CPT 73100Radiology

X-ray exam of wrist

CPT code 73100 is for a basic x-ray examination of the wrist, typically involving 2 views to evaluate bones and joints for fractures, arthritis, or other abnormalities.

Showing rates for

National Average

Base Medicare rate

$32.67

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)

0.83

MP RVU

0.02

Total RVU

1.01

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

NCCI bundling edits

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Billing tips

Always append RT or LT modifier to indicate laterality, as this is required by most payers and prevents denials
Impact: Prevents 15-20% of initial denials for missing laterality modifiers; avoids payment delays of 30-45 days
Split bill using 26 and TC modifiers when professional and technical components are performed by different entities
Impact: Ensures proper payment distribution; facility receives approximately $26.14 (TC) and interpreting physician receives approximately $6.53 (26)
Document the specific number and type of views obtained (minimum 2 views for 73100) in the radiology report
Impact: Prevents downcoding or denials; insufficient views may result in denial or reduction to lower-valued screening code
Link to specific ICD-10 diagnosis codes that demonstrate medical necessity (trauma codes, pain codes with laterality, arthritis)
Impact: Reduces denial rate by 25-30%; non-specific diagnosis codes like M25.539 (pain in unspecified wrist) have higher denial rates than laterality-specific codes
For bilateral wrist x-rays, bill 73100-50 (bilateral modifier) rather than two separate line items with RT and LT
Impact: Bilateral modifier typically reimburses at 150% of single code rate ($49.01 vs. $65.34 for two separate codes), resulting in 25% payment reduction
Verify that 73100 is not bundled with fracture care codes (2xxxx series) when billed on the same date of service
Impact: Prevents denials under NCCI edits; x-rays taken as part of fracture treatment may be bundled and non-separately reimbursable

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Frequently asked questions

What is the Medicare reimbursement rate for CPT 73100 in 2025?

The 2025 Medicare national average reimbursement for CPT 73100 is $32.67 for both facility and non-facility settings. This rate is based on 1.01 total RVUs multiplied by the 2025 conversion factor of 32.3465.

How many views are required for CPT code 73100?

CPT 73100 requires a minimum of 2 views of the wrist, typically anteroposterior (AP) and lateral projections. If 3 or more views are obtained, CPT 73110 should be billed instead for a more comprehensive examination.

What is the difference between CPT 73100 and 73110?

CPT 73100 is for a basic wrist x-ray with a minimum of 2 views, while CPT 73110 is for a complete wrist x-ray with a minimum of 3 views. The number of views obtained determines which code to bill, with 73110 having higher reimbursement due to additional imaging.

Do I need to use modifier 26 or TC when billing 73100?

Use modifier 26 if billing only the professional component (physician interpretation), modifier TC if billing only the technical component (equipment and technologist), or no modifier if billing the global service (both components). Split billing is common when the imaging facility and interpreting physician are separate entities.

Is CPT 73100 subject to the multiple procedure payment reduction (MPPR)?

No, diagnostic imaging services like 73100 are not subject to MPPR when billed with other imaging on the same day. However, when billing bilateral procedures or multiple imaging studies, verify payer-specific policies as some commercial payers apply reductions.

What diagnosis codes are typically used with CPT 73100?

Common ICD-10 codes include S69.91XA/S69.92XA (unspecified wrist injury), M25.531/M25.532 (wrist pain with laterality), M19.031/M19.032 (primary osteoarthritis of wrist), S52.501A-S52.502A (distal radius fractures), and M25.831/M25.832 (other specified joint disorders of wrist).

Can CPT 73100 be billed bilaterally with modifier 50?

Yes, when both wrists are imaged during the same session, append modifier 50 to indicate bilateral procedure. However, reimbursement is typically 150% of the single procedure rate (approximately $49.01) rather than 200%, per Medicare bilateral surgery rules applied to imaging.