The Appropriate Valuation of Echo

By Michael Main posted 18 days ago


An AMA/Specialty Society Relative Value Scale Update Committee (RUC) survey related to the physician work associated with our base transthoracic echo code (93306, complete TTE with Doppler and color flow) was completed last month. These surveys are critical to ensuring fair code valuation.   

The purpose of the AMA RUC survey of a CPT code is to obtain physician estimates of:

  • Time required for the individual service; and
  • The intensity/complexity in comparison to other services

The relative value of the physician work is one component of the total relative value.  The total relative value includes physician work + practice expense + professional liability components.

RUC methodology involves determining the proper fit of the surveyed code with other codes in the existing relative value system. 

Definition of Physician Work
Physician work includes the following elements:

  • The time it takes to perform the service
  • Three intensity/complexity measures
  • The mental effort and judgment necessary with respect to the amount of clinical data that needs to be considered, the fund of knowledge required, the range of possible decisions, the number of factors considered in making a decision, and the degree of complexity of the interaction of these factors
  • The technical skill required with respect to knowledge, training, and actual experience necessary to perform the service and physical effort involved to perform the service; and
  • Psychological stress factors such as risk of significant complications, morbidity, and mortality; risk of a malpractice suit with a poor outcome.


As shown in the figure below, the majority of codes undergoing RUC review see a decrease in value or are deleted.


 Having strong survey data is critical to codes being appropriately valued. 

I would like to thank all the participants who were randomly selected and completed the 93306 survey. The information collected was the basis of our RUC presentation last month. 

The RUC process cannot work without you!