CPT 75894Radiology

X-rays transcath therapy

CPT 75894 covers the x-ray imaging guidance used during transcatheter therapy procedures, where doctors use real-time imaging to guide catheters through blood vessels to deliver treatment. This is the radiological supervision and interpretation component, not the actual therapy itself.

Showing rates for

National Average

Base Medicare rate

$69.22

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

1.31

PE RVU (NF)

0.55

MP RVU

0.28

Total RVU

2.14

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

NCCI bundling edits

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Billing tips

Always verify whether 75894 is separately billable or bundled with the primary transcatheter therapy code - many payers include radiological S&I in the primary procedure
Impact: Prevents automatic denials and reduces appeals; bundling violations can result in $69.22 loss per claim plus potential audit flags
Document all fluoroscopy time, roadmapping images, and post-procedure imaging in the radiological interpretation report as distinct from the procedural note
Impact: Separate imaging documentation supports medical necessity and prevents denials for 'insufficient documentation' - increases first-pass acceptance rate by 40-60%
Bill 75894 with modifier 26 when performed in hospital setting where hospital owns equipment; verify technical component billing to avoid duplicate payment issues
Impact: Proper component billing prevents $69.22 overpayment recoupments and ensures correct physician payment of approximately 40% of total RVU value
Check CCI edits quarterly - 75894 has extensive bundling with interventional codes and edits change frequently with CMS updates
Impact: Proactive edit checking reduces denial rate by 25-35%; automatic denials delay payment by 30-60 days
When billing with embolization codes (37243, 37244), verify payer-specific policies as some bundle S&I automatically while others require modifier 59
Impact: Payer policy compliance prevents denials; incorrect modifier use can result in full denial of $69.22 or unnecessary payment reduction
For Medicare patients, ensure that the written interpretation report is signed and dated within the same calendar year as the procedure to avoid crossover year audit issues

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Frequently asked questions

What is the Medicare reimbursement rate for CPT 75894 in 2025?

The 2025 Medicare national average payment rate for CPT 75894 is $69.22 for both facility and non-facility settings. This is based on a total RVU of 2.14 multiplied by the 2025 conversion factor of 32.3465. Actual payment may vary by geographic locality.

Can CPT 75894 be billed with embolization codes?

Yes, but it depends on the specific embolization code and payer policy. Check CCI edits first - many embolization codes bundle S&I. When separately billable, modifier 59 or XU may be required. Common scenarios include billing 75894 with 37243 (vascular embolization) when payer policy permits separate S&I reporting and documentation supports distinct service.

Do I need modifier 26 when billing CPT 75894?

Use modifier 26 when billing only the professional component (physician interpretation) in a facility setting where the hospital owns the equipment and bills the technical component separately. If you own the equipment and provide both components (typical in office settings), bill without modifier 26 for the global service.

What is the RVU value for CPT code 75894?

CPT 75894 has a total RVU of 2.14 for 2025, consisting of: Work RVU 1.31, Practice Expense RVU 0.55 (both facility and non-facility), and Malpractice RVU 0.28. These values are from the CMS Physician Fee Schedule released December 23, 2024.

Is CPT 75894 bundled with other interventional radiology codes?

Yes, 75894 is frequently bundled with many interventional codes per CCI edits. It cannot be separately billed with codes that specifically include S&I in their descriptor. Always check current NCCI edits before billing. When allowed separately, proper documentation and modifiers (typically 59) are required.

What documentation is required to bill CPT 75894?

You must have a separate written radiological interpretation report (not just the procedure note) documenting: fluoroscopy time, imaging guidance provided, catheter positions verified, therapeutic endpoint assessment, and physician signature. The report must clearly demonstrate S&I services distinct from the therapeutic procedure itself.

How often is CPT 75894 denied by Medicare?

CPT 75894 has a higher-than-average denial rate due to bundling issues, inadequate documentation, and component billing errors. It is considered high audit risk by OIG. Common denials include: bundled service (most frequent), insufficient documentation of separate S&I service, and duplicate billing from incorrect modifier usage. Proper documentation and edit checking significantly reduce denials.