The following chart provides payment information that is based on the national unadjusted Medicare physician fee schedule for the ultrasound services discussed. Payment will vary by geographic region.
The information provided below is intended to assist providers in determining appropriate codes and the other information for reimbursement purposes. It represents the information available to United Medical Instruments as of January 2014. Subsequent guidance might alter the information provided. United Medical Instruments disclaims any responsibility to update the information provided. It is the provider’s responsibility to determine and submit appropriate codes, modifiers, and claims for the services rendered. Before filing any claims, providers should verify current requirements and policies with the applicable payer.
|2014 Medicare Physician Fee Schedule – National Average*|
|CPT Code||Description||Non Facility1||Facility2||Professional Payment3||Technical Payment4|
|76998||Ultrasound Guidance, Intraoperative||n/a||n/a||65.91||n/a|
|76770||Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; complete||$134.69||$134.69||$37.61||$97.08|
|76775||Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; limited||$66.27||$66.27||$29.37||$36.90|
|93880||Duplex scan of extracranial arteries; complete bilateral study||$192.01||$192.01||$30.45||$161.56|
|93882||Duplex scan of extracranial arteries; limited or unilateral study||$124.31||$124.31||$20.78||$103.53|
|93886||Transcranial Doppler study of the intracranial arteries; complete study||$361.45||$361.45||$49.08||$312.37|
|93888||Transcranial Doppler study of the intracranial arteries; limited study||$211.35||$211.35||$31.88||$179.47|
|93925||Duplex scan of lower extremity arteries or arterial bypass grafts; complete bilateral study||$247.89||$247.89||$40.48||$207.41|
|93926||Duplex scan of lower extremity arteries or arterial bypass grafts; unilateral or limited study||$142.22||$142.22||$25.43||$116.78|
|93970||Duplex scan of extremity veins including responses to compression and other maneuvers; complete bilateral study||$188.79||$188.79||$35.82||$152.95|
|93971||Duplex scan of extremity veins including responses to compression and other maneuvers; unilateral or limited study||$114.63||$114.63||$22.93||$91.71|
|93975||Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and or retroperitoneal organs; complete study||$361.81||$361.81||$90.99||$270.82|
|93976||Duplex scan of arterial inflow and venous outflow of abdominal, pelvic, scrotal contents and or retroperitoneal organs; limited study||$213.50||$213.50||$61.62||$151.89|
|93978||Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts, complete study||$226.76||$226.76||$32.96||$193.80|
|93979||Duplex scan of aorta, inferior vena cava, iliac vasculature, or bypass grafts; unilateral or limited study||$156.90||$156.90||$21.85||$135.05|
|93980||Duplex scan of arterial inflow and venous outflow of penile vessels; complete study||$123.59||$123.59||$63.05||$60.54|
|93981||Duplex scan of arterial inflow and venous outflow of penile vessels; follow-up or limited study||$74.87||$74.87||$22.21||$52.66|
|93990||Duplex scan of hemodialysis access (including arterial inflow, body of access and venous outflow)||$195.95||$195.95||$12.90||$183.05|
|G0365||Vessel mapping of vessels for hemodialysis access (Services for preoperative vessel mapping prior to creation of hemodialysis access using an autogenous hemodialysis conduit, including arterial inflow and venous outflow)||$208.38||$208.49||$12.54||$190.84|
|G0389||Ultrasound, real time with image documentation; for abdominal aortic aneurysm (AAA) screening.||$66.27||$66.27||$29.37||$36.90|
1Non Facility: use to estimate services in the physician officee setting.
2Facility: use to estimate services in the hospital (inpatient, outpatient, and emergency department), ambulatory surgical centers (ASCs), and skilled nursing facilities (SNFs).
3Professional Payment: use to estimate the reimbursement to the physician.
4Technical Payment: use to estimate the reimbursement to the technologist.
CPT™ five digit codes, nomenclature and other data are Copyright 2013 American Medical Association. All rights reserved. No fee schedules, basic units, relative values or related listings are included in CPT. The AMA assumes no liability for the data contained herein. Applicable FARS/DFARS restrictions apply to government use.
Deficit Reduction Act of 2005 Adjustment has not been figured into the above global fees.
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