X-ray exam hips bi 5/> views
CPT code 73523 covers a comprehensive X-ray examination of both hips using five or more different views to thoroughly evaluate the hip joints, bones, and surrounding structures.
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
Conversion factor: 32.3465 · Source: CMS MPFS RVU25A · Confidence: High
NCCI bundling edits
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Billing tips
Document all five or more views explicitly in the radiology report (e.g., AP pelvis, bilateral frog-leg lateral, bilateral cross-table lateral) to support the comprehensive study requirement
Impact: Prevents downcoding to 73522 (2-4 views) which reimburses approximately 15-20% less
Verify bilateral imaging was actually performed; if only one hip was imaged with 5+ views, use 73522 with RT or LT modifier instead
Impact: Avoids upcoding allegations and potential refund demands of $20-30 per study during audits
When performed in hospital setting, ensure facility bills technical component and radiologist bills professional component separately to maximize appropriate reimbursement
Impact: Proper component billing ensures full $60.16 reimbursement is appropriately split between facility and professional services
Link appropriate ICD-10 diagnosis codes that support medical necessity for bilateral comprehensive imaging rather than limited views
Impact: Strong diagnosis linkage (M25.559 for bilateral hip pain, M16.0 for bilateral hip OA) reduces denial rate by 40-60%
Do not bill 73523 with unilateral hip codes (73501-73503, 73521-73522) for the same date of service unless anatomically distinct and separately documented
Impact: Prevents bundling denials and National Correct Coding Initiative (NCCI) edits that would result in complete claim rejection
For pre-authorization requirements, submit prior studies and clinical indication demonstrating why comprehensive bilateral imaging is necessary versus limited views
Pre-authorization approval increases clean claim rate to 95%+ and accelerates payment by 10-15 days
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