CPT 73551Radiology

X-ray exam of femur 1

CPT code 73551 covers a single X-ray examination of the femur (thighbone), typically performed to evaluate fractures, bone lesions, or alignment issues. This is a standard diagnostic imaging procedure commonly ordered after trauma or when investigating leg pain.

Showing rates for

National Average

Base Medicare rate

$28.79

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)

0.71

MP RVU

0.02

Total RVU

0.89

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 specify laterality, as this is required by most payers including Medicare for anatomically paired structures
Impact: Prevents automatic denials and claim rejections; avoids 10-15 day payment delays for claims requiring clarification
Bill 73551 for single or limited views only; upgrade to 73552 (minimum 2 views) when two or more projections are obtained to receive $37.51 instead of $28.79
Impact: Captures additional $8.72 per study when documentation supports multiple views; potential revenue loss of 30% when undercoding
Separate professional and technical components appropriately in split-billing arrangements between radiologists and imaging facilities using modifiers 26 and TC
Impact: Ensures proper payment distribution and prevents duplicate billing issues that trigger audits
Link appropriate ICD-10 codes documenting medical necessity such as trauma codes (S72.xxx), pathological fracture codes (M84.4xx), or bone lesion codes (M89.xxx)
Impact: Reduces denial rate by 40-60%; claims without specific diagnosis codes face high denial probability
Do not bill 73551 in addition to complete lower extremity studies (73592) or when femur is included in hip (73501-73523) or knee (73560-73564) studies
Impact: Prevents bundling denials and recoupment demands; NCCI edits will deny 73551 as component of more comprehensive studies
Document time and medical necessity clearly when billing same-day repeat studies with modifier 76, including what changed clinically or what technical issue required repeat
Increases approval rate for repeat imaging from approximately 30% to 85% with proper documentation

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Frequently asked questions

What is the Medicare reimbursement rate for CPT code 73551 in 2025?

The 2025 Medicare national average reimbursement for CPT 73551 is $28.79 for both facility and non-facility settings. This rate is based on 0.89 total RVUs multiplied by the 2025 conversion factor of 32.3465. Actual payment may vary by geographic locality due to GPCI adjustments.

What is the difference between CPT 73551 and 73552?

CPT 73551 covers a femur X-ray with minimum of 1 view and pays $28.79, while CPT 73552 requires minimum of 2 views and reimburses at $37.51. Always code to the actual number of views documented; billing 73551 when two or more views were obtained results in undercoding and lost revenue of $8.72 per study.

Do I need to use a laterality modifier with CPT 73551?

Yes, Medicare and most commercial payers require laterality modifiers RT (right) or LT (left) with CPT 73551 to specify which femur was imaged. Failure to include laterality modifiers results in automatic claim rejections or denials requiring resubmission.

Can CPT 73551 be billed bilaterally on the same date of service?

Yes, when both femurs are imaged on the same date, bill 73551 on two separate lines with RT modifier on one line and LT modifier on the other. Do not use modifier 50 (bilateral) as each side should be reported separately. Some payers may require modifier 59 on the second line to prevent duplicate denials.

What diagnosis codes support medical necessity for CPT 73551?

Common supporting diagnoses include femoral fractures (S72.xxx series), pathological fractures (M84.4xx), bone lesions or tumors (M89.xxx, C40.2x), osteomyelitis (M86.xxx), leg pain (M79.606), and trauma evaluation (mechanism codes from V-Y series). The diagnosis must clearly indicate why femur imaging specifically was necessary.

How do I bill CPT 73551 in a split-billing scenario?

In split-billing arrangements, the facility bills 73551-TC for the technical component (equipment and technologist) while the interpreting radiologist bills 73551-26 for the professional component (interpretation and report). Never bill the global code (73551 without modifier) when services are split, as this causes duplicate payment issues.

What are the RVU values for CPT code 73551 in 2025?

For 2025, CPT 73551 has Work RVU of 0.16, Practice Expense RVU of 0.71 (both facility and non-facility), and Malpractice RVU of 0.02, totaling 0.89 RVUs. When multiplied by the 2025 conversion factor of 32.3465, this yields the $28.79 Medicare payment rate.