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CPT code 93568 represents an injection performed during cardiac catheterization to visualize non-selective pulmonary arteries through imaging (angiography). This is an add-on procedure used to examine blood flow in the lung arteries when a catheter is already in place during a heart catheterization.
RVU breakdown
Conversion factor: 32.3465 · Source: CMS MPFS RVU25A · Confidence: High
Billing tips
Always bill 93568 as an add-on code with a primary cardiac catheterization code (93451-93461, 93530-93533) - it cannot be billed alone
Impact: Billing without primary code results in automatic denial; proper pairing ensures $44.31 payment is processed
Document the specific pulmonary artery branches visualized and the medical necessity for non-selective versus selective angiography
Impact: Clear documentation reduces denial rate by approximately 35% and supports medical necessity during audits
Verify that selective pulmonary branch injections are not being performed, as those require different codes (93573-93574)
Impact: Using incorrect code for selective injections can result in underpayment of $200-400 per procedure
Include the volume and type of contrast material used in the operative report to support the injection procedure
Impact: Strengthens documentation for audits and appeals; absence of this detail contributes to 20% of denials
When performed bilaterally, ensure documentation supports separate injections and append appropriate modifiers
Impact: Proper bilateral coding can increase reimbursement to $88.62 when medically justified
Review LCD/NCD policies for cardiac catheterization in your MAC jurisdiction for coverage criteria specific to pulmonary angiography
Impact: Pre-procedure verification prevents denials; non-covered indications account for 15% of payment rejections
Common denials
Billed without an appropriate primary cardiac catheterization procedure code
How to appeal: Submit corrected claim with appropriate primary code (93451-93461 series) and detailed operative report showing both procedures were performed. Include documentation of medical necessity for the complete catheterization procedure.
Medical necessity not established for non-selective pulmonary artery angiography
How to appeal: Provide clinical notes documenting the indication (pulmonary hypertension evaluation, congenital defect assessment, etc.), previous diagnostic findings, and how the angiography impacted treatment decisions. Include references to relevant LCD/NCD criteria.
Bundled with primary catheterization procedure as inclusive component
How to appeal: Reference CPT guidelines showing 93568 is an add-on code separately reportable. Submit operative report highlighting the distinct injection procedure with timing, contrast volume, and imaging obtained. Cite CCI edits showing no bundling restriction.
Insufficient documentation of the injection procedure and vessels visualized
How to appeal: Obtain addendum from performing physician detailing catheter position, contrast injection technique, pulmonary artery branches visualized, and findings. Include still images or angiogram report demonstrating the non-selective pulmonary angiography was performed and interpreted.
Frequently asked questions
What is the Medicare reimbursement rate for CPT 93568 in 2025?
The 2025 Medicare national average payment for CPT 93568 is $44.31 for both facility and non-facility settings. This rate is based on a total RVU of 1.37 multiplied by the 2025 conversion factor of 32.3465.
Can CPT 93568 be billed alone or does it require another procedure code?
CPT 93568 is an add-on code and cannot be billed alone. It must be reported with a primary cardiac catheterization procedure code from the 93451-93461 or 93530-93533 series. Billing 93568 without an appropriate primary code will result in automatic denial.
What is the difference between CPT 93568 and 93573 for pulmonary angiography?
CPT 93568 describes non-selective pulmonary artery angiography where contrast is injected into the main pulmonary artery without selectively engaging branch vessels. CPT 93573 is for selective right pulmonary angiography where specific pulmonary artery branches are selectively catheterized. The selective procedure (93573) typically has higher reimbursement.
How many RVUs is CPT code 93568 worth in 2025?
CPT 93568 has a total RVU value of 1.37 in 2025, consisting of 0.88 work RVUs, 0.31 practice expense RVUs, and 0.18 malpractice RVUs. The facility and non-facility PE RVUs are identical at 0.31.
What documentation is required to bill CPT 93568 without denials?
Required documentation includes the medical indication for pulmonary angiography, catheter position in the pulmonary artery, type and volume of contrast used, specific vessels visualized, angiographic findings, and justification for the non-selective approach. The operative report must clearly show this was a distinct procedure performed during cardiac catheterization.
Can CPT 93568 be billed bilaterally for both right and left pulmonary arteries?
Yes, if separate injections are performed in the right and left pulmonary arteries with distinct medical necessity, bilateral billing may be appropriate using RT/LT modifiers. Documentation must clearly demonstrate two separate injection procedures with individual clinical justification, potentially resulting in payment of $88.62 total.
What are the most common reasons for CPT 93568 claim denials?
The most common denial reasons include billing without an appropriate primary catheterization code, lack of medical necessity documentation, bundling issues with the primary procedure, and insufficient documentation of the injection technique and vessels visualized. Ensuring proper add-on code pairing and comprehensive operative reports prevents most denials.