How much does Medicare pay for CPT 93986?

Medicare allowed an average of $91.50 per service and paid $69.81 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $306.05, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 93986?

Complete ultrasound of artery and vein blood flow pre-op assessment on side of body for hemodialysis access. It was billed 2,511 times to 2,308 Medicare beneficiaries by 104 providers in 2024.

Does 93986 pay differently in an office than a hospital?

Yes. The allowed amount averaged $116.68 in an office setting and $33.17 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 93986 most?

Vascular Surgery, with 1,243 services from 53 clinicians. Next are Nephrology, General Surgery, Ambulatory Surgical Center.

CPT 93986

Complete ultrasound of artery and vein blood flow pre-op assessment on side of body for hemodialysis access

$91.50Medicare-allowed amount per service, averaged across 2,511 services

Providers submitted

$306.05

Asking price, not received

Medicare allowed

$91.50

The fee schedule figure

Medicare paid

$69.81

Balance is patient coinsurance

Providers submitted an average of $306.05 for this code and Medicare allowed $91.50 — 3.3× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $69.81 (76%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $116.68
Hospital / facility: $33.17

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 1,754 services were billed in an office setting and 757 in a facility.

Services: 2,511
Beneficiaries: 2,308
Providers billing it: 104
Total allowed: $229,757

What Medicare pays for CPT 93986

Across 2,511 services billed by 104 providers to 2,308 beneficiaries, Medicare allowed an average of $91.50 per service. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 93986

Specialty	Services	Beneficiaries	Avg allowed	Providers
Vascular Surgery	1,243	1,155	$106.29	53
Nephrology	401	360	$83.49	18
General Surgery	351	300	$89.49	11
Ambulatory Surgical Center	243	237	$52.10	10
Internal Medicine	66	66	$103.42	3
Interventional Radiology	60	60	$33.13	3
Diagnostic Radiology	55	46	$52.37	2
Thoracic Surgery	37	36	$121.39	1
Cardiac Surgery	27	24	$120.45	1
Interventional Cardiology	15	12	$22.55	1
Cardiology	13	12	$23.82	1

93986 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
Texas	455	$103.58	$78.83	18
Florida	378	$93.68	$69.97	11
New Jersey	181	$136.27	$94.39	5
Alabama	134	$72.01	$66.97	7
Ohio	130	$43.02	$32.46	6
Louisiana	128	$103.06	$93.87	5
Mississippi	125	$102.44	$90.81	1
Michigan	124	$44.66	$34.27	5
California	124	$103.78	$70.12	6
New York	122	$98.26	$64.87	8
Tennessee	102	$114.62	$98.57	4
Oklahoma	56	$22.34	$16.01	2
Illinois	50	$56.26	$40.36	2
Georgia	49	$128.04	$81.10	3
Pennsylvania	47	$43.74	$33.90	3
Missouri	42	$90.89	$69.96	2
Arizona	38	$68.42	$53.12	3
Virginia	35	$122.61	$100.81	1
Massachusetts	30	$85.88	$64.18	2
Arkansas	25	$36.69	$31.38	2
Washington	22	$22.43	$14.65	1
Maryland	20	$125.27	$100.48	1
Iowa	19	$116.06	$100.31	1
North Carolina	18	$117.60	$99.84	1
Connecticut	18	$22.08	$16.90	1
Kentucky	15	$113.92	$92.18	1
Hawaii	13	$139.14	$100.23	1
Delaware	11	$126.52	$100.47	1

Related codes

93971Ultrasound study of one arm or leg veins$51.34
93970Ultrasound study of arm or leg veins$96.22
93925Ultrasound of leg arteries or artery grafts$179.07
93922Ultrasound study of arm and leg arteries$54.80
93923Complete ultrasound study of arm and leg arteries$95.57
93978Complete ultrasound of aorta$144.08
93926Ultrasound of one leg arteries or artery grafts$73.51
93975Complete ultrasound of abdomen and pelvis artery and vein blood flow$173.24
93976Ultrasound of abdomen and pelvis artery and vein blood flow$86.57
93990Ultrasound of hemodialysis access$103.15
93979Ultrasound of aorta$89.63
93924Ultrasound of leg arteries at rest and after exercise$138.34

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.