CPT 75807Radiology

Lymph vessel x-ray trunk

CPT code 75807 covers an x-ray examination of the lymphatic vessels in the trunk of the body, using a contrast dye to make these vessels visible on imaging. This helps doctors diagnose problems with lymph flow, blockages, or abnormalities in the chest, abdomen, or pelvis.

Showing rates for

National Average

Base Medicare rate

$50.14

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

1.17

PE RVU (NF)

0.31

MP RVU

0.07

Total RVU

1.55

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

NCCI bundling edits

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Billing tips

Separately report contrast material administration code 96374 when applicable, as contrast injection is not bundled into 75807
Impact: Additional reimbursement of $25-40 when properly documented and medically necessary
Bill facility versus non-facility setting correctly - both rates are $50.14 for 75807, but submission location affects other bundled services
Impact: Prevents claim rejections and ensures proper processing of associated services
Document pre-procedure imaging review and post-procedure interpretation separately with timestamps to support professional component billing
Impact: Strengthens audit defense and supports modifier 26 billing when split billing is necessary
Do not unbundle fluoroscopic guidance (77001, 77002) as it is included in the lymphangiography procedure code
Impact: Prevents denial of $30-80 in inappropriately billed fluoroscopy codes and avoids fraud investigation triggers
Verify medical necessity documentation includes specific indication such as ICD-10 codes for lymphedema (I89.0), chylothorax (J94.0), or lymphatic malformation (Q82.0)
Impact: Reduces denial rate from 15-20% to under 5% based on LCD/NCD compliance
When billing with lymph node biopsy codes (38500-38530), append modifier 59 to 75807 to indicate distinct diagnostic service
Impact: Maintains full reimbursement of $50.14 instead of bundled denial

Common denials

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Frequently asked questions

What is the Medicare reimbursement rate for CPT code 75807 in 2025?

The 2025 Medicare national average reimbursement rate for CPT 75807 is $50.14 for both facility and non-facility settings. This rate is based on 1.55 total RVUs multiplied by the 2025 conversion factor of 32.3465. Actual payment may vary based on geographic location and MAC-specific adjustments.

How many RVUs is CPT code 75807 worth?

CPT 75807 has a total of 1.55 RVUs for 2025, broken down as: 1.17 work RVUs, 0.31 practice expense RVUs (both facility and non-facility), and 0.07 malpractice RVUs. These values are from the CMS Medicare Physician Fee Schedule RVU25A released December 23, 2024.

Can CPT 75807 be billed with modifier 26 for professional component only?

Yes, CPT 75807 can be split into professional and technical components using modifier 26 (professional component) or TC (technical component). This is common when a hospital owns the equipment (bills TC) and a separate radiology group provides interpretation (bills 26). Both components together equal the full $50.14 allowable.

What is the difference between CPT 75807 and other lymphangiography codes?

CPT 75807 specifically covers lymphangiography of the trunk (chest, abdomen, pelvis), while codes 75801-75803 cover extremity lymphangiography. The trunk code is used for evaluation of central lymphatic structures like the thoracic duct, while extremity codes address peripheral lymphedema. Code selection depends on anatomical area examined.

Does CPT 75807 require prior authorization from Medicare?

Prior authorization requirements for CPT 75807 vary by Medicare Administrative Contractor (MAC) and specific LCD/NCD policies. Many MACs do not require prior auth but do require medical necessity documentation. Commercial payers frequently require prior authorization due to availability of alternative imaging like MR lymphangiography. Always verify with the specific payer before scheduling.

What diagnosis codes support medical necessity for CPT 75807?

Common supporting ICD-10 codes include I89.0 (lymphedema), Q82.0 (lymphatic malformation), J94.0 (chylothorax), R18.8 (chylous ascites), C81-C85 series (lymphoma staging), and I97.2 (postoperative lymphedema). Documentation must clearly link the diagnostic imaging to evaluation or management of these conditions with specific clinical details.

Is fluoroscopic guidance separately billable with CPT 75807?

No, fluoroscopic guidance codes (77001, 77002) are not separately billable with CPT 75807 as fluoroscopy is inherent to the lymphangiography procedure. Attempting to bill both will result in denial of the fluoroscopy code as bundled. The $50.14 reimbursement for 75807 includes all imaging guidance necessary to complete the procedure.