Billing code 75573: Cardiac CTMedicare rate & RVUs in Washington
Contrast-enhanced cardiac CT evaluates congenital heart anatomy, including complex chamber, great-vessel, and venous relationships when detailed structural imaging is needed.
Medicare pays $320.70–$362.45 for 75573 in the office in Washington, from Rest Of Washington to Seattle (King Cnty). Which amount applies depends on the service address.
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 9 sections
What 75573 covers
This examination uses contrast-enhanced computed tomography to map cardiac structures in congenital heart disease. It can show chamber connections, great vessels, and venous anatomy, with three-dimensional image processing and functional assessment when performed. Radiologists commonly interpret the study in coordination with congenital cardiologists or cardiac surgeons. It may be used to define anatomy in a patient with a known or suspected congenital defect or to support procedural planning when detailed cross-sectional imaging is needed.
Choose this code for a congenital heart disease evaluation, rather than a general cardiac morphology study or a coronary-focused CT angiogram. The report should establish the congenital indication and document the structures assessed and interpretation; the imaging record should support the contrast-enhanced cardiac study. CMS recognizes professional and technical components: report modifier 26 for interpretation, modifier TC for equipment and staff, or neither for the global service. The diagnostic imaging multiple procedure reduction applies to both the technical and professional components.
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 75573 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | $320.70 | Unavailable |
| Seattle (King Cnty) | $362.45 | Unavailable |
How the 75573 rate is calculated
Each of 75573’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 · 75573
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 2.49Practice expense 6.60Malpractice 0.17
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 75573
The CMS indicators that decide how 75573 is paid alongside other services.
CMS payment indicators · 75573
Cardiac CT
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| Multiple procedures | 4 | Diagnostic imaging reduction applies to the technical component (and professional component) of additional services. |
| 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
75573 without 26 · national office
$309.29
Cardiac CT
75573-26 · Professional component
$118.24
Pays only the interpretation and report.
75573 compared with similar codes
Compare codes
75573 vs 75572 vs 75574 vs 75561: national Medicare rates
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How to choose
- 75572Cardiac CT
- 75573 is selected for a congenital heart disease evaluation. 75572 covers contrast-enhanced cardiac morphology imaging without that congenital focus.
- 75574Coronary CTA
- 75574 is coronary CT angiography, while 75573 evaluates congenital cardiac anatomy. The intended structures and imaging protocol distinguish them.
- 75561Cardiac MRI
- 75561 uses MRI with contrast for cardiac morphology; 75573 uses CT with contrast for congenital heart disease evaluation.
75573 billing questions
When is 75573 a better fit than 75572?
Use 75573 when the CT is specifically evaluating congenital heart disease. Code 75572 is for cardiac morphology imaging without that congenital-heart evaluation focus.
How does 75573 differ from 75574?
75573 evaluates congenital cardiac anatomy; 75574 is a coronary CT angiography service. Select based on the examination's documented purpose and protocol.
Can the professional and technical portions be billed separately?
Yes. Modifier 26 identifies the professional interpretation, and modifier TC identifies the technical service. Billing without either modifier represents the global service.
Does the multiple procedure reduction affect both components?
Yes. CMS applies the diagnostic imaging multiple procedure reduction to both the technical and professional components.
What documentation supports reporting 75573?
Document the congenital heart disease indication, the cardiac structures evaluated, and the interpreting physician's findings. The record should support a contrast-enhanced cardiac CT examination.
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
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