CPT 73115Radiology

Contrast x-ray of wrist

CPT 73115 covers a specialized x-ray of the wrist where contrast material (dye) is injected into the wrist joint to make internal structures more visible on the imaging.

Showing rates for

National Average

Base Medicare rate

$127.12

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)

3.34

MP RVU

0.05

Total RVU

3.93

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

NCCI bundling edits

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Billing tips

Always append laterality modifier (RT or LT) as 73115 is a bilateral code and many payers reject claims without proper laterality designation
Impact: Prevents automatic denials and claim delays that can hold up the full $127.12 payment for 30-60 days
Verify prior authorization requirements before procedure as many commercial payers require pre-certification for arthrography studies
Impact: Failure to obtain authorization can result in 100% denial ($127.12 write-off) even with proper documentation
Document the specific contrast agent type, volume, and injection site in the operative/procedure note as payers increasingly audit contrast procedures
Impact: Prevents medical necessity denials and supports the 3.34 PE RVU component related to supply costs
Bill contrast material separately using HCPCS J-codes or revenue codes when performed in facility setting as 73115 does not include contrast supply reimbursement
Impact: Recovers additional $20-50 for contrast materials not included in the $127.12 base payment
For bilateral wrist arthrograms on same date, bill 73115 twice with RT and LT modifiers rather than modifier 50, as this is imaging with separate anatomic sites
Impact: Ensures full payment for both sides ($254.24 total) versus reduced bilateral allowance of typically 150% ($190.68)
Document medical necessity clearly explaining why standard radiographs (73100-73110) were insufficient and why MRI arthrogram (73221) was not the appropriate choice
Impact: Reduces denials for lack of medical necessity which account for 25-30% of arthrography claim rejections

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Frequently asked questions

What is the Medicare reimbursement rate for CPT 73115 in 2025?

The 2025 Medicare national average payment for CPT 73115 is $127.12 for both facility and non-facility settings. This rate is based on 3.93 total RVUs multiplied by the 2025 conversion factor of 32.3465. Actual payment may vary by geographic locality based on GPCI adjustments.

Does CPT 73115 include the contrast injection or is that billed separately?

CPT 73115 includes the diagnostic contrast injection as part of the arthrography procedure and the injection should not be billed separately using injection codes like 20605 or 25246. However, the contrast material supply itself may be separately billable using appropriate HCPCS J-codes, particularly in facility settings.

What modifier should I use when billing 73115 for a right wrist arthrogram?

Use modifier RT when performing the procedure on the right wrist, or modifier LT for the left wrist. Laterality modifiers are required for proper claim processing as 73115 is designated as a bilateral procedure code by most payers.

Can I bill CPT 73115 and wrist MRI on the same day?

Yes, you can bill both if medically necessary and they serve different diagnostic purposes. Append modifier 59 to indicate they are distinct services. However, documentation must clearly justify why both imaging modalities were necessary, as payers may question the medical necessity of performing both conventional arthrography and MRI on the same day when MR arthrography (73221) might be more appropriate.

How many RVUs is CPT code 73115 worth in 2025?

CPT 73115 has a total of 3.93 RVUs in 2025, consisting of 0.54 work RVUs, 3.34 practice expense RVUs (both facility and non-facility), and 0.05 malpractice RVUs according to the CMS Medicare Physician Fee Schedule RVU25A.

Does CPT 73115 require prior authorization from Medicare or commercial payers?

Medicare typically does not require prior authorization for 73115, though some Medicare Advantage plans may. Most commercial payers do require prior authorization for arthrography procedures as part of advanced imaging management programs. Always verify authorization requirements with the specific payer before scheduling to avoid denials.

What is the difference between CPT 73115 and 73221 for wrist imaging?

CPT 73115 is conventional radiographic arthrography using x-rays after contrast injection, while 73221 is MRI arthrography of the wrist. CPT 73221 involves MRI imaging after contrast injection and provides more detailed soft tissue visualization but is more expensive. The choice depends on clinical indication, with 73115 often used for initial evaluation and 73221 for more complex soft tissue assessment.