CPT 93986
Global XXX ActiveDup-scan hemo compl uni std
CPT 93986 Billing & Documentation Guide
CPT code 93986 (Dup-scan hemo compl uni std) is classified under Cardiovascular with a global period indicator of XXX. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 0.49, a non-facility practice expense RVU of 3.85, and a malpractice RVU of 0.1, a total non-facility RVU of 4.44 and facility RVU of 4.44. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $153.76, though rates vary from $128.55 to $205.39 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 93986, 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 93986 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 93986 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 93986
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 0.49 | 0.49 |
| Practice Expense RVU | 3.85 | 3.85 |
| Malpractice RVU | 0.1 | 0.1 |
| Total RVU | 4.44 | 4.44 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 93986
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 | $170.92 | $170.92 | $159.37 - $205.39 | 29 |
| Florida | $151.89 | $151.89 | $144.32 - $158.68 | 3 |
| Georgia | $143.07 | $143.07 | $135.05 - $151.08 | 2 |
| Illinois | $147.06 | $147.06 | $138.99 - $154.47 | 4 |
| Michigan | $141.82 | $141.82 | $137.54 - $146.09 | 2 |
| North Carolina | $138.48 | $138.48 | $138.48 - $138.48 | 1 |
| New York | $165.14 | $165.14 | $140.88 - $176.51 | 5 |
| Ohio | $137.14 | $137.14 | $137.14 - $137.14 | 1 |
| Pennsylvania | $146.04 | $146.04 | $137.57 - $154.51 | 2 |
| Texas | $146.16 | $146.16 | $136.49 - $155.41 | 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 93986
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 93986 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 |
| 76881 | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 76882 | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 76937 | Column 1 (primary), can be billed with modifier | Yes | More extensive procedure |
| 76970 | 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 | Mutually exclusive procedures |
| 93922 | Column 1 (primary), can be billed with modifier | Yes | More extensive procedure |
Frequently Asked Questions, CPT 93986
What does CPT code 93986 mean? +
CPT code 93986 represents: Dup-scan hemo compl uni std. It's in the Cardiovascular category with a global period of XXX.
What is the Medicare reimbursement for CPT 93986? +
The 2026 Medicare national average non-facility payment for CPT 93986 is $153.76. Rates range from $128.55 to $205.39 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 93986? +
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 93986? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on June 1, 2026.
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