CPT 93981
Global XXX ActivePenile vascular study
CPT 93981 Billing & Documentation Guide
CPT code 93981 (Penile vascular study) is classified under Cardiovascular with a global period indicator of XXX. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 0.43, a non-facility practice expense RVU of 1.73, and a malpractice RVU of 0.04, a total non-facility RVU of 2.2 and facility RVU of 2.2. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $76.1, though rates vary from $64.69 to $99.98 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 93981, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 93981 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
No global period (E/M and other non-procedural services)
MUE Limit (Medically Unlikely Edits)
Submitting more than 1 units of 93981 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 93981
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 0.43 | 0.43 |
| Practice Expense RVU | 1.73 | 1.73 |
| Malpractice RVU | 0.04 | 0.04 |
| Total RVU | 2.2 | 2.2 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 93981
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $83.97 | $83.97 | $78.65 - $99.98 | 29 |
| Florida | $74.94 | $74.94 | $71.61 - $77.89 | 3 |
| Georgia | $71.11 | $71.11 | $67.5 - $74.72 | 2 |
| Illinois | $72.8 | $72.8 | $69.21 - $76.17 | 4 |
| Michigan | $70.51 | $70.51 | $68.63 - $72.38 | 2 |
| North Carolina | $69.13 | $69.13 | $69.13 - $69.13 | 1 |
| New York | $81.33 | $81.33 | $70.2 - $86.47 | 5 |
| Ohio | $68.47 | $68.47 | $68.47 - $68.47 | 1 |
| Pennsylvania | $72.52 | $72.52 | $68.67 - $76.37 | 2 |
| Texas | $72.57 | $72.57 | $68.19 - $76.71 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 93981
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 93981 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 0689T | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 0690T | Column 1 (primary), can be billed with modifier | Yes | CPT Manual or CMS manual coding instruction |
| 36591 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 36592 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 76856 | Column 1 (primary), can be billed with modifier | Yes | Mutually exclusive procedures |
| 76970 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 76986 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 76998 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 93325 | Column 1 (primary), can be billed with modifier | Yes | CPT Manual or CMS manual coding instruction |
| 96523 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
Frequently Asked Questions, CPT 93981
What does CPT code 93981 mean? +
CPT code 93981 represents: Penile vascular study. It's in the Cardiovascular category with a global period of XXX.
What is the Medicare reimbursement for CPT 93981? +
The 2026 Medicare national average non-facility payment for CPT 93981 is $76.1. Rates range from $64.69 to $99.98 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 93981? +
Medicine section spans a wide range: therapy services use GP/GO/GN (PT/OT/SLP plans of care) and KX (above cap with documentation). Drug administration uses JW (waste) and JZ (no waste). Professional/technical split applies to some diagnostic codes.
What bundling edits apply to CPT 93981? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
Get the full PayerReady toolkit
Free access to CPT/ICD-10 lookup, denial appeals, fee comparator, and claim auditing with credentialing enrollment.
Start free →Run this code through our claim audit tool
Check NCCI bundling, MUE limits, and modifier logic before submission.
Try the auditor →Did this page help?
Quick signal so we know what to improve.
If you want a code reference page that doesn't exist yet, email coding@payerready.com.
Tell us what's missing or wrong: coding@payerready.com. We respond within 5 business days.
Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
Powered by 11K CPT · 98K ICD-10 · 860K MPFS rates · 4.5M NCCI edits · 9.5M NPIs. Our data methodology · About our coding team