CPT 73562Radiology

X-ray exam of knee 3

CPT code 73562 is used when a healthcare provider orders an x-ray examination of the knee that includes three different views or angles. This is more comprehensive than a basic 1 or 2 view knee x-ray and helps doctors see the knee joint from multiple perspectives to diagnose injuries, arthritis, or other conditions.

Showing rates for

National Average

Base Medicare rate

$39.46

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

0.18

PE RVU (NF)

1.02

MP RVU

0.02

Total RVU

1.22

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

NCCI bundling edits

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Billing tips

Verify and document exactly three views were obtained and interpreted; if only two views were taken, use 73560 instead, and if four or more views, use 73564
Impact: Prevents $5-15 undercoding or overcoding discrepancies and reduces audit risk by 40-60%
Always append RT or LT modifier to specify laterality, as many payers including Medicare require anatomic specificity for extremity imaging
Impact: Prevents automatic denials for lack of specificity which account for approximately 15-20% of knee x-ray claim rejections
For bilateral knee x-rays, bill 73562-RT and 73562-LT on separate lines with modifier 59 on the second line to ensure payment for both sides
Impact: Ensures full reimbursement of approximately $78.92 for bilateral studies instead of single-side payment of $39.46
Ensure the radiology report explicitly mentions all three views by name (e.g., 'AP, lateral, and sunrise views of the knee') to support the code during audits
Impact: Reduces documentation-related denials by 30-40% and protects against recoupment in post-payment audits
Split bill using modifier 26 and TC when professional and technical components are performed by different entities to maximize compliant reimbursement
Impact: Ensures accurate payment distribution between reading physician and imaging facility, preventing compliance issues
Check payer-specific policies on add-on views; some payers may require 73562 for standard three views but have specific rules about what constitutes the third view
Impact: Reduces payer-specific denials by 25% through proactive compliance with individual payer policies

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Frequently asked questions

What is the Medicare reimbursement rate for CPT code 73562 in 2025?

The 2025 Medicare national average reimbursement rate for CPT 73562 is $39.46 for both facility and non-facility settings. This rate is based on 1.22 total RVUs multiplied by the 2025 conversion factor of 32.3465. Actual payments may vary by geographic locality based on the Medicare Administrative Contractor (MAC) adjustments.

What is the difference between CPT 73560, 73562, and 73564?

The difference is the number of views obtained: CPT 73560 is for 1 or 2 views of the knee, CPT 73562 is for exactly 3 views, and CPT 73564 is for 4 or more views. You must bill the code that accurately reflects the number of views documented in the radiology report. Billing the wrong code based on view count is a common cause of denials and audit findings.

Do I need to use a modifier when billing CPT 73562 for a knee x-ray?

Yes, you should append the RT (right) or LT (left) modifier to indicate which knee was imaged, as most payers including Medicare require laterality modifiers for extremity imaging. If billing the professional component only, use modifier 26; for technical component only, use modifier TC. For bilateral knee x-rays, bill 73562-RT and 73562-LT separately with modifier 59 on the second line.

How many RVUs is CPT code 73562 worth in 2025?

CPT 73562 has a total of 1.22 RVUs in 2025, consisting of 0.18 work RVUs, 1.02 practice expense RVUs (both facility and non-facility), and 0.02 malpractice RVUs. These values are from the CMS Medicare Physician Fee Schedule RVU25A released December 23, 2024.

Can I bill CPT 73562 for both knees on the same day?

Yes, you can bill for bilateral knee x-rays by reporting 73562-RT for the right knee and 73562-LT for the left knee on separate claim lines. Many payers require modifier 59 on the second line to indicate these are distinct services. This allows you to receive payment for both knees when medically necessary, totaling approximately $78.92 for Medicare patients.

What documentation is required to support billing CPT 73562?

You must have a physician's order with clinical indication, a radiology report that explicitly documents all three views by name (such as AP, lateral, and oblique), laterality specification, the interpreting physician's signed report, and documentation supporting medical necessity. The report must clearly show three distinct views were obtained and interpreted to justify using 73562 instead of 73560.

What are common denial reasons for CPT 73562 and how can I prevent them?

Common denials include view count discrepancies (report documents only 2 views but billed as 3 views), missing laterality modifiers, lack of medical necessity documentation, and duplicate service edits when billed with other knee imaging codes. Prevent denials by ensuring the radiology report explicitly lists all three views, always using RT/LT modifiers, documenting clinical necessity in the order, and verifying the correct code based on actual views obtained.