Which payers have published criteria for CT angiography abdominal aorta with leg runoff (CPT 75635)?

The imaging guidelines used by Aetna, Anthem BCBS, Cigna, Medicare, UnitedHealthcare include criteria that apply to this study. Whether a specific patient's plan requires prior authorization depends on the plan, so confirm on the payer's portal or by phone before scheduling.

Who reviews prior authorization requests for CT angiography abdominal aorta with leg runoff (CPT 75635)?

Most commercial payers hand imaging reviews to a radiology benefit manager. For the payers tracked here, requests are reviewed using guidelines from eviCore, Carelon, CMS, UnitedHealthcare / eviCore. The request is submitted through that organization's portal rather than the health plan's general line.

What should be in the clinical notes before requesting CT angiography abdominal aorta with leg runoff (CPT 75635)?

Reviewers look for a recent office visit that documents the symptoms and how long they have lasted, exam findings, results of any earlier imaging, treatments already tried and how the patient responded, and the specific question the study is expected to answer. The diagnosis code on the request should match what the notes describe.

CPT 75635: CT angiography abdominal aorta with leg runoff - Prior Authorization and Price

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CPT 75635

Reviewing a CT angiography of the abdominal aorta and leg arteries that includes contrast.

CTA Abdomen & Pelvis

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Payer guidelines that apply

Payer	Reviewed using	Guideline	Sections
Aetna	eviCore	Peripheral Vascular Disease (PVD) Imaging Guidelines 2.0.2026, effective Sep 1, 2026 Chest Imaging Guidelines 1.0.2026, effective Feb 3, 2026 Pediatric Cardiac Imaging Guidelines effective Feb 3, 2026	4 that name this code
Anthem BCBS	Carelon	Advanced imaging for vascular indications effective Sep 19, 2026	3 that name this code
Cigna	eviCore	Peripheral Vascular Disease (PVD) Imaging Guidelines 2.0.2026, effective Sep 1, 2026 Chest Imaging Guidelines 1.0.2026, effective Feb 3, 2026 Pediatric Cardiac Imaging Guidelines 1.0.2026, effective Feb 3, 2026	4 that name this code
Medicare	CMS	NCD 220.1: Computed Tomography effective Mar 12, 2008	1 that name this code
Original Medicare does not run a prior authorization program for outpatient imaging; claims are judged against the coverage policies above. Medicare Advantage plans set their own prior authorization rules.
UnitedHealthcare	UnitedHealthcare / eviCore	Commercial and Exchange Cardiovascular and Radiology Imaging Guidelines 09.2026, effective Sep 1, 2026	4 that name this code

Guidelines collected from the payers' published documents on September 29, 2026. Payers revise these documents during the year. Open the guideline link to confirm the current version before you submit.

Conditions the guidelines address for this study

These are the clinical situations where payer guidelines discuss CT angiography abdominal aorta with leg runoff. Each has its own criteria for when the study is considered appropriate.

Lung Transplantation Aetna · Cigna · UnitedHealthcare
Computed Tomography Medicare
Other vascular indications in lower extremity Anthem BCBS
Peripheral arterial disease (PAD) Anthem BCBS
Venous thrombosis or occlusion Anthem BCBS

Typical price

Commercial insurance, median

$1,038

Middle half of rates: $472 to $2,244

Medicare, hospital outpatient

$179

Facility payment

Medicare, physician fee schedule

$413

National, non-facility

Commercial figures come from negotiated rates published by 1,044 hospitals; Medicare figures from CMS fee schedules. Rates vary widely by hospital and plan. Pricing data from CenterIQ.

Get notified when the rules for this study change

Payers update imaging guidelines several times a year. We will email you when the criteria for CT angiography abdominal aorta with leg runoff change.

CPT 75635: CT angiography abdominal aorta with leg runoff - Prior Authorization and Price

Payer guidelines that apply

Conditions the guidelines address for this study

Typical price

Get notified when the rules for this study change

Frequently asked questions

Imaging CPT Code Coverage Lookup

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CPT 75635: CT angiography abdominal aorta with leg runoff - Prior Authorization and Price

Payer guidelines that apply

Conditions the guidelines address for this study

Typical price

Get notified when the rules for this study change

Frequently asked questions

Related studies

Imaging CPT Code Coverage Lookup

Quick Access - Common Imaging CPT Codes

CT

MRI

MRA

PET