CPT 71046Radiology

X-ray exam chest 2 views

CPT code 71046 covers a standard chest x-ray taken from two different angles (typically front and side views). This is one of the most commonly ordered diagnostic imaging tests to evaluate the lungs, heart, and chest cavity.

Showing rates for

National Average

Base Medicare rate

$32.67

This calculator gives a typical-case estimate using standard Medicare modifier rules. Actual payment depends on payer policies, documentation, code-specific CMS status indicators, and locality. Verify before billing.

RVU breakdown

Work RVU

0.22

PE RVU (NF)

0.77

MP RVU

0.02

Total RVU

1.01

Conversion factor: 32.3465 · Source: CMS MPFS RVU25A · Confidence: High

NCCI bundling edits

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Billing tips

Verify the actual number of views obtained before billing 71046; if only one view was taken, bill 71045 instead to avoid overpayment recovery
Impact: Prevents $9-12 overpayment per claim that could trigger audit and recoupment actions
Ensure proper place of service (POS) coding - POS 22 for outpatient hospital yields facility rate, POS 11 for office may trigger different edits
Impact: Incorrect POS codes can result in claim denials or incorrect payment amounts requiring resubmission
Document medical necessity with appropriate ICD-10 codes; avoid using screening codes (Z12.x) for Medicare patients without specific coverage criteria
Impact: Using symptom-based diagnosis codes instead of screening codes prevents automatic denials and ensures $32.67 payment
When splitting professional and technical components, ensure both billers use the same date of service and consistent diagnosis codes
Impact: Mismatched information between 26 and TC claims can cause payment delays or denials requiring manual correction
Check frequency limitations for your specific payer; most allow 71046 without prior authorization but may limit multiple studies within short timeframes
Impact: Proactive frequency checking prevents denials on 15-20% of repeat studies performed within 30 days
For portable chest x-rays performed at bedside, verify payer-specific policies on whether 71046 or 71045 is more appropriate for portable technique
Impact: Some payers have specific portable x-ray codes or requirements that affect reimbursement accuracy

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Frequently asked questions

What is the Medicare reimbursement rate for CPT 71046 in 2025?

The 2025 Medicare national average reimbursement rate for CPT 71046 is $32.67 for both facility and non-facility settings. This is based on 1.01 total RVUs multiplied by the 2025 conversion factor of 32.3465.

What is the difference between CPT 71045 and 71046?

CPT 71045 covers a chest x-ray with a single view, while 71046 covers a chest x-ray with two views (typically PA and lateral). You must bill the code that matches the actual number of views obtained. The reimbursement for 71046 ($32.67) is higher than 71045.

Can you bill an E/M visit and CPT 71046 on the same day?

Yes, you can bill an evaluation and management service with 71046 on the same day as they are not bundled. However, the E/M must be separately identifiable and documented, and modifier 25 may be required on the E/M code depending on payer policy.

Does Medicare require prior authorization for CPT 71046?

Generally, Medicare does not require prior authorization for 71046 chest x-rays when performed for diagnostic purposes with appropriate medical necessity. However, some Medicare Advantage plans may have different requirements, so verify with the specific plan.

How many RVUs is CPT code 71046 worth?

CPT 71046 has 1.01 total RVUs for 2025, consisting of 0.22 work RVUs, 0.77 practice expense RVUs, and 0.02 malpractice RVUs. The facility and non-facility PE RVUs are the same at 0.77.

What diagnosis codes are commonly used with CPT 71046?

Common ICD-10 codes include R05.x (cough), R06.02 (shortness of breath), J18.9 (pneumonia), I50.9 (heart failure), R07.9 (chest pain), J44.9 (COPD), and Z87.891 (history of tobacco use). The diagnosis must support medical necessity for the study.

Can CPT 71046 be billed with modifier 26 for professional component only?

Yes, modifier 26 should be appended to 71046 when billing only the professional component (physician interpretation). The technical component would be billed separately with modifier TC. This split billing is common when the physician group and facility bill separately.