Vascular testing is reimbursable

A guide to CPT codes 93922, 93923, and 93924

periflux 6000 segmental pressure all cuffs male patient

We offer several configurations of PeriFlux 6000 supporting exams covered by vascular CPT® codes* 93922, 93923, and 93924. Exams depend on instrument configuration and include ankle pressure and ABI, toe pressure and TBI, segmental pressure, pulse volume recording (PVR), skin perfusion pressure (SPP), transcutaneous oxygen (TcpO2), and treadmill testing (exercise ABI).

Accurate use of vascular diagnostic CPT codes can streamline billing, maximize reimbursements, and enhance patient care. In this guide to CPT codes 93922, 93923, and 93924, you will find practical insights, examples of the exams included in each code, and answers to questions we are often asked by our customers.

*CPT® is a registered trademark of the American Medical Association (AMA). 

CPT® code 93922 Limited bilateral noninvasive physiological studies of upper or lower extremity arteries

CPT® code 93923 Complete bilateral noninvasive physiological studies of upper or lower extremity arteries; 3 or more levels

CPT® code 93924 Noninvasive physiological studies of upper or lower extremity arteries; at rest and following treadmill stress testing complete bilateral study

Understanding anatomical locations in vascular testing

CPT codes 93922, 93923, and 93924 fall under the category of noninvasive vascular diagnostic studies and are used for assessing blood flow in the extremities (arms and legs). The distinction between these codes relates to the level of service provided, based on the complexity of the study and the number of limbs evaluated.

Single level means the measurement is conducted at one level of the limb, such as the ankle, for example, ankle-brachial index or ABI. 

Multiple levels involve assessing blood flow at more than one level, such as the thigh, calf, and ankle.

Bilateral means that the diagnostic study is performed on both sides of the body — typically on both arms or both legs. Bilateral studies are common in vascular diagnostics because comparing the blood flow between opposite limbs can help identify differences, such as those caused by blockages, artery disease, or other vascular conditions.

Summary of levels:

  • Single level (93922) — basic, limited testing at one location.
  • Multiple levels (93923) — more detailed testing at multiple sites or with functional challenges.
  • Rest and post-exercise (93924) — adds treadmill or exercise testing for greater diagnostic depth.

Exam scenarios

Providers should select the procedure, diagnosis, and technology coding that best represents each patient’s medical condition and treatment. The following scenarios are examples for illustrative purposes only.

93922 — 1 to 2 levels

  • ABI and PVR
  • ABI and SPP
  • ABI and TcpO2
  • ABI and finger pressure and PVR
  • ABI and TcpO2 and PVR

93923 — 3 or more levels

  • ABI and PVR at 3 or more levels
  • ABI and SPP at 3 or more levels
  • ABI and TcpO2 with provocation (1-2 levels)
  • ABI and Segmental pressure
  • ABI and TcpO2 at 3 or more levels
  • ABI and SPP and PVR at 3 or more levels

93924 — Treadmill use

  • Treadmill use and any exam listed above

CPT code 93922 description — limited bilateral study, 1-2 levels

CPT code 93922 is used for noninvasive, bilateral physiological studies to evaluate arterial function in the upper or lower extremity arteries at 1-2 levels. Exams include ankle pressure and ABI, toe pressure and TBI, PVR, and plethysmography — critical for identifying peripheral artery disease (PAD) or other circulation-related conditions. ABI studies on their own are not reportable by these codes. 

Key details CPT 93922

  • Procedure scope — limited physiologic study of the arteries.
  • Common uses — early PAD detection, evaluation of poor circulation, or identifying arterial obstruction.
  • Billing insights — document the symptoms or clinical justification thoroughly to maximize reimbursement success. 

CPT code 93923 description — complete bilateral study, 3 or more levels

CPT code 93923 applies to bilateral physiologic testing of the extremity arteries at multiple levels, such as segmental pressure, PVR, ankle pressure and ABI, and TcpO2 or SPP at 3 or more levels This code covers extensive assessment of circulation in systemic vascular conditions. Physiological vascular equipment used to perform these exams are capable of stress testing.

Key details CPT 93923

  • Procedure scope — comprehensive study of bilateral extremity arteries at multiple levels. 
  • Diagnostic applications — detecting widespread arterial blockages or vascular disease such as PAD.
  • Reimbursement tips — provide detailed procedural documentation and medical necessity for optimal billing results. 

CPT code 93924 — study at rest and following treadmill stress testing

CPT code 93924 is used for full vascular studies that include both resting and post-exercise evaluations such as exercise ABI and PVR. This code builds upon the elements of CPT 93922 by incorporating a regimented exercise protocol, allowing clinicians to detect circulatory issues exacerbated by physical activity, such as intermittent claudication. The code covers a detailed assessment of functional vascular health, making it an essential tool for diagnosing conditions linked to impaired blood flow. By including post-exercise evaluations, this code supports accurate diagnosis of conditions triggered or aggravated by physical activity.

Key details CPT 93924

  • Procedure scope — full physiologic testing of extremity arteries, including post-exercise assessments.
  • Clinical applications — ideal for identifying exercise-induced circulation issues.
  • Billing tips — include pre- and post-exercise findings to justify this code.

FAQs about vascular diagnostic testing CPT codes

What is the main difference between CPT 93922 and 93923?

CPT 93922 covers patient assessment at one or two levels, while CPT 93923 covers a more comprehensive study at three or more levels.

What CPT codes cover TcpO2 and SPP?

CPT codes 93922 and 93923 may be used to bill microcirculatory studies such as toe pressures, TcpO2, and/or SPP. PeriFlux 6000 is one of the only instruments that supports this kind of macro- and micro-circulatory physiological exams in a single device.

How can I ensure reimbursement for codes 93922, 93923, and 93924?

Contact your commercial payers or a reimbursement specialist to inquire about specific requirements. Accurate and detailed documentation of the medical necessity is essential, ensuring ICD-10 codes[1] support examinations under these CPT codes. Ensure facility and staff credentials are compliant with guidelines, and document the results of each test, including exercise components if applicable.

Quick comparison of CPT Codes 93922, 93923, and 93924

CPT codeCMS descriptionMedicare National Average[2] Hospital OP
93922Limited bilateral noninvasive physiologic studies of upper or lower extremity arteries (e.g., for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis arteries plus bidirectional, Doppler waveform recording and analysis at 1-2 levels, or ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis arteries plus volume plethysmography at 1-2 levels, or ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis arteries with, transcutaneous oxygen tension measurement at 1-2 levels).$122
93923Complete bilateral noninvasive physiologic studies of upper or lower extremity arteries, 3 or more levels (e.g., for lower extremity: ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis arteries plus segmental blood pressure measurements with bidirectional Doppler waveform recording and analysis, at 3 or more levels, or ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis arteries plus segmental volume plethysmography at 3 or more levels, or ankle/brachial indices at distal posterior tibial and anterior tibial/dorsalis pedis arteries plus segmental transcutaneous oxygen tension measurements (TcpO2) at 3 or more levels), or single level study with provocative functional maneuvers (eg, measurements with postural provocative tests, or measurements with reactive hyperemia).$149
93924Noninvasive physiologic studies of lower extremity arteries, at rest and following treadmill stress testing (i.e., bidirectional Doppler waveform or volume plethysmography recording and analysis at rest with ankle/brachial indices immediately after and at timed intervals following performance of a standardized protocol on a motorized treadmill plus recording of time of onset of claudication or other symptoms, maximal walking time, and time to recovery) complete bilateral study.$149

References

  1. Centers for Medicare & Medicaid Services (U.S.) (2023). ICD-10-CM Official Guidelines for Coding and Reporting FY 2024 — UPDATED October 1, 2023 (October 1, 2023 – September 30, 2024).
  2. https://www.cms.gov/medicare/payment/fee-schedules/physician/carrier-specific-files