CPT 71120Radiology

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CPT code 71120 is for an X-ray examination of the breastbone (sternum) using two or more different angles to get a complete view of the bone structure.

Showing rates for

National Average

Base Medicare rate

$32.35

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

0.2

PE RVU (NF)

0.78

MP RVU

0.02

Total RVU

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

NCCI bundling edits

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Billing tips

Verify that at least two views were actually obtained and documented in the radiology report before billing 71120
Impact: Single-view sternum studies should be billed with 71100 (1 view) at lower reimbursement; incorrect coding can result in downcoding and loss of approximately $5-10 per claim
For hospital-based imaging, split bill using modifier 26 for physician interpretation and TC for hospital technical component
Impact: Ensures both facility and physician receive appropriate payment portions; improper component billing can delay payment by 30-60 days pending clarification
Document the clinical indication clearly in the order and radiology report, especially for trauma or specific injury mechanisms
Impact: Medical necessity documentation prevents denials; approximately 15-20% of imaging denials are due to insufficient medical necessity documentation
When performed in conjunction with rib series or chest X-rays, bill separately as sternum imaging requires specific positioning and views
Impact: 71120 is separately payable with rib series (71100-71111) and chest X-rays (71045-71048); failure to bill separately loses $32.35 per encounter
Verify payer-specific policies regarding global versus split billing in different settings before submitting claims
Impact: Some Medicare contractors and commercial payers have specific place-of-service requirements; incorrect billing format causes 20-30% rejection rate requiring resubmission
For repeat imaging on the same day, append modifier 76 or 77 and document the specific clinical change or reason for repeat study

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Frequently asked questions

What is the Medicare reimbursement rate for CPT code 71120 in 2025?

The 2025 Medicare national average reimbursement for CPT 71120 is $32.35 for both facility and non-facility settings. This rate is based on 1.0 total RVUs (0.2 work RVU, 0.78 PE RVU, 0.02 MP RVU) multiplied by the 2025 conversion factor of 32.3465.

What is the difference between CPT 71100 and 71120?

CPT 71100 is for a sternum X-ray with a single view, while 71120 requires a minimum of two or more views. The additional views in 71120 provide more comprehensive evaluation of the sternum and typically result in higher reimbursement due to increased technical and professional work.

How many RVUs is CPT code 71120 worth?

CPT 71120 has a total of 1.0 RVUs in 2025, consisting of 0.2 work RVUs, 0.78 practice expense RVUs (both facility and non-facility), and 0.02 malpractice RVUs according to the CMS Physician Fee Schedule RVU25A released December 23, 2024.

Can CPT 71120 be billed with a chest X-ray on the same day?

Yes, CPT 71120 can be billed separately with chest X-rays (71045-71048) performed on the same day as they are distinct anatomical studies. The sternum X-ray requires specific positioning different from standard chest imaging. No modifier is typically required unless specifically requested by the payer.

What diagnosis codes support medical necessity for CPT 71120?

Common supporting diagnosis codes include S22.20XA-S22.23XA (sternal fractures), S20.349A (external chest wall injuries), M94.0 (chondrocostal junction syndrome), R07.2 (precordial pain), and Z48.815 (post-cardiac surgery encounters). The specific code should match the clinical presentation and reason for the study.

Do I need to use modifier 26 when billing CPT 71120?

Modifier 26 (professional component) is only required when billing for the physician interpretation alone, typically in hospital or facility settings where the facility bills the technical component separately with modifier TC. In office or freestanding imaging center settings where the provider owns the equipment, bill the global service without modifiers.

What specialties typically bill CPT code 71120?

Radiologists most commonly bill CPT 71120 for the interpretation component. Emergency medicine physicians, orthopedic surgeons, trauma surgeons, and primary care physicians may order the study. The technical component is typically billed by hospitals, imaging centers, or practices that own the X-ray equipment and employ the radiologic technologists.