CPT code 75630 – Abdominal aortography with lower extremity runoff

Key takeaways

CPT code 75630 reports abdominal aortography plus bilateral iliofemoral runoff, while 75625 covers the aortogram without runoff.

75630 is the imaging supervision and interpretation code only, so catheter placement (36200, 36245-36248) goes on its own line.

Billing 75716 for the same runoff duplicates 75630, and modifier -59 fits only a separately documented, distinct study.

Most denials trace to missing runoff wording, overlap with 75710 or 75716, missing prior authorization, or an unsupported diagnosis.

Pabau’s claims management software pre-fills claims from the patient record and tracks each 75630 claim through Claim.MD to payment.

CPT code 75630 pairs an abdominal aortogram with runoff down both legs

CPT code 75630 reports abdominal aortography plus bilateral iliofemoral lower extremity runoff, done through a catheter by serialography. It covers the radiological supervision and interpretation of that study.

In practice, contrast goes into the abdominal aorta through a catheter. The team images the aorta, then follows the contrast down both legs in timed runs with fluoroscopic or digital subtraction imaging.

Code 75630 sits in the Vascular Procedures subsection of Diagnostic Radiology (CPT 75600-75989), maintained by the American Medical Association. Three elements define its scope:

• Abdominal aortography: contrast injected at the level of the abdominal aorta, with imaging of the aorta and its major branches.
• Bilateral lower extremity runoff: sequential imaging of the iliofemoral vessels on both sides, from the iliac arteries down.
• Radiological supervision and interpretation (S&I): the radiologist’s oversight of the imaging and the written interpretation. 75630 reports only the imaging S&I. Catheter placement (36200, 36245-36248) is separate.

75630 has a professional and a technical component. In an office, one physician bills the global service. In a hospital outpatient setting, the facility bills the technical component and the radiologist appends modifier -26.

75630 vs 75625: The runoff decides the code

The only clinical difference between 75625 and 75630 is whether bilateral runoff imaging was performed and documented. Billing 75630 without runoff images in the report is upcoding, and it invites a denial or an audit.

Never report 75625 and 75630 for the same encounter. 75630 already includes the abdominal aortogram that 75625 describes. Billing both is unbundling, and NCCI edits catch it.

Documentation for CPT code 75630 must name both legs

The radiology or operative report needs each of these elements before 75630 holds up on audit:

1. Catheter access: the access route (typically the femoral or brachial artery) and advancement to the aortic level.
2. Contrast injection: the type and volume of iodinated contrast injected into the abdominal aorta.
3. Abdominal aortic imaging: fluoroscopic or digital subtraction angiography (DSA) images of the abdominal aorta and branch vessels, with each image series identified.
4. Bilateral lower extremity runoff sequences: iliofemoral runoff on both sides. Document any more distal vessels as imaged, and make “bilateral” explicit.
5. Supervision and interpretation: a signed radiologist report covering all the imaging, both the abdominal and the runoff runs.

A report that shows abdominal aortography with no runoff supports only 75625. Payers auditing 75630 pull the radiology report first. If “bilateral runoff” or similar wording is missing, expect the claim to be downcoded. Sending clean claim documentation with the report attached, where payers ask for it, cuts that risk.

Catheter placement is billed on top of 75630

Catheter placement codes are reported separately from CPT code 75630. They describe placing and steering the catheter, while 75630 covers only the imaging S&I. A non-selective study from the aorta takes 36200.

Report only the highest selective order reached in each vascular family, per the CPT catheter-placement guidelines. Lower orders in the same family are included in that code. A third-order placement, for example, is reported with 36247 alone. For bundling questions, the CMS NCCI edits covered in the next section are the reference.

75710 and 75716 rarely belong next to 75630

NCCI edits bundle CPT code 75630 with the extremity angiography codes 75710 and 75716. Because 75630 already includes bilateral runoff, billing either one for the same runs is duplicate billing.

• 75630 + 75716: not separately reportable for the same runoff. The bilateral extremity imaging in 75716 overlaps the runoff in 75630, so payers reject 75716 as bundled.
• 75630 + 75710: reportable with modifier -59 only for a clinically distinct, separate unilateral extremity study beyond the standard runoff. One example is a dedicated upper extremity study in the same session for an unrelated indication. The operative report must clearly separate the two studies.
• Modifier -59 caveat: using -59 on a service that isn’t clinically distinct is improper billing. CMS audits flag patterns of -59 use on 75630 claims. The documentation must describe a separate procedure beyond the runoff already captured by 75630.

Check current pairs in the CMS NCCI edits before each coding cycle, because edit pairs update quarterly.

Modifiers for CPT code 75630 follow the billing setting

Four modifiers apply to 75630, depending on the setting and what happened during the study:

In a physician office (POS 11), the global code goes out without -26 or -TC, because the physician owns both components. Never put -26 and -TC on the same claim line.

How a 75630 claim comes together, line by line

Take a typical session for suspected aortoiliac disease. The radiologist enters through the femoral artery, injects at the aorta, and follows the contrast down both legs.

The coder reads the report first. Bilateral runoff is documented, so the imaging line is 75630. The catheter stayed in the aorta, so the access line is 36200. Finally, the study ran in a hospital outpatient department, so the radiologist’s line carries -26. The three calls below cover most sessions you’ll code.

Medicare pays CPT code 75630 from the physician fee schedule

Medicare pays CPT code 75630 under the Physician Fee Schedule (MPFS), with separate national rates for facility and non-facility settings.

The 2026 MPFS final rule, published by CMS in late 2025, sets those rates. It applies the conversion factor to the code’s relative value unit (RVU) totals. Both change every year, so check current figures in the CMS MPFS look-up tool before billing.

The global RVU total for 75630 has three parts. Work RVUs reflect the physician’s effort on the S&I. Practice expense RVUs cover overhead and equipment, and malpractice RVUs cover liability cost. Non-facility rates run higher because the physician carries the practice expense in an office.

For coverage, see Novitas billing and coding article A56682 (applies in Novitas jurisdictions only), and check your own MAC’s LCD. Covered indications include suspected aortic aneurysm, aortic occlusive disease, and pre-operative assessment for revascularization.

Confirm the patient’s diagnosis fits your MAC’s covered indications before coding.

Prior authorization for 75630 depends on the payer

Prior authorization rules for CPT code 75630 vary by payer type and plan. No single rule covers commercial insurers, Medicare Advantage plans, and state Medicaid programs.

• Traditional Medicare (Parts A and B): prior authorization isn’t required for 75630 under fee-for-service Medicare. Coverage rests on your MAC’s LCD and billing articles, such as Novitas article A56682, plus medical necessity documentation.
• Medicare Advantage plans: many MA plans require prior authorization for interventional radiology procedures, including 75630. Check the specific plan’s authorization list before scheduling.
• Commercial payers: requirements vary widely. Some payers require pre-certification for any aortography, while others use post-service review. Confirm through each payer’s provider portal.
• Medicaid: fee schedules and prior authorization rules differ by state. Some states list 75630 among procedures that need authorization regardless of urgency.

When you request authorization, include the diagnosis code, the patient’s history, and the ordering physician’s note on medical necessity. Add any prior imaging that supports the need for diagnostic aortography. A complete superbill with the procedure code, diagnosis codes, and treating provider avoids back-and-forth. Re-check insurance eligibility at every visit, since a plan change can alter authorization rules mid-episode.

Five denial patterns on CPT 75630, and how to fix each

Denials on CPT code 75630 fall into five recurring patterns. Each has its own fix, and the denial codes on the remittance tell you which one you’re facing.

1. Missing bilateral runoff documentation. The report doesn’t explicitly document bilateral runoff imaging. Fix: ask the interpreting radiologist for an addendum that addresses the runoff sequences performed. Resubmit with the updated report attached.
2. NCCI bundling with 75716. Both codes were billed for the same session. Fix: remove 75716 from the claim. Resubmit only if a distinct study (e.g. catheter repositioned for separate extremity imaging) is documented, with -59 and operative notes.
3. No prior authorization. The payer required authorization that wasn’t obtained. Fix: file a retrospective authorization request with clinical justification. Success rates vary, so submit promptly with full supporting documentation and watch the payer’s appeal deadline.
4. Medical necessity not established. The diagnosis doesn’t meet your MAC’s coverage criteria, such as those in Novitas article A56682, or the payer’s own policy. Fix: map the documented condition to a covered ICD-10-CM code from the table below. Then resubmit with supporting clinical notes.
5. Missing modifier -26 in a hospital outpatient setting. The physician billed the global service while the facility claimed the technical component. Fix: resubmit the professional claim with -26 appended to 75630.

ICD-10 codes that support medical necessity for 75630

The ICD-10-CM codes on a 75630 claim must support diagnostic abdominal aortography with runoff. Your MAC’s coverage article, such as Novitas A56682, lists the covered diagnoses.

Check each code against the current fiscal year code set, which updates every October.

Avoid R-range symptom codes as the primary diagnosis when the record documents a specific vascular disease. Specific codes cut medical necessity denials and line up with coverage criteria.

Before you submit a 75630 claim, run this check

These five checks catch the denial patterns above before the claim leaves your practice:

• The report says “bilateral” and describes iliofemoral runoff on both sides.
• Only one imaging code is on the claim, 75630 or 75625, never both.
• Catheter work sits on its own line, coded to the highest order reached in each vascular family.
• The modifier matches the place of service: -26 in a facility setting, none in the office.
• The diagnosis is specific and covered, and any required authorization number is on file.

Place of service changes who bills what

The billing venue for CPT code 75630 affects the rate, who bills which component, and how the claim is built.

• Hospital outpatient (POS 22): the facility files a UB-04 or 837I claim under the Outpatient Prospective Payment System (OPPS). OPPS groups 75630 into an Ambulatory Payment Classification (APC). The radiologist or interventional physician files a CMS-1500 (or 837P) with modifier -26. The physician doesn’t bill the global code.
• Ambulatory surgical center (POS 24): ASC facility claims follow the ASC payment system, and the physician again bills with modifier -26. Verify ASC coverage, as some payers apply different fee schedules to ASC-based radiology.
• Physician office (POS 11): the global code is billed without a modifier split. Practice expense RVUs are higher in the non-facility schedule, reflecting overhead the practice absorbs. This setting is uncommon for aortography, given the equipment involved.

When facility and professional claims go out for the same encounter, confirm the POS code on the professional claim matches the care setting. A POS mismatch between the two claims is a common reason the professional claim gets denied.

How Pabau keeps 75630 claims moving from record to payment

Billing a 75630 claim often means hopping between the report, a clearinghouse portal, and a spreadsheet of open denials. Each handoff is another chance to drop a modifier or miss an eligibility problem.

Pabau, the practice management platform we build, pre-fills the claim from the patient record. Its claims management software includes CPT and ICD-10 lookup libraries and checks that claim-required fields are complete. Claims then go to payers through Claim.MD, with real-time eligibility checks before the visit.

Once a claim is out, ERA posting brings payments back into the record, and claim-status tracking shows which 75630 claims are still open. That leaves your team free to focus on report wording and modifiers instead of status calls.

Keep 75630 claims moving with Pabau

Pabau pre-fills claims from the patient record, checks required fields, verifies eligibility in real time, and submits through Claim.MD. ERA posting and claim-status tracking show where each vascular imaging claim stands.

Book a demo

Conclusion

On 75630, the report is the claim. If the radiologist writes “bilateral iliofemoral runoff” and the catheter work sits on its own line, most of the denial risk is gone. If either piece is missing, no modifier fixes it later.

So start upstream. Agree on standard runoff wording with your radiologists, and add the five checks above to your pre-submission routine. Then track which denial pattern comes back most often, and fix that one first.

Want eligibility, submission, and remittance for these claims in one record? Book a demo to see how Pabau tracks vascular imaging claims from submission to payment.

Continue your research

Need to understand how clearinghouse claim validation works? Medical claims clearinghouse guide explains how clearinghouses screen claims before payer submission.

Want to reduce vascular billing denials systematically? Denial codes in medical billing covers CARC and RARC interpretation for effective appeal workflows.

Looking for ERA automation guidance? Electronic remittance advice (ERA) explains how 835 ERA files map payment and denial data back to your billing system.

Coding a first-order branch instead? CPT code 36245 covers selective first-order catheter placement in the abdominal, pelvic, and leg arteries.

Sending facility and professional claims together? The 837 file explains how electronic claim files are built and sent to payers.

Frequently asked questions