CPT 73090Radiology

X-ray exam of forearm

CPT 73090 covers an X-ray examination of the forearm, which includes imaging the area between the elbow and wrist to diagnose fractures, injuries, or bone conditions.

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

Loading bundling edits…

Billing tips

Always append RT or LT modifier to indicate laterality, even though not required by all payers
Impact: Prevents 5-10% of claims from being rejected for missing laterality information and reduces audit risk
Document the minimum number of views obtained (typically 2 views minimum for 73090)
Impact: Single view forearm imaging may be downcoded to a lower-paying code or denied; proper documentation ensures full $28.46 reimbursement
Use modifier 50 for bilateral studies rather than billing 73090 twice with RT and LT
Impact: Correct bilateral modifier increases reimbursement to $42.69 vs. potential denial of second claim
Verify medical necessity is clearly documented in ordering physician notes before performing study
Impact: Prevents up to 15% of denials related to lack of medical necessity documentation
For global billing, ensure both technical and professional components are documented; split billing when appropriate
Impact: Appropriate use of 26 and TC modifiers in split-billing scenarios prevents overpayment recoveries and ensures accurate facility vs. professional reimbursement
Do not bill 73090 with 73100 (wrist) unless separate, distinct clinical indications exist for each anatomic area
Impact: Prevents bundling denials and potential fraud allegations; when appropriate, both can be billed but requires clear documentation of separate medical necessity

Common denials

Live Field Datano reports yet

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.

Working with CPT 73090?

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.

Related actions

Frequently asked questions

What is the Medicare reimbursement rate for CPT 73090 in 2025?

The 2025 Medicare national average reimbursement for CPT 73090 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.

How many views are required to bill CPT 73090?

CPT 73090 typically requires a minimum of two views (usually anteroposterior and lateral) of the forearm. Documentation must specify the number and type of views obtained. A single view may not meet the code requirements and could result in downcoding or denial.

Can I bill CPT 73090 for both wrist and elbow if the forearm is imaged?

No, CPT 73090 is specific to the forearm (radius and ulna between elbow and wrist). Separate codes exist for wrist (73100) and elbow (73070) imaging. Bill only for the anatomic area specifically ordered and imaged unless separate clinical indications exist for each area.

Do I need a modifier when billing 73090 for bilateral forearm X-rays?

Yes, use modifier 50 for bilateral forearm X-rays performed during the same session. This increases reimbursement to 150% of the single procedure rate. Alternatively, some payers accept RT and LT modifiers on separate line items, but modifier 50 is generally preferred for bilateral procedures.

What is the difference between modifier 26 and TC for CPT 73090?

Modifier 26 represents the professional component (physician interpretation and report only), while modifier TC represents the technical component (equipment, supplies, and technologist). When billed globally without modifiers, 73090 includes both components at the full $28.46 rate. Split billing is used when different entities provide each component.

How do I bill CPT 73090 when performed in the emergency department?

In the ED, bill 73090 with the appropriate place of service code (23 for emergency room-hospital). If the hospital owns the equipment, the facility bills the technical component (TC modifier) and the interpreting radiologist bills the professional component (26 modifier). Documentation must include medical necessity supporting emergency imaging.

What are the RVU values for CPT 73090 in 2025?

For 2025, CPT 73090 has a Work RVU of 0.16, Practice Expense RVU of 0.7 (both facility and non-facility), and Malpractice RVU of 0.02, totaling 0.88 RVUs. These values multiplied by the conversion factor of 32.3465 equal the $28.46 Medicare reimbursement rate.