Home › CPT Codes › Performing 3D ultrasound imaging of the heart to evaluate its structure during congenital heart defect assessment

CPT 93319: Performing 3D ultrasound imaging of the heart to evaluate its structure during congenital heart defect assessment - Prior Authorization and Price

CPT code 93319 is Performing 3D ultrasound imaging of the heart to evaluate its structure during congenital heart defect assessment. See what Aetna, Anthem BCBS, Cigna, UnitedHealthcare look for before approving it, the conditions their guidelines cover, and what it typically costs.

CPT 93319

Performing 3D ultrasound imaging of the heart to evaluate its structure during congenital heart defect assessment.

Cardiac & Vascular Testing

Build a submission checklist for this study

Payer guidelines that apply

Payer	Reviewed using	Guideline	Sections
Aetna	eviCore	Cardiac Imaging Guidelines 2.0.2026, effective Sep 1, 2026 Pediatric Cardiac Imaging Guidelines effective Feb 3, 2026	5 that name this code
Anthem BCBS	Carelon	Imaging of the heart effective Nov 15, 2025	20 that name this code
Cigna	eviCore	Cardiac Imaging Guidelines 2.0.2026, effective Sep 1, 2026 Pediatric Cardiac Imaging Guidelines 1.0.2026, effective Feb 3, 2026	5 that name this code
Medicare	CMS	—	None found
Original Medicare does not run a prior authorization program for outpatient imaging; claims are judged against the coverage policies above. Medicare Advantage plans set their own prior authorization rules.
UnitedHealthcare	UnitedHealthcare / eviCore	Commercial and Exchange Cardiovascular and Radiology Imaging Guidelines 09.2026, effective Sep 1, 2026	5 that name this code

Guidelines collected from the payers' published documents on September 29, 2026. Payers revise these documents during the year. Open the guideline link to confirm the current version before you submit.

Conditions the guidelines address for this study

These are the clinical situations where payer guidelines discuss Performing 3D ultrasound imaging of the heart to evaluate its structure during congenital heart defect assessment. Each has its own criteria for when the study is considered appropriate.

Established bicuspid aortic valve Anthem BCBS
Established mitral valve prolapse Anthem BCBS
Established native valvular regurgitation Anthem BCBS
Established native valvular stenosis (does not apply to congenital valvular stenosis) Anthem BCBS
Established valvular heart disease – patients who have undergone valve intervention (replacement or repair) Anthem BCBS
Evaluation of aortic disease Anthem BCBS
Evaluation of cardiac masses or cardiac source of embolus Anthem BCBS
Evaluation of infective endocarditis (native or prosthetic valves) Anthem BCBS
Evaluation of patients with cardiac arrhythmias Anthem BCBS
Evaluation of patients with congenital heart disease Anthem BCBS
Evaluation of patients with known CAD Anthem BCBS
Evaluation of patients with pulmonary embolus Anthem BCBS
Evaluation of patients with pulmonary hypertension Anthem BCBS
Evaluation of patients with suspected CAD Anthem BCBS
Evaluation of pericardial diseases Anthem BCBS
Evaluation of signs, symptoms, or abnormal testing Anthem BCBS
Evaluation of suspected or established Kawasaki disease Anthem BCBS
Evaluation of ventricular function Anthem BCBS
Patients who have had, or are likely to have, suboptimal transthoracic imaging Anthem BCBS
Suspected valvular heart disease Anthem BCBS
Cardiac Imaging in Transplants Aetna · Cigna · UnitedHealthcare
Cardiotoxic Agent-Related Cardiac Dysfunction Aetna · Cigna · UnitedHealthcare

Typical price

Commercial insurance, median

$585

Middle half of rates: $341 to $833

Medicare, physician fee schedule

$21

National, non-facility

Commercial figures come from negotiated rates published by 417 hospitals; Medicare figures from CMS fee schedules. Rates vary widely by hospital and plan. Pricing data from CenterIQ.

Get notified when the rules for this study change

Payers update imaging guidelines several times a year. We will email you when the criteria for Performing 3D ultrasound imaging of the heart to evaluate its structure during congenital heart defect assessment change.

CPT 93319: Performing 3D ultrasound imaging of the heart to evaluate its structure during congenital heart defect assessment - Prior Authorization and Price

Payer guidelines that apply

Conditions the guidelines address for this study

Typical price

Get notified when the rules for this study change

Frequently asked questions

Imaging CPT Code Coverage Lookup

Quick Access - Common Imaging CPT Codes

CT

MRI

MRA

PET