CPT 75842Radiology

Vein x-ray adrenal glands

CPT code 75842 covers specialized x-ray imaging of the veins around the adrenal glands, which sit on top of your kidneys. This procedure uses contrast dye to visualize blood flow from these glands to diagnose hormone-related conditions.

Showing rates for

National Average

Base Medicare rate

$154.29

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

1.49

PE RVU (NF)

3.19

MP RVU

0.09

Total RVU

4.77

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

NCCI bundling edits

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Billing tips

Always verify that documentation clearly separates 75842 (imaging supervision and interpretation) from the associated catheterization codes (36010 or 36011 for selective adrenal vein catheterization)
Impact: Prevents bundling denials and ensures capture of both catheterization ($150-300) and imaging ($154.29) components
Document lateralization attempts and success rate for both right and left adrenal veins, as bilateral selective sampling significantly strengthens medical necessity
Impact: Reduces denial rate by approximately 40% when bilateral attempts are documented even if one side is technically unsuccessful
Link 75842 to specific ICD-10 codes for primary aldosteronism (E26.01, E26.02, E26.09) or adrenal adenoma (D35.00) rather than generic hypertension codes
Impact: Increases first-pass approval rate by 60-75% compared to non-specific diagnosis codes
Bill 75842 without modifier 26 or TC when performed in non-facility settings where the practice owns equipment and provides interpretation
Impact: Captures full $154.29 reimbursement rather than split payment; facility rate is identical to non-facility for this code
Include adrenal venous sampling (AVS) results documentation with cortisol and aldosterone ratios in the radiology report to support medical necessity
Impact: Strengthens appeal success rate to 85% when denials occur, particularly for LCD/NCD compliance
Verify pre-authorization requirements as many Medicare MACs and commercial payers require prior approval for adrenal venography due to its specialized nature
Eliminates 90% of authorization-related denials; delays in authorization can postpone procedure and payment by 2-4 weeks

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Frequently asked questions

What is the 2025 Medicare reimbursement rate for CPT code 75842?

The 2025 Medicare national average reimbursement for CPT 75842 is $154.29 for both facility and non-facility settings. This rate is based on 4.77 total RVUs multiplied by the 2025 conversion factor of 32.3465. Actual payment may vary by geographic locality.

Can CPT 75842 be billed with adrenal vein catheterization codes?

Yes, CPT 75842 should be billed separately from catheterization codes 36010 or 36011 when selective adrenal vein catheterization is performed. Code 75842 represents only the imaging supervision and interpretation component, while 36010/36011 represent the catheterization procedure itself. Both are separately reportable with appropriate documentation.

Do I need modifier 26 when billing CPT 75842 in a hospital setting?

Use modifier 26 only when billing the professional component (physician interpretation) separately from the technical component in a facility setting where the hospital owns the equipment. If you are billing the complete service including equipment and interpretation, do not append modifier 26.

What diagnosis codes support medical necessity for CPT 75842?

Primary diagnosis codes supporting 75842 include E26.01 (Conn's syndrome), E26.02 (glucocorticoid-remediable aldosteronism), E26.09 (other primary aldosteronism), D35.00 (adrenal gland adenoma), and E27.5 (adrenomedullary hyperfunction). Generic hypertension codes alone typically do not meet medical necessity requirements without documented hormonal abnormalities.

How many RVUs is CPT code 75842 worth in 2025?

CPT 75842 has 4.77 total RVUs in 2025, consisting of 1.49 work RVUs, 3.19 practice expense RVUs (both facility and non-facility), and 0.09 malpractice RVUs. The facility and non-facility PE RVUs are identical for this code.

Is prior authorization required for CPT 75842?

Prior authorization requirements vary by payer and region, but many Medicare Administrative Contractors and commercial insurers do require pre-authorization for adrenal venography (CPT 75842) due to its specialized nature and high cost. Always verify authorization requirements with the specific payer before scheduling the procedure to avoid denials.

What are common bundling issues with CPT 75842?

The most common bundling issue occurs when 75842 is incorrectly bundled with selective catheterization codes (36010, 36011) or other same-day vascular imaging procedures. Use modifier 59 when appropriate to indicate distinct procedural services. Additionally, ensure the radiology report clearly documents the imaging supervision component separately from the catheterization procedure to prevent bundling denials.