CPT 93567Cardiology

Njx car cth sprvlv aortgrphy

CPT 93567 covers the injection procedure and imaging (aortography) performed during cardiac catheterization to visualize the aorta above the aortic valve. This add-on code is used when a cardiologist injects contrast dye and takes X-ray images of the supravalvular aorta during a heart catheterization procedure.

Showing rates for

National Average

Base Medicare rate

$35.58

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

0.7

PE RVU (NF)

0.24

MP RVU

0.16

Total RVU

1.1

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

NCCI bundling edits

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Billing tips

Always bill 93567 as an add-on code with a primary cardiac catheterization code (93451-93461, 93530-93533); it cannot be billed independently
Impact: Billing alone will result in automatic denial; proper pairing ensures the $35.58 Medicare reimbursement is captured
Document the specific medical necessity for supravalvular imaging separate from routine left heart catheterization views, including clinical indication and findings
Impact: Prevents medical necessity denials that can delay payment by 30-60 days; reduces audit risk by approximately 40%
Verify that your documentation includes catheter position above the aortic valve, contrast injection volume and type, and separate interpretation of supravalvular anatomy
Impact: Complete documentation supports the 1.1 total RVUs; missing elements can trigger downcoding or denial
Do not bill 93567 when supravalvular imaging is performed as part of a coronary angiography protocol without specific additional clinical indication
Impact: Routine views included in base catheterization codes will be denied as bundled services; targeted billing improves clean claim rate by 25%
Check payer-specific LCD/NCD policies for coverage criteria, as some payers require pre-authorization for add-on catheterization imaging codes
Impact: Pre-authorization compliance prevents retrospective denials; retroactive authorization can delay payment 45-90 days
When billing globally in a hospital-owned facility, ensure facility and professional components are properly split to maximize total reimbursement
Proper component billing can optimize total facility reimbursement beyond the $35.58 professional payment

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Frequently asked questions

What is the Medicare reimbursement rate for CPT 93567 in 2025?

The 2025 Medicare national average reimbursement for CPT 93567 is $35.58 for both facility and non-facility settings. This is based on 1.1 total RVUs (0.7 work RVU, 0.24 practice expense RVU, 0.16 malpractice RVU) multiplied by the 2025 conversion factor of 32.3465.

Can CPT 93567 be billed alone or does it require another code?

CPT 93567 is an add-on code and cannot be billed independently. It must be reported with a primary cardiac catheterization procedure code such as 93451-93461, 93530-93533, or other appropriate base catheterization codes. Billing 93567 alone will result in automatic claim denial.

What is the difference between CPT 93567 and 93566?

CPT 93566 represents injection for selective coronary angiography during cardiac catheterization, while 93567 represents injection for supravalvular aortography (imaging above the aortic valve). 93566 focuses on coronary arteries, whereas 93567 focuses on the ascending aorta, aortic root, and supravalvular structures. These codes may be billed together when both procedures are medically necessary and documented.

What documentation is required to bill CPT 93567?

Required documentation includes: specific medical indication for supravalvular imaging, catheter position above the aortic valve, contrast type and volume, imaging projections obtained, separate interpretation of supravalvular anatomy, findings related to the aortic root and ascending aorta, and correlation with the clinical indication. The procedural report must clearly distinguish this from routine catheterization imaging.

How many RVUs is CPT 93567 worth in 2025?

CPT 93567 has a total of 1.1 RVUs in 2025, consisting of 0.7 work RVUs, 0.24 practice expense RVUs (both facility and non-facility), and 0.16 malpractice RVUs, according to the CMS Medicare Physician Fee Schedule RVU25A released December 23, 2024.

What are common reasons for denial of CPT 93567 claims?

Common denial reasons include: billing without an appropriate primary catheterization code, lack of documented medical necessity separate from the base procedure, bundling with other aortography codes under NCCI edits, and incomplete procedural documentation. Each denial can be appealed with proper supporting documentation and corrected claim submission.

Which medical specialties typically bill CPT 93567?

CPT 93567 is primarily billed by interventional cardiologists, general cardiologists, pediatric cardiologists, and cardiothoracic surgeons who perform cardiac catheterization procedures. The procedure must be performed by or under direct supervision of a physician with hospital credentialing and privileges for cardiac catheterization.