X-ray exam of shoulder
CPT code 73030 covers a standard x-ray examination of the shoulder, which uses radiation imaging to capture pictures of the shoulder bones and joint. This is one of the most common diagnostic imaging procedures ordered for shoulder pain, injury, or suspected bone abnormalities.
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
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Billing tips
Always append RT or LT modifier to specify laterality
Impact: Prevents automatic denials and audit triggers; required by most payers including Medicare for proper claim adjudication
Verify minimum view requirements are met (typically 2 views) before coding 73030
Impact: Single-view shoulder x-rays may require different coding or reduced reimbursement; ensures full $33.64 payment
Split professional and technical components appropriately in facility settings
Impact: Improper component billing can result in 50-100% payment loss; ensure radiologist bills 26 modifier while facility bills TC
Document medical necessity clearly in the order and report, linking to ICD-10 diagnosis
Impact: Vague indications like 'shoulder pain' may trigger review; specific diagnosis codes improve first-pass payment rate by 15-20%
Do not bill 73030 with comprehensive shoulder studies (73020, 73040) performed same day
Impact: Bundling violations can result in denial of the lesser-valued code; use appropriate comprehensive code instead
Ensure interpretation report is signed and dated within payer timeframes
Impact: Missing or delayed reports can result in full denial of $33.64; most payers require completion within 24-48 hours
Common denials
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