CPT 73050Radiology

X-ray exam of shoulders

CPT code 73050 covers an X-ray examination of both shoulders, typically performed to evaluate pain, injury, arthritis, or other shoulder problems. This is a bilateral imaging study that captures radiographic images of both shoulder joints in a single session.

Showing rates for

National Average

Base Medicare rate

$28.14

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

0.18

PE RVU (NF)

0.67

MP RVU

0.02

Total RVU

0.87

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

NCCI bundling edits

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Billing tips

Verify bilateral clinical necessity is documented before using 73050; if only one shoulder requires imaging, use CPT 73060 with appropriate laterality modifier
Impact: Prevents denials and downcoding; 73060 has same reimbursement rate but correct coding ensures compliance
Do not append modifier -50 (bilateral procedure) to 73050 as the code descriptor already includes both shoulders
Impact: Modifier -50 will trigger denial or be ignored; proper coding prevents processing delays and audit flags
Split bill professional and technical components when performed in different settings using modifiers 26 and TC
Impact: Ensures proper payment distribution; hospitals bill TC for facility services while radiologists bill 26 for interpretation
Bundle appropriate views within 73050 rather than billing multiple single-view codes (73020); the complete exam includes minimum two views per shoulder
Impact: Prevents unbundling denials and compliance violations; 73050 at $28.14 is appropriate for complete bilateral study
Document medical necessity for bilateral imaging in the order and clinical notes, especially when symptoms are unilateral but comparison views are needed
Impact: Reduces medical necessity denials; clear documentation of comparative need supports billing for bilateral study
Verify insurance-specific policies on bilateral imaging; some payers may require prior authorization for 73050 or prefer two units of 73060
Impact: Prevents denials and expedites payment; payer-specific compliance reduces appeals and resubmissions

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Frequently asked questions

What is the Medicare reimbursement rate for CPT 73050 in 2025?

The 2025 Medicare national average reimbursement rate for CPT 73050 is $28.14 for both facility and non-facility settings. This rate is based on 0.87 total RVUs multiplied by the 2025 conversion factor of 32.3465.

Does CPT 73050 require modifier 50 for bilateral shoulder X-rays?

No, CPT 73050 does not require modifier 50 because the code descriptor inherently includes examination of both shoulders. Adding modifier 50 is incorrect and will result in claim denials or the modifier being ignored during processing.

What is the difference between CPT 73050 and 73060?

CPT 73050 is for bilateral shoulder X-ray examination (both shoulders), while CPT 73060 is for unilateral shoulder X-ray (one shoulder). Use 73060 with RT or LT modifier when only one shoulder requires imaging, and 73050 when both shoulders need examination.

How many RVUs is CPT code 73050 worth in 2025?

CPT 73050 has 0.87 total RVUs in 2025, broken down as: 0.18 work RVU, 0.67 practice expense RVU (both facility and non-facility), and 0.02 malpractice RVU.

Can I bill CPT 73050 and 73060 together on the same date of service?

Generally no, as this represents unbundling. If both shoulders are imaged in the same session, bill only 73050. Billing both codes together will typically result in denial unless documentation clearly supports two separate imaging sessions with distinct clinical indications requiring modifier 59.

What diagnosis codes support medical necessity for CPT 73050?

Common supporting diagnoses include bilateral shoulder pain (M25.519), rheumatoid arthritis affecting multiple joints (M06.9), bilateral rotator cuff syndrome (M75.10), polymyalgia rheumatica (M35.3), osteoarthritis of bilateral shoulders, or any condition requiring comparative imaging of both shoulders for accurate diagnosis.

Do I need prior authorization for CPT 73050 with Medicare?

Traditional Medicare generally does not require prior authorization for CPT 73050, but Medicare Advantage plans may have different requirements. Always verify authorization requirements with the specific payer, as some commercial insurers and managed care plans require pre-certification for diagnostic imaging.