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CPT 93563: Injecting a contrast agent for imaging of coronary arteries during congenital abnormality evaluation - Prior Authorization and Price
CPT code 93563 is Injecting a contrast agent for imaging of coronary arteries during congenital abnormality evaluation. See what major commercial payers look for before approving it, the conditions their guidelines cover, and what it typically costs.
CPT 93563
Injecting a contrast agent for imaging of coronary arteries during congenital abnormality evaluation.
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.
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.
Typical price
Commercial insurance, median
$1,892
Middle half of rates: $889 to $3,377
Medicare, physician fee schedule
$45
National, non-facility
Commercial figures come from negotiated rates published by 451 hospitals; Medicare figures from CMS fee schedules.
Rates vary widely by hospital and plan. Pricing data from CenterIQ.
Frequently asked questions
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.
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.
Across 451 hospitals that publish their negotiated rates, the median commercial insurance rate is $1,892, with the middle half of rates between $889 and $3,377. A patient's own cost depends on their plan, deductible and where the study is done.
Read the denial letter for the stated reason, then request a peer-to-peer conversation between the ordering clinician and the reviewing physician, which often resolves missing-information denials. If that fails, file a written appeal that answers the stated reason directly and attach the supporting notes. The denial letter lists the deadline and where to send the appeal.
Imaging CPT Code Coverage Lookup
Compare prior authorization requirements across payers