stress Test Billing Guide
covering supervision, NCCI edits, and interpretation rules.
Payer Rules and Reimbursement Considerations
Medicare
Medicare reimburses 93307 only when:
- The study is complete
- No Doppler is performed
- Documentation supports medical necessity
- A formal interpretation is included
Common Medicare denials include:
- “Downcoded—Doppler indicated but not reported.”
- “Documentation insufficient for complete study”
- “Screening services not covered.”
Medicaid
Medicaid denial patterns vary by state, but often include:
- Missing medical necessity
- Billing 93307 when a limited study was performed
- Repeating studies too soon without justification
Commercial Insurers
Commercial payers often deny 93307 for:
- Incomplete exams
- Missing measurements
- Missing comparison to prior echo
- Bundling rules with E/M visits (modifier 25 may be required)
Modifier Usage: When to Apply 26 or TC
In many cardiology workflows, technical and professional components are separated.
- 93307-26 → Interpretation only (professional component)
- 93307-TC → Technical component only (facility or imaging center)
- 93307 (no modifier) → Global service (provider performs + interprets)
Examples:
- Cardiologist interprets a hospital echo → 93307-26
- Hospital bills for the machine + technician → 93307-TC
- Private clinic performs and interprets → 93307 global
Common Coding & Billing Mistakes for CPT 93307
❌ Mistake 1: Using 93307 when Doppler was performed
Even a small Doppler sample = 93306, not 93307.
❌ Mistake 2: Coding 93307 for a limited study
A limited exam → 93308.
❌ Mistake 3: Missing required structures in the report
The exam must be completed.
Get complete clarity on supervision and split-billing requirements from our CPT 93016 Stress Test Supervision Billing Guide optimized for cardiology practices.
❌ Mistake 4: Billing 93307 with an E/M without modifier -25
Some payers require modifier 25 on the E/M to justify separate services.
❌ Mistake 5: Repeating the echo too soon
Payers want clear medical justification for repeat studies.
Correct & Incorrect Billing Scenarios
Correct Example
A clinic performs a complete 2D echo with all cardiac structures evaluated.
No Doppler is performed.
→ Bill 93307
Incorrect Example
The provider performs a 2D echo and uses color Doppler briefly “just to check flow.”
→ Must bill 93306, not 93307.
Correct Example (Split Billing)
The hospital performs the 2D echo, and the cardiologist interprets.
→ Hospital bills 93307-TC
→ Cardiologist bills 93307-26
Incorrect Example
Follow-up pericardial effusion exam billed as a complete echo.
→ Should bill 93308
Final Thoughts
CPT 93307 is frequently used for complete transthoracic echocardiograms that do not include Doppler. However, billing this code requires precise documentation, correct identification of exam components, and clear differentiation between complete and limited studies. Many denials happen because providers unintentionally include Doppler or fail to document all required structures.
If you need help reducing echo-related denials or improving cardiology documentation workflows, Global Tech Billing LLC supports clinics with accurate coding, payer-specific guidance, and cardiology-focused billing expertise.
Improve reimbursements instantly by using our detailed CPT 93000–93010 EKG Billing Guide to code EKG services correctly the first time.
Frequently Asked Questions About CPT 93307
1. Does 93307 require Doppler?
No — Doppler must not be performed for this code.
2. Is 93307 reimbursed lower than 93306?
Yes — Doppler-inclusive studies (93306) are reimbursed at a higher rate.
3. Can NPs or PAs bill 93307?
Yes, as long as it is allowed under state scope-of-practice rules and they perform the full interpretation.
4. Can 93307 be billed with a preventive visit?
Only if medically necessary. Screening echoes are not covered.
5. Can 93307 be done via telehealth?
No. Interpretation (modifier 26) may be remote, but the imaging must be in-person.
6. Is M-mode required?
It is included “when performed,” but the exam must still be complete.
7. Can limited follow-up studies be billed as 93307?
No — limited studies → 93308.
