93880
Carotid duplex, bilateral complete
Duplex scan of extracranial arteries (carotid), complete bilateral study. CMS 2026 global wRVU 0.65, total RVU approximately 3.15, Medicare global allowable approximately $105. The vascular ultrasound standard for TIA / stroke workup and screening of asymptomatic carotid disease.
When to use it
Use 93880 for bilateral complete carotid duplex ultrasound:
Full guidance
B-mode imaging plus spectral Doppler analysis of the common, internal, and external carotid arteries on both sides, including peak systolic and end-diastolic velocity measurements. Standard indications: TIA or stroke workup, carotid bruit on examination, screening of high-risk patients (CAD, PVD, abdominal aortic aneurysm), post-CEA or CAS surveillance. 93882 (limited) is the unilateral or limited follow-up version.
Documentation checklist
- ✓Order with indication (TIA, CVA, bruit, screening of high-risk patient, post-procedure surveillance).
- ✓B-mode imaging of CCA, ICA, ECA bilaterally with measurements (intima-media thickness when applicable).
- ✓Spectral Doppler waveforms with PSV and EDV at standardized sites (proximal CCA, distal CCA, bulb, proximal ICA, mid ICA, distal ICA when visible, ECA, vertebral artery).
- ✓Interpretation with stenosis grading (NASCET criteria most commonly: PSV thresholds for less than 50, 50 to 69, 70+ percent).
- ✓Setting modifier; signed report.
Common pitfalls
- !Missing the bilateral complete documentation. If only one side was studied, the correct code is 93882 (limited or follow-up).
- !Failing to document PSV and EDV at standardized sites. Velocity measurements are the structural deliverable; descriptive imaging alone won't pass audit.
- !Reading a 93880 and missing vertebral artery assessment. Most modern protocols include bilateral vertebral arteries; their absence is a quality-of-report issue.
- !Confusing 93880 with 93882. 93882 pays less and is reserved for limited or unilateral studies, including follow-up after a previous complete study.
- !Billing 93880 for transcranial Doppler — that's a different code (93886 / 93888).
Payer notes
Medicare covers 93880 for symptomatic indications (TIA, stroke, bruit) and surveillance after CEA/CAS. Asymptomatic screening of high-risk patients is covered under USPSTF Grade B/C recommendations for selected populations but commercial coverage varies. Some Medicare Advantage plans require prior auth for outpatient carotid duplex; document indication and clinical urgency.