CPT 75805Radiology

Lymph vessel x-ray trunk

CPT code 75805 covers an x-ray examination of the lymph vessels in the trunk of the body, which helps doctors visualize the lymphatic system to diagnose blockages, malformations, or other lymphatic disorders.

Showing rates for

National Average

Base Medicare rate

$37.20

This calculator gives a typical-case estimate using standard Medicare modifier rules. Actual payment depends on payer policies, documentation, code-specific CMS status indicators, and locality. Verify before billing.

RVU breakdown

Work RVU

0.81

PE RVU (NF)

0.3

MP RVU

0.04

Total RVU

1.15

Conversion factor: 32.3465 · Source: CMS MPFS RVU25A · Confidence: High

NCCI bundling edits

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Billing tips

Always verify whether facility or non-facility setting applies; both have identical Medicare rates ($37.20) for 75805, simplifying place-of-service billing decisions
Impact: Prevents place-of-service denials and ensures correct claim submission on first attempt
Document the specific anatomical lymphatic structures visualized (thoracic duct, cisterna chyli, abdominal lymphatics) and clinical indication; generic documentation leads to medical necessity denials
Impact: Reduces denial rate by 30-40% and strengthens appeal success when specificity is included
Bill contrast material separately using HCPCS codes (Q9965-Q9967 for low osmolar contrast) as 75805 is supervision and interpretation only; contrast is separately reimbursable
Impact: Adds $15-45 in additional reimbursement per case depending on contrast type and volume used
Do not bill 75805 with extremity lymphangiography codes (75801-75803) for same session; these are mutually exclusive and will result in bundling denials
Impact: Prevents automatic denial and potential audit flags; choose most appropriate anatomical code only
When performed with lymph node injection procedure (38790), ensure separate documentation of radiological supervision and technical injection service to support both codes
Impact: Preserves additional $85-120 in reimbursement for injection procedure when properly documented
For bilateral or multiple trunk region studies, append modifier 50 only if payer-specific policy supports bilateral imaging (most consider trunk a single midline structure); otherwise risk denial
Prevents $37.20 denial from inappropriate bilateral modifier use

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Frequently asked questions

What is the Medicare reimbursement rate for CPT code 75805 in 2025?

The 2025 Medicare national average reimbursement for CPT 75805 is $37.20 for both facility and non-facility settings. This rate is based on 1.15 total RVUs (0.81 work RVU, 0.30 PE RVU, 0.04 MP RVU) multiplied by the 2025 conversion factor of 32.3465.

What is the difference between CPT 75805 and 75801-75803?

CPT 75805 is specifically for lymphangiography of the trunk (thoracic duct, cisterna chyli, abdominal lymphatics), while codes 75801-75803 cover extremity lymphangiography (arms and legs). The anatomical region visualized, not the injection site, determines the correct code. These codes are mutually exclusive and should not be billed together for the same session.

Can CPT 75805 be billed with modifier 26 for professional component only?

Yes, modifier 26 should be appended when billing only the professional component (radiologist's interpretation) separately, typically in hospital settings where the facility bills the technical component separately with modifier TC. This splits the $37.20 total reimbursement between professional and technical services.

What documentation is required to support medical necessity for CPT 75805?

Documentation must include specific clinical indication (such as chylothorax, lymphatic injury, or trunk lymphedema), why lymphangiography is necessary versus less invasive alternatives like lymphoscintigraphy or ultrasound, prior imaging results if applicable, and how results will guide treatment decisions. The radiology report must detail trunk lymphatic structures visualized and clinically relevant findings.

Is contrast material included in CPT 75805 reimbursement?

No, CPT 75805 covers only radiological supervision and interpretation. Contrast material must be billed separately using appropriate HCPCS codes (typically Q9965-Q9967 for low osmolar contrast agents), which can add $15-45 in additional reimbursement depending on the type and volume used.

How many RVUs is CPT code 75805 worth in 2025?

CPT 75805 has a total of 1.15 RVUs in 2025, consisting of 0.81 work RVU, 0.30 practice expense RVU (both facility and non-facility), and 0.04 malpractice RVU. This relatively low RVU value reflects the supervision and interpretation nature of the service.

What are common reasons for denial of CPT 75805 claims?

Common denials include lack of documented medical necessity, bundling with other same-day imaging studies, incorrect code selection (using trunk code when extremity code appropriate or vice versa), missing or incomplete radiologist interpretation report, and failure to demonstrate why lymphangiography was necessary versus alternative imaging modalities like lymphoscintigraphy.