Billing code 75809: ShuntogramMedicare rate & RVUs
Fluoroscopic shunt imaging evaluates flow or patency in a nonvascular shunt, such as a cerebrospinal fluid shunt, when obstruction or leakage is suspected.
Medicare pays $85.17 for 75809 nationally in the office. Local office rates run $74.75–$116.20.
Medicare rate · 75809
Shuntogram
Swap in your local Medicare rate.
- Work RVUs
- 0.46
- Total RVUs
- 2.55
- Global days
- XXX
National rate · 2026
$85.17
Office setting, before claim adjustments.
See every locality for 75809 → · Billed by an NP, PA or therapist? →
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 10 sections
What 75809 covers
A nonvascular shuntogram uses fluoroscopic imaging to follow contrast through a shunt and assess its passage, patency, or possible leak. A common clinical setting is evaluation of a cerebrospinal fluid shunt, such as a ventriculoperitoneal shunt, when symptoms raise concern for malfunction. The study may involve contrast introduced through the shunt access reservoir, with a radiologist supervising the imaging and interpreting the findings. It is performed in a radiology department or hospital imaging setting equipped for fluoroscopy.
Report this code for the radiologic shunt study, not for shunt placement, revision, or repair. Documentation should identify the nonvascular shunt examined, the imaging performed, and the contrast-flow findings and interpretation. Modifier 26 represents the professional interpretation; modifier TC represents the technical service, including equipment and staff. Without either modifier, the code represents the global service. CMS applies the cardiovascular diagnostic multiple procedure reduction to the technical component; when that reduction is triggered, it affects the technical portion rather than the professional interpretation.
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
Where 75809 pays more and less
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 payment localities
$74.75 to $116.20
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $75.93 | Unavailable |
| Alaska* | $96.53 | Unavailable |
| Arizona | $82.82 | Unavailable |
| Arkansas | $74.75 | Unavailable |
| Atlanta | $86.64 | Unavailable |
| Austin | $88.96 | Unavailable |
| Bakersfield | $91.35 | Unavailable |
| Baltimore/Surr. Cntys | $90.79 | Unavailable |
| Beaumont | $78.92 | Unavailable |
| Brazoria | $84.31 | Unavailable |
| Chicago | $87.78 | Unavailable |
| Chico | $91.20 | Unavailable |
| Colorado | $89.35 | Unavailable |
| Connecticut | $91.08 | Unavailable |
| Dallas | $84.80 | Unavailable |
| Dc + Md/Va Suburbs | $98.32 | Unavailable |
| Delaware | $84.26 | Unavailable |
| Detroit | $83.93 | Unavailable |
| East St. Louis | $81.41 | Unavailable |
| El Centro | $91.21 | Unavailable |
| Fort Lauderdale | $87.41 | Unavailable |
| Fort Worth | $84.14 | Unavailable |
| Fresno | $91.20 | Unavailable |
| Galveston | $84.53 | Unavailable |
| Hanford-Corcoran | $91.20 | Unavailable |
| Hawaii, Guam | $93.80 | Unavailable |
| Houston | $85.45 | Unavailable |
| Idaho | $78.84 | Unavailable |
| Indiana | $79.34 | Unavailable |
| Iowa | $78.37 | Unavailable |
| Kansas | $77.80 | Unavailable |
| Kentucky | $77.47 | Unavailable |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | $97.71 | Unavailable |
| Madera | $91.20 | Unavailable |
| Manhattan | $98.17 | Unavailable |
| Merced | $91.20 | Unavailable |
| Metropolitan Boston | $98.84 | Unavailable |
| Metropolitan Kansas City | $80.98 | Unavailable |
| Metropolitan Philadelphia | $88.56 | Unavailable |
| Metropolitan St. Louis | $81.91 | Unavailable |
| Miami | $90.52 | Unavailable |
| Minnesota | $85.97 | Unavailable |
| Mississippi | $75.27 | Unavailable |
| Modesto | $91.20 | Unavailable |
| Montana** | $85.17 | Unavailable |
| Napa | $106.99 | Unavailable |
| Nebraska | $78.89 | Unavailable |
| Nevada** | $84.96 | Unavailable |
| New Hampshire | $87.76 | Unavailable |
| New Mexico | $79.85 | Unavailable |
| New Orleans | $81.38 | Unavailable |
| North Carolina | $80.00 | Unavailable |
| North Dakota** | $84.18 | Unavailable |
| Northern Nj | $97.16 | Unavailable |
| Nyc Suburbs/Long Island | $100.46 | Unavailable |
| Ohio | $79.26 | Unavailable |
| Oklahoma | $77.51 | Unavailable |
| Oxnard-Thousand Oaks-Ventura | $97.37 | Unavailable |
| Portland | $92.55 | Unavailable |
| Poughkpsie/N Nyc Suburbs | $92.69 | Unavailable |
| Puerto Rico | $85.90 | Unavailable |
| Queens | $99.29 | Unavailable |
| Redding | $91.20 | Unavailable |
| Rest Of California | $91.20 | Unavailable |
| Rest Of Florida | $83.01 | Unavailable |
| Rest Of Georgia | $78.13 | Unavailable |
| Rest Of Illinois | $80.18 | Unavailable |
| Rest Of Louisiana | $77.27 | Unavailable |
| Rest Of Maine | $79.09 | Unavailable |
| Rest Of Maryland | $86.01 | Unavailable |
| Rest Of Massachusetts | $88.69 | Unavailable |
| Rest Of Michigan | $79.46 | Unavailable |
| Rest Of Missouri | $75.73 | Unavailable |
| Rest Of New Jersey | $92.22 | Unavailable |
| Rest Of New York | $81.27 | Unavailable |
| Rest Of Oregon | $84.40 | Unavailable |
| Rest Of Pennsylvania | $79.49 | Unavailable |
| Rest Of Texas | $81.54 | Unavailable |
| Rest Of Washington | $88.58 | Unavailable |
| Rhode Island | $87.53 | Unavailable |
| Riverside-San Bernardino-Ontario | $91.74 | Unavailable |
| Sacramento-Roseville-Folsom | $96.06 | Unavailable |
| Salinas | $95.71 | Unavailable |
| San Diego-Chula Vista-Carlsbad | $98.22 | Unavailable |
| San Francisco-Oakland-Berkeley (Marin Cnty) | $113.66 | Unavailable |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | $113.61 | Unavailable |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | $116.20 | Unavailable |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | $115.97 | Unavailable |
| San Luis Obispo-Paso Robles | $94.13 | Unavailable |
| Santa Cruz-Watsonville | $99.37 | Unavailable |
| Santa Maria-Santa Barbara | $96.14 | Unavailable |
| Santa Rosa-Petaluma | $100.39 | Unavailable |
| Seattle (King Cnty) | $101.10 | Unavailable |
| South Carolina | $79.74 | Unavailable |
| South Dakota** | $84.06 | Unavailable |
| Southern Maine | $83.94 | Unavailable |
| Stockton | $91.20 | Unavailable |
| Suburban Chicago | $88.41 | Unavailable |
| Tennessee | $78.20 | Unavailable |
| Utah | $80.91 | Unavailable |
| Vallejo | $106.90 | Unavailable |
| Vermont | $83.67 | Unavailable |
| Virgin Islands | $85.90 | Unavailable |
| Virginia | $83.52 | Unavailable |
| Visalia | $91.20 | Unavailable |
| West Virginia | $76.97 | Unavailable |
| Wisconsin | $81.15 | Unavailable |
| Wyoming** | $84.74 | Unavailable |
| Yuba City | $91.20 | Unavailable |
75809 rates by state
Office rate range in each state. Select a state to see its payment localities.
Explore a state
Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
$74.75
$103.70
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $96.53 | 1 |
| AL | $75.93 | 1 |
| AR | $74.75 | 1 |
| AZ | $82.82 | 1 |
| CA | $91.20–$116.20 | 29 |
| CO | $89.35 | 1 |
| CT | $91.08 | 1 |
| DC | $98.32 | 1 |
| DE | $84.26 | 1 |
| FL | $83.01–$90.52 | 3 |
| GA | $78.13–$86.64 | 2 |
| GU | $93.80 | 1 |
| HI | $93.80 | 1 |
| IA | $78.37 | 1 |
| ID | $78.84 | 1 |
| IL | $80.18–$88.41 | 4 |
| IN | $79.34 | 1 |
| KS | $77.80 | 1 |
| KY | $77.47 | 1 |
| LA | $77.27–$81.38 | 2 |
| MA | $88.69–$98.84 | 2 |
| MD | $86.01–$98.32 | 3 |
| ME | $79.09–$83.94 | 2 |
| MI | $79.46–$83.93 | 2 |
| MN | $85.97 | 1 |
| MO | $75.73–$81.91 | 3 |
| MS | $75.27 | 1 |
| MT | $85.17 | 1 |
| NC | $80.00 | 1 |
| ND | $84.18 | 1 |
| NE | $78.89 | 1 |
| NH | $87.76 | 1 |
| NJ | $92.22–$97.16 | 2 |
| NM | $79.85 | 1 |
| NV | $84.96 | 1 |
| NY | $81.27–$100.46 | 5 |
| OH | $79.26 | 1 |
| OK | $77.51 | 1 |
| OR | $84.40–$92.55 | 2 |
| PA | $79.49–$88.56 | 2 |
| PR | $85.90 | 1 |
| RI | $87.53 | 1 |
| SC | $79.74 | 1 |
| SD | $84.06 | 1 |
| TN | $78.20 | 1 |
| TX | $78.92–$88.96 | 8 |
| UT | $80.91 | 1 |
| VA | $83.52–$98.32 | 2 |
| VI | $85.90 | 1 |
| VT | $83.67 | 1 |
| WA | $88.58–$101.10 | 2 |
| WI | $81.15 | 1 |
| WV | $76.97 | 1 |
| WY | $84.74 | 1 |
How the 75809 rate is calculated
Each of 75809’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 75809
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 0.46Practice expense 2.04Malpractice 0.05
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 75809
The CMS indicators that decide how 75809 is paid alongside other services.
CMS payment indicators · 75809
Shuntogram
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| Multiple procedures | 6 | Diagnostic cardiovascular reduction applies to the technical component. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 1 | Diagnostic test with separate professional (26) and technical (TC) components. |
What modifiers do to the payment
Modifier 26 · payment effect
With and without the modifier
75809 without 26 · national office
$85.17
Shuntogram
75809-26 · Professional component
$23.38
Pays only the interpretation and report.
75809 compared with similar codes
Compare codes
75809 vs 74018 vs 75801 vs 75820: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 74018Abdomen X-ray
- This is a plain abdominal radiograph that may show distal shunt tubing. Code 75809 describes fluoroscopic evaluation of contrast passage through a nonvascular shunt.
- 75801Lymph vessel x-ray arm/leg
- This code is for lymphatic imaging of an arm or leg. Code 75809 evaluates a nonvascular shunt rather than lymphatic vessels.
- 75820Extremity venography
- This code describes venous imaging of an extremity. Code 75809 evaluates a nonvascular shunt, not veins.
75809 billing questions
When is a shuntogram appropriate instead of plain shunt-series radiographs?
Use this code for fluoroscopic evaluation of contrast passage through a nonvascular shunt. Plain shunt-series films show catheter course and continuity but do not trace contrast flow through the shunt.
Which modifier identifies the radiologist's interpretation?
Append modifier 26 for the professional interpretation. Modifier TC identifies the technical service, and no modifier represents the global service.
Does this code include shunt revision or repair?
No. It represents radiologic supervision and interpretation of the shunt study, not surgical treatment of a malfunctioning shunt.
What documentation supports reporting a nonvascular shuntogram?
Document the shunt evaluated, the fluoroscopic study and contrast-flow observations, and the radiologist's findings, including any evidence of impaired passage or leakage.
Which portion is affected by the cardiovascular diagnostic multiple procedure reduction?
CMS applies the reduction to the technical component. The professional interpretation is represented separately with modifier 26.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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