X-ray exam of shoulder blade
CPT code 73010 covers an X-ray examination of the shoulder blade (scapula), a flat triangular bone on the upper back that connects the arm to the trunk. This is a simple diagnostic imaging test that helps doctors identify fractures, dislocations, or abnormalities in the shoulder blade.
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
Conversion factor: 32.3465 · Source: CMS MPFS RVU25A · Confidence: High
NCCI bundling edits
Loading bundling edits…
Billing tips
Always append modifier 26 or TC when splitting professional and technical components; never bill the global code if components are separate
Impact: Prevents overpayment recoveries and audits; incorrect component billing can result in 100% claim denial and recoupment
Document the specific clinical indication and body part side (right/left scapula) in the order and report to support medical necessity
Impact: Reduces medical necessity denials by 40-60%; lack of specificity is the leading cause of 73010 claim rejections
Do not bill 73010 when scapular views are included as part of a comprehensive shoulder series (73030); verify imaging protocol before coding
Impact: Prevents bundling denials and compliance issues; unbundling can result in loss of entire $23.29 payment plus potential fraud investigation
Link appropriate ICD-10 diagnosis codes that justify imaging (trauma codes, pain, suspected fracture) rather than screening codes
Impact: Screening indications typically result in patient responsibility as non-covered service; proper diagnosis coding ensures Medicare coverage
Verify that the radiology report explicitly mentions the scapula and documents all views obtained; generic shoulder reports may not support 73010
Impact: Insufficient documentation is cited in 25-30% of RAC audits for basic X-rays; can lead to payment recoupment even years later
When billing in facility setting, ensure hospital and physician use matching modifiers to avoid coordination of benefits issues
Impact: Modifier mismatches can delay payment 30-60 days and require manual claims reprocessing
Real billers contribute denial patterns and appeal strategies for this code. Once 5+ reports come in, you’ll see live aggregated data here — the only place this exists, free.
Get the free Revenue Protection Toolkit — the denial triggers, modifier pitfalls, and bundling conflicts that quietly cost you reimbursement. Instant download.
Help build the field knowledge
MedPayIQ gets smarter as billers contribute. If you've had this code denied, share what happened so others learn from it. Anonymous, no patient info.