CPT 73070Radiology

X-ray exam of elbow

CPT code 73070 covers a standard x-ray examination of the elbow joint, typically performed to evaluate injuries, fractures, arthritis, or elbow pain. This is one of the most common diagnostic imaging procedures ordered by physicians for elbow-related complaints.

Showing rates for

National Average

Base Medicare rate

$28.46

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

0.16

PE RVU (NF)

0.7

MP RVU

0.02

Total RVU

0.88

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

NCCI bundling edits

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Billing tips

Always append laterality modifiers (RT/LT) even when not strictly required by Medicare, as many commercial payers mandate them
Impact: Prevents denials and resubmission delays that can cost $25-40 in administrative rework per claim
For bilateral elbow x-rays, bill 73070 twice with RT and LT modifiers rather than using modifier 50, as radiology codes typically don't follow the 50% reduction rule
Impact: Ensures full payment of $28.46 per side ($56.92 total) rather than risking incorrect bilateral adjustment
Verify whether your facility bills globally or splits professional/technical components; incorrect component billing is a top denial reason
Impact: Component errors result in 50-60% underpayment or overpayment requiring correction and potential recoupment
Document medical necessity clearly in the order and report; elbow x-rays for routine screening without symptoms are not covered
Impact: Medical necessity denials forfeit the entire $28.46 payment and are difficult to appeal without proper documentation
When performed on the same day as other upper extremity imaging, ensure separate anatomical sites are documented to prevent bundling
Impact: Bundling errors can result in denial of $28.46 per improperly grouped study
Use modifier 76 appropriately for same-day repeat studies after fracture reduction or failed initial imaging, and document the clinical reason
Impact: Proper use allows additional $28.46 payment; improper use triggers audits and potential recoupment

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Frequently asked questions

What is the Medicare reimbursement rate for CPT code 73070 in 2025?

The 2025 Medicare national average payment for CPT 73070 is $28.46 for both facility and non-facility settings. This rate is based on 0.88 total RVUs multiplied by the 2025 conversion factor of 32.3465. Actual payment may vary by geographic locality.

How many RVUs is CPT code 73070 worth?

CPT 73070 has 0.88 total RVUs in 2025, consisting of 0.16 work RVU, 0.7 practice expense RVU (both facility and non-facility), and 0.02 malpractice RVU according to the CMS Medicare Physician Fee Schedule RVU25A.

Do I need a modifier when billing bilateral elbow x-rays?

Yes, for bilateral elbow x-rays, bill CPT 73070 twice with RT modifier for the right elbow and LT modifier for the left elbow. Do not use modifier 50 for radiology codes, as they should be billed separately with laterality modifiers to ensure proper payment for each side.

What is the difference between modifier 26 and TC for CPT 73070?

Modifier 26 indicates billing for only the professional component (physician interpretation and report), while modifier TC indicates billing for only the technical component (equipment, technologist, supplies). Use 26 when a radiologist interprets films from another facility, or TC when a facility bills for performing the x-ray but not the interpretation.

Can CPT 73070 and 73080 be billed together on the same day?

Yes, CPT 73070 (elbow x-ray) and 73080 (elbow x-ray, minimum of 3 views) can be billed on the same day if medically necessary and performed on different elbows or at different times for valid clinical reasons. However, billing both codes for the same elbow on the same encounter would be considered unbundling and is not appropriate.

What diagnosis codes support medical necessity for CPT 73070?

Common supporting diagnosis codes include elbow pain (M25.521/M25.522), elbow fracture (S42.4 series), elbow sprain (S53 series), elbow arthritis (M19.021/M19.022), and trauma/injury codes. The diagnosis must demonstrate medical necessity for imaging and cannot be for routine screening without symptoms.

How long should documentation for CPT 73070 be retained?

Medicare requires retention of medical records including imaging reports for at least 7 years from the date of service. Many states have longer requirements (up to 10 years), and records should be retained for at least 10 years to cover potential audits, litigation, and compliance reviews. Always follow the longest applicable retention requirement.