CPT 93574Cardiology

Njx cath slct pulm vn angrph

CPT 93574 covers the injection of contrast dye through a catheter positioned in a specific pulmonary vein to take x-ray images (angiography) of the blood vessels in the lungs. This helps doctors visualize the anatomy and blood flow in the pulmonary veins.

Showing rates for

National Average

Base Medicare rate

$65.99

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

1.44

PE RVU (NF)

0.5

MP RVU

0.1

Total RVU

2.04

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

NCCI bundling edits

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Billing tips

Always verify that 93574 is not bundled with the primary ablation code (93656) by your payer. Many carriers bundle pulmonary vein angiography into the ablation code.
Impact: Can prevent $65.99 denial; approximately 40-60% of Medicare carriers bundle this as inclusive to ablation procedures
Document selective catheterization of each pulmonary vein separately with distinct injections and imaging sequences. Generic statements about pulmonary venography may result in denials.
Impact: Specific documentation of catheter repositioning and separate injections supports medical necessity and reduces audit risk by approximately 70%
Bill 93574 only once per session regardless of number of pulmonary veins imaged, as the code descriptor covers angiography of one or more veins.
Impact: Prevents automatic downcoding or denial for duplicate billing; saves appeal time and maintains compliance
When performed with atrial fibrillation ablation, append modifier 59 or XU only if you can demonstrate separate diagnostic purpose beyond procedural mapping.
Impact: Without proper modifier and documentation, expect 85-95% denial rate when billed with 93656; with proper modifier, approval rate increases to 30-40% depending on payer
Verify LCD/NCD coverage for your MAC jurisdiction as some Medicare contractors consider pulmonary vein angiography investigational when performed solely for ablation planning.
Impact: Proactive coverage verification prevents $65.99 write-offs and patient balance billing issues
For commercial payers, obtain pre-authorization when 93574 is planned as a stand-alone diagnostic procedure rather than part of an ablation.

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Frequently asked questions

What is the Medicare reimbursement rate for CPT 93574 in 2025?

The 2025 Medicare national average payment rate for CPT 93574 is $65.99 for both facility and non-facility settings. This is based on a total RVU of 2.04 (Work RVU 1.44, PE RVU 0.5, MP RVU 0.1) multiplied by the 2025 conversion factor of 32.3465.

Can CPT 93574 be billed with atrial fibrillation ablation code 93656?

CPT 93574 can potentially be billed with 93656, but it is commonly bundled by many payers as pulmonary vein imaging is considered integral to AF ablation. You must append modifier 59 or XU and document a separate diagnostic purpose beyond procedural mapping. Most Medicare carriers bundle this combination, resulting in 85-95% denial rates without exceptional documentation.

How many times can I bill 93574 if multiple pulmonary veins are imaged?

CPT 93574 should be billed only once per session regardless of the number of pulmonary veins imaged. The code descriptor specifically states 'one or more' pulmonary veins, making it inclusive of all veins visualized during the same catheterization session. Billing multiple units will result in denial for duplicate services.

What documentation is required to bill CPT 93574 separately from an ablation procedure?

Documentation must clearly establish selective catheterization of individual pulmonary veins with distinct contrast injections, specify the diagnostic indication separate from ablation guidance (such as suspected stenosis or variant anatomy), detail the angiographic findings, and explain how these findings influenced clinical decision-making beyond routine procedural mapping.

What modifiers are most commonly used with CPT 93574?

The most common modifiers for 93574 are modifier 59 or XU (distinct procedural service when billed with other cath codes), modifier 26 (professional component only), and modifier 76 (repeat procedure by same physician). Modifier 59/XU requires strong documentation showing the pulmonary vein angiography was a separate, medically necessary service.

Is CPT 93574 a bilateral code or can it be billed with RT/LT modifiers?

CPT 93574 is an inherently bilateral code covering all pulmonary veins imaged during the session. While some payers may accept RT/LT modifiers for anatomical specificity, the code should not be billed twice for right and left sided veins. The descriptor 'one or more' makes it inclusive of all veins regardless of laterality.

What is the work RVU for CPT code 93574 in 2025?

The work RVU for CPT 93574 in 2025 is 1.44. The total RVU is 2.04, which includes work RVU of 1.44, practice expense RVU of 0.5 (both facility and non-facility), and malpractice RVU of 0.1, based on the CMS Physician Fee Schedule RVU25A released December 23, 2024.