CPT 73085Radiology

Contrast x-ray of elbow

CPT code 73085 covers a contrast x-ray of the elbow, where a radiologist injects contrast dye into the elbow joint and then takes x-ray images to see structures like ligaments, cartilage, and joint capsule that don't show up well on regular x-rays.

Showing rates for

National Average

Base Medicare rate

$95.10

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

0.54

PE RVU (NF)

2.36

MP RVU

0.04

Total RVU

2.94

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

NCCI bundling edits

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Billing tips

Always bill the contrast injection separately using CPT 24220 (injection for elbow arthrography) in addition to 73085 for the imaging
Impact: CPT 24220 adds approximately $80-120 to total reimbursement; failure to bill separately loses this additional revenue
Document laterality (right vs left) in both the order and report, and apply RT or LT modifier to prevent denials for incomplete coding
Impact: Prevents automatic denials that delay payment by 30-60 days and require resubmission
For facility billing, ensure contrast material (HCPCS codes for iodinated contrast) is separately reportable and documented with dosage
Impact: Contrast supply billing can add $20-40 to hospital outpatient claims when properly documented
Split bill with modifier 26 and TC when radiologist is not employed by facility to ensure both parties receive appropriate payment
Impact: Proper component billing prevents overpayment recovery audits and ensures radiologist receives approximately $38-45 and facility receives $50-57
Verify prior authorization requirements as many payers require pre-cert for arthrography since MRI is often considered first-line
Impact: Lack of authorization can result in 100% denial ($95.10 loss) even when medically appropriate
Document medical necessity clearly, especially why conventional radiography or MRI were insufficient or contraindicated
Impact: Strong documentation reduces denial rate from 15-20% to under 5%, protecting revenue and reducing appeal costs

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Frequently asked questions

What is the Medicare reimbursement rate for CPT 73085 in 2025?

The 2025 Medicare national average reimbursement for CPT 73085 is $95.10 for both facility and non-facility settings. This rate is based on 2.94 total RVUs multiplied by the 2025 conversion factor of $32.3465. Actual payment may vary based on geographic location and MAC adjustments.

Can you bill CPT 73085 and 24220 together?

Yes, CPT 73085 (elbow arthrography imaging) and CPT 24220 (injection procedure for elbow arthrography) should be billed together as they represent distinct components of the service. Code 24220 covers the injection procedure while 73085 covers the imaging supervision and interpretation. These codes are not bundled and both are separately reimbursable.

Do I need modifier 26 or TC for CPT 73085?

Use modifier 26 for professional component only (radiologist interpretation) or modifier TC for technical component only (equipment and technologist). If the same entity provides both components, bill the global code 73085 without a modifier. Split billing is common when radiologists interpret images taken at separate facilities.

What is the difference between CPT 73085 and 73080?

CPT 73080 is a complete x-ray examination of the elbow (minimum 3 views) without contrast, while CPT 73085 is arthrography with contrast injection. Code 73085 is more invasive and provides enhanced visualization of soft tissue structures. The procedures cannot be billed together for the same encounter as 73085 includes the radiographic examination.

Does CPT 73085 require prior authorization?

Prior authorization requirements vary by payer, but many Medicare Advantage and commercial insurers do require pre-authorization for elbow arthrography (CPT 73085) because MRI is typically considered first-line imaging for soft tissue evaluation. Always verify authorization requirements with the specific payer before scheduling to avoid denials.

How many RVUs is CPT code 73085 worth?

CPT 73085 has 2.94 total RVUs in 2025, consisting of 0.54 work RVUs, 2.36 practice expense RVUs, and 0.04 malpractice RVUs. Both facility and non-facility practice expense RVUs are identical at 2.36 for this code.

What diagnosis codes support medical necessity for CPT 73085?

Common supporting ICD-10 codes include: M24.22 (ligament disorder of elbow), S53.4 (sprain of elbow), M25.52 (elbow pain), M24.12 (loose body in elbow joint), M19.92 (elbow arthritis), and M25.62 (elbow stiffness). Documentation must show why arthrography is necessary over conventional imaging or MRI for the specific clinical scenario.