CPT 93306 complete TTE with Doppler for accurate coding

Last Updated on September 16, 2025

Most transthoracic echoes you run are complete with Doppler, and that is exactly what CPT 93306 captures: a complete transthoracic echocardiogram with 2D imaging plus spectral Doppler and color flow Doppler in a single code. If both Dopplers were performed and interpreted, you do not append separate Doppler add-ons (93320/93325)

What CPT 93306 includes and excludes

Includes with 93306

• Complete transthoracic echo with 2D imaging (M-mode if done) and spectral Doppler and color flow Doppler.
• Documentation of following Cardiac structures: Left/right atria, Left/right ventricles, Aortic, mitral, tricuspid valves, Aorta and Pericardium

Not this code

• 93307 when the complete TTE is without spectral or color Doppler; add 93320 and or 93325 only if those Dopplers were actually performed.
• 93308 when the study is limited or follow up; add 93321 and or 93325 only if limited Doppler or color was used.
• Studies with fewer than 9 cardiac structures documented (without explanation).
• Incomplete study due to poor visualization without documentation

93312 series for transesophageal echo, 93350 93351 for stress echo, 93303 93304 for congenital focus.

Quick win: several competitor posts advise adding 93320 or 93325 to “finish” a complete study. That is incorrect for 93306 because both Dopplers are already included.

CPT 93306 vs 93307 vs 93308 how to choose

Use this during coding or QA to pressure-test your choice.

Situation	Code to report	Why not 93306
Complete TTE with spectral and color Doppler documented	93306	Dopplers are part of 93306 already.
Complete TTE without Doppler	93307 ± 93320 and or 93325 if Dopplers were actually done	93306 requires both Dopplers.
Limited or follow up TTE	93308 ± 93321 and or 93325 if limited Doppler or color was done	Scope is limited, not complete.

If the study is TEE or stress echo, move to those families immediately rather than forcing 93306.

Common CPT 93306 mistakes and the correct approach

Mistake Add 93320 93325 to “complete” a 93306.
Fix Do not append these to 93306. They pair with 93307 or 93308 only when Dopplers were performed and interpreted.

Mistake Treat 93308 as a TEE code.
Fix 93308 is limited TTE. TEE lives in the 93312 family.

Mistake Use 93352 contrast add-on with routine 93306.
Fix +93352 is for stress echo in the physician office; hospitals use HCPCS C or Q contrast codes instead of +93352.

Mistake Throw modifier 59 at Doppler.
Fix There is nothing to “unbundle” from 93306; verify unusual pairs with the NCCI PTP resources instead.

Add ons with CPT 93306 

Belongs with 93306 when documented

• +93356 myocardial strain imaging using speckle tracking, listed in addition to an echo code (e.g., 93306). Document quantification, not just images.
  
• 76376 76377 3D post-processing and rendering with physician interpretation (rare; requires true 3D reconstruction work).

Does not belong with 93306

• +93320 and +93325 Doppler add-ons (already included in 93306).
• +93352 contrast with routine TTE (use only with stress echo in the office; hospitals report contrast via HCPCS).
  

Modifiers for CPT 93306 that prevent edits

• 26 or TC split professional vs technical when components are billed separately (e.g., physician interpretation of a facility study).
• 76 or 77 true repeat echocardiograms on the same date with a new medical need (post-procedure change, clinical deterioration). Check Medically Unlikely Edits and payer policy first.
• 52 rarely fits echo; if the study is inherently limited, you are usually in 93308 rather than reduced 93306.
• Avoid 59 for Doppler on 93306, use the NCCI PTP files or your MAC lookup to validate any unusual code pairings.

Billing Global vs Split

Global (no modifier): Same provider performs professional + technical component

Split billing:

93306-26 → Professional only (interpretation)
93306-TC → Technical only (equipment/facility)

Documentation for CPT 93306 that payers expect

• Indication in policy language (heart failure evaluation, valvular disease, pre-op risk, oncology baseline).
• Study type stated plainly: complete vs limited, transthoracic vs transesophageal.
• Doppler performed and interpreted if using 93306 (spectral and color).
• Key measurements and findings (chambers, valves, gradients, function, pericardium).
  CMS articles that complement local LCDs for TTE explicitly point you back to NCCI and OPPS packaging, use these as your audit anchor.
  

Need a system for clean notes every time Put our compliance program to work for your echo lab

CPT 93306 vs 93307 vs 93308 in practice five fast checks

1. Both Dopplers present If yes, 93306. If no, see 93307 or 93308 with only the add-ons actually performed.
2. Complete versus limited If the report reads like a focused recheck, it is 93308.
3. Family fit TEE 93312 series, stress echo 93350 93351, congenital 93303 93304.
4. Add-on drift check If you added 93320 93325 to 93306, back up—those Dopplers are included.
5. Repeat same day If clinically necessary, document the why and apply 76 or 77; verify MUEs before billing.

NCCI and MUE sanity for echo

Before pairing echo families or stacking add-ons, check the NCCI PTP edit tables and your MAC’s lookup tools to confirm whether a modifier can bypass an edit. For TTE services, CMS also flags that echo and Doppler services are subject to OPPS packaging and edit logic, so teach your team the workflow rather than hard-coding old numbers.

If repeat edits or denials keep bouncing back, route the batch to denials management for root-cause fixes

FAQs about CPT 93306

Does CPT 93306 include Doppler
Yes. 93306 is a complete transthoracic echo with spectral and color Doppler; do not add 93320 or 93325 to complete it.

What is the difference between 93306 and 93307
93306 is complete with Doppler; 93307 is complete without Doppler and may take add-on Dopplers only if they are performed and interpreted.

When do I use 93308
When the exam is limited or follow up rather than complete. Add 93321 and or 93325 only if limited Doppler or color was used.

How do I code contrast for echo
Use +93352 only with stress echo in the physician office; hospitals report contrast with HCPCS C or Q codes instead of +93352 with 93306.Can I report 93356 with 93306
Yes. +93356 is an add-on for myocardial strain imaging when documented as quantification using speckle tracking.