What is an ankle-brachial index test?

An ankle-brachial index (ABI) test, also called ankle-brachial pressure index (ABPI), measures the blood pressure at your ankle and compares it to the blood pressure in your arm. A Doppler ultrasound probe is used to detect blood flow. The ratio of the two pressures reveals whether blood is flowing normally to your legs, or whether there is narrowing of the arteries (peripheral arterial disease).

What does an ABI result mean?

ABI values: above 1.40 = possibly stiff arteries (common in diabetes); 1.00–1.40 = normal; 0.91–0.99 = borderline; 0.41–0.90 = mild to moderate peripheral arterial disease (PAD); 0.40 or below = severe PAD. A result below 0.90 usually indicates reduced blood flow to the legs and warrants further investigation. Your GP will interpret results in context — a single number doesn't tell the whole story.

Why would my GP order an ABI test?

Your GP may order an ABI if you have symptoms of peripheral arterial disease — leg pain when walking (intermittent claudication), poor wound healing on the feet or legs, cold or discoloured feet, or reduced pulses in the feet. It is also ordered as a screening tool in people with high cardiovascular risk (diabetes, smoking history, hypertension) even without symptoms.

Does Medicare cover an ABI test in Australia?

Yes. MBS item 11610 covers bilateral ABI measurement with Doppler or plethysmographic techniques, including waveform analysis and a written report. The Medicare fee is $76.25 and Medicare pays 75% ($57.20). A hard copy trace must be produced and retained. The test must be performed with Doppler or plethysmography — a simple BP cuff comparison alone does not qualify.

What Is an Ankle-Brachial Index (ABI) Test?

📋 Sources: MBS Online item 11610 (July 2026). ABI thresholds: AHA/ACC 2016 Guideline on the Management of Patients with Lower Extremity Peripheral Artery Disease; TASC II consensus document. Verify current Medicare fees at mbsonline.gov.au.

What is the test?

The ankle-brachial index (ABI) — also called ankle-brachial pressure index (ABPI) — compares the blood pressure in your ankle to the blood pressure in your arm. A small Doppler probe (like a handheld ultrasound) is used to detect blood flow sounds at each site.

Normally the blood pressure in your ankle should be similar to or slightly higher than your arm. If the ankle pressure is significantly lower, it suggests that arteries in the leg are narrowed — a condition called peripheral arterial disease (PAD).

What do the results mean?

ABI value	Interpretation	What happens next
Above 1.40	Arteries may be calcified / non-compressible	Common in diabetes — further testing needed (toe pressures)
1.00 – 1.40	Normal	No evidence of PAD in the legs
0.91 – 0.99	Borderline	Cardiovascular risk factor management
0.41 – 0.90	Mild to moderate PAD	Lifestyle changes, medications, possible vascular referral
0.40 or below	Severe PAD	Urgent vascular surgery review usually needed

These thresholds are from international vascular guidelines (AHA/ACC, TASC II). Your GP interprets results alongside your symptoms, examination findings, and overall cardiovascular risk.

Why would my GP order this?

Common reasons:

Intermittent claudication — cramping or aching in the calf, thigh, or buttock that comes on with walking and resolves with rest
Poor wound healing — ulcers or wounds on the feet or lower legs that aren't healing well
Cold or discoloured feet — feet that are persistently cold, pale, blue, or red
Weak pulses — reduced foot pulses found on examination
Cardiovascular risk screening — in people with diabetes, heavy smoking history, or multiple cardiovascular risk factors, even without symptoms

What to expect

The test is painless and takes about 20–30 minutes. You lie flat on an examination table. BP cuffs are placed on both arms and both ankles. A handheld Doppler probe is held over pulse points at the ankle and wrist while each cuff inflates. The technician or clinician records waveforms and calculates the index. A written report with printout is produced.

No preparation needed. Wear comfortable, loose clothing that can be rolled up easily.

Cost and Medicare — by country

🇦🇺 Australia — MBS item 11610

Medicare fee: $76.25. Medicare pays 75% ($57.20). Covers bilateral measurement of posterior tibial, dorsalis pedis (or toe), and brachial pressures using Doppler or plethysmography, with waveform analysis, hard copy trace, and written report. The hard copy trace must be retained. Verify at mbsonline.gov.au.

🇬🇧 United Kingdom — NHS

ABI is performed free on NHS when referred by a GP. Typically done in a vascular laboratory, community vascular service, or specialist clinic. Also used by district nurses and tissue viability teams for wound assessment. No cost to patient.

🇳🇿 New Zealand

ABI is available through GP or vascular referral, subsidised under Health NZ for eligible patients. Some GP practices and community health services have Doppler equipment. Co-payment may apply depending on practice arrangement.

🇨🇦 Canada

ABI is covered under provincial health insurance when ordered by a physician. Usually performed at a vascular lab or diagnostic imaging centre. No out-of-pocket cost for the test itself. Availability of community testing varies by region.