CPT 73092Radiology

X-ray exam of arm infant

CPT code 73092 is used when a healthcare provider performs an X-ray examination of an infant's arm. This specialized imaging procedure is designed specifically for babies and young infants to diagnose fractures, deformities, or other bone conditions.

Showing rates for

National Average

Base Medicare rate

$30.41

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)

0.76

MP RVU

0.02

Total RVU

0.94

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

NCCI bundling edits

Loading bundling edits…

Billing tips

Verify patient age documentation is clearly indicated in the medical record showing infant status (typically under 24 months) to justify use of 73092 instead of standard arm X-ray codes
Impact: Prevents denials for age-inappropriate code selection; age-specific codes may have different coverage policies
Document the specific anatomic area imaged (humerus, elbow, forearm, wrist) and number of views obtained to support medical necessity and prevent downcoding
Impact: Ensures full reimbursement of $30.41 rather than risk of denial or request for refund
When imaging both arms, bill 73092 twice with RT and LT modifiers rather than using a bilateral modifier, as this code does not have a bilateral indicator
Impact: Ensures payment for both sides at 100% each ($60.82 total) rather than potential denial for improper modifier use
Ensure the ordering physician's documentation clearly states medical necessity, especially in cases of suspected non-accidental trauma where additional scrutiny applies
Impact: Reduces audit risk and prevents medical necessity denials that could result in $30.41 recoupment
Submit claims with appropriate ICD-10 diagnosis codes that support infant-specific pathology (e.g., birth trauma, developmental conditions) rather than generic injury codes
Impact: Increases first-pass claim acceptance rate by 15-25% and reduces payer inquiries
For Medicare Advantage and Medicaid plans, verify prior authorization requirements for pediatric imaging, as some plans require pre-approval even for basic X-rays in infants
Prevents denials for lack of authorization which result in zero payment and difficult appeals

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 73092?

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 code 73092 in 2025?

The 2025 Medicare national average reimbursement rate for CPT 73092 is $30.41 for both facility and non-facility settings. This rate is based on a total RVU of 0.94 and a conversion factor of 32.3465.

At what age does a patient qualify as an infant for CPT 73092 billing purposes?

While CPT guidelines generally define infant as a child under 2 years of age, specific payer policies may vary. Most payers consider patients under 12-24 months as infants for code 73092. Always verify age criteria with the specific payer and document the patient's age clearly in the medical record.

Can CPT 73092 be billed bilaterally for both arms on the same date?

Yes, you can bill for both arms, but CPT 73092 does not have a bilateral indicator. Bill the code twice on separate lines with RT (right) and LT (left) modifiers to indicate each arm was imaged separately. Each service should be reimbursed at the full rate of $30.41.

What is the difference between CPT 73092 and standard arm X-ray codes?

CPT 73092 is specifically designated for infant patients and reflects the specialized techniques, positioning, and reduced radiation parameters required for this age group. Standard arm X-ray codes (73060-73080) are used for older children and adults. Using the age-appropriate code ensures proper reimbursement and compliance.

How many RVUs is CPT code 73092 worth?

CPT 73092 has a total RVU value of 0.94, consisting of 0.16 work RVU, 0.76 practice expense RVU (both facility and non-facility), and 0.02 malpractice RVU according to the 2025 Medicare Physician Fee Schedule.

Do I need a separate order for each arm when billing 73092?

Each arm should have documented medical necessity, though a single order may specify bilateral imaging if clinically appropriate. The key is that the medical record clearly supports the need to image each extremity separately. Document clinical findings for each arm independently to support medical necessity.

What modifiers are most commonly used with CPT 73092?

The most common modifiers are RT (right side) and LT (left side) for laterality designation, modifier 26 for professional component only, modifier TC for technical component only, and modifier 76 for repeat procedures on the same day. Always append the appropriate laterality modifier when billing 73092.