CPT 71111Radiology

X-ray exam ribs/chest4/> vws

CPT code 71111 covers a comprehensive X-ray examination of the ribs and chest using four or more different views to thoroughly evaluate bone injuries, fractures, or abnormalities.

Showing rates for

National Average

Base Medicare rate

$50.78

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

0.32

PE RVU (NF)

1.22

MP RVU

0.03

Total RVU

1.57

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

NCCI bundling edits

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Billing tips

Document all four or more views explicitly in the radiology report with specific projection names (e.g., PA, lateral, RAO, LAO, oblique)
Impact: Prevents downcoding to 71110 (3 views or less at $39.42), protecting $11.36 per claim
Verify medical necessity documentation supports the need for 4+ views rather than standard chest X-ray; include clinical indication such as 'localize suspected rib fracture' or 'evaluate all ribs for metastatic disease'
Impact: Reduces denial rate by 30-40% and eliminates costly appeals process
Do not bill 71111 on the same date as 71046-71048 (standard chest X-rays) unless clearly distinct anatomic areas or separate sessions with modifier 59
Impact: Prevents automatic bundling denials and potential $50.78 write-off
For hospital-based radiology, ensure facility and professional components are billed separately with appropriate modifiers (TC and 26) to maximize total reimbursement
Impact: Proper component billing ensures full payment collection from both facility and professional fee schedules
When ordering physician is requesting rib series, confirm technologist performs minimum 4 views before patient leaves department to avoid recall and rebilling issues
Impact: Eliminates need for patient callbacks and prevents claim corrections that delay payment 30-45 days
Use laterality modifiers (RT/LT) when protocol focuses on unilateral rib injury, even though not required by CPT; some Medicare contractors mandate this for payment
Impact: Prevents automatic denials in MAC jurisdictions requiring laterality, avoiding 14-21 day payment delays

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Frequently asked questions

What is the Medicare reimbursement rate for CPT 71111 in 2025?

The 2025 Medicare national average reimbursement for CPT 71111 is $50.78 for both facility and non-facility settings. This rate is based on 1.57 total RVUs multiplied by the 2025 conversion factor of 32.3465.

How many views are required to bill CPT 71111?

CPT 71111 requires a minimum of four views of the ribs and chest. If fewer than four views are obtained, you must use CPT 71110 instead. The radiology report must explicitly document all four or more projections taken to support billing 71111.

What is the difference between CPT 71111 and 71110?

CPT 71111 covers chest/rib X-rays with 4 or more views and reimburses at $50.78, while CPT 71110 covers chest/rib X-rays with 3 views or fewer and reimburses at a lower rate. The key distinction is the number of radiographic projections obtained and documented.

Can you bill CPT 71111 with a regular chest X-ray on the same day?

Generally, CPT 71111 should not be billed with standard chest X-rays (71045-71048) on the same date as they may be considered bundled services. If both are medically necessary for distinct clinical indications or separate sessions, append modifier 59 to 71111 with clear documentation supporting the medical necessity of both studies.

What are the work RVUs for CPT code 71111?

CPT 71111 has 0.32 work RVUs, 1.22 practice expense RVUs (both facility and non-facility), and 0.03 malpractice RVUs, for a total of 1.57 RVUs in 2025.

Do I need modifier 26 or TC when billing CPT 71111?

Use modifier 26 when billing only the professional component (radiologist interpretation) and modifier TC when billing only the technical component (equipment and technologist services). If your facility owns the equipment and employs the radiologist, bill the global service without modifiers to receive the full $50.78 reimbursement.

What diagnosis codes support medical necessity for CPT 71111?

Common supporting diagnoses include rib fractures (S22.3x), chest wall trauma (S29.9), chest pain requiring detailed evaluation (R07.x), suspected bone metastases (C79.51), and other conditions requiring comprehensive rib visualization. Documentation must clearly link the clinical indication to the need for 4+ views rather than a standard chest X-ray.