CPT 73600Radiology

X-ray exam of ankle

CPT code 73600 covers a basic X-ray examination of the ankle, typically involving at least two different views (such as front and side) to evaluate bones, joints, and alignment for injuries or abnormalities.

Showing rates for

National Average

Base Medicare rate

$31.05

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)

0.78

MP RVU

0.02

Total RVU

0.96

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 when performing unilateral ankle X-rays
Impact: Prevents denials for lack of specificity; some payers now require laterality modifiers and will deny claims without them, delaying payment by 30-45 days
For bilateral ankle X-rays performed on the same date, bill 73600-RT and 73600-LT separately rather than using modifier 50
Impact: Ensures full reimbursement of $62.10 total (2 x $31.05) rather than risking reduced payment at 150% of single procedure rate
Split bill using modifier 26 (professional) and TC (technical) when interpretation and imaging occur in different settings
Impact: Prevents overbilling; ensures correct payment allocation between facility ($24.20 TC) and physician ($6.85 PC) based on PE RVU distribution
Document the specific number of views obtained (minimum two required for 73600) in both the order and the interpretation report
Impact: Prevents downcoding or denials; missing view documentation can result in claim rejection or request for records, delaying payment
Verify medical necessity with appropriate ICD-10 codes linking ankle symptoms or injury to the imaging order
Impact: Medicare and commercial payers increasingly audit imaging claims; poor diagnosis linkage results in 15-25% denial rate for this code
Do not bill 73600 with more comprehensive ankle studies (73610) performed on same date and same ankle; bill only the highest level code
Impact: Prevents bundling denials and potential fraud flags; billing both codes together results in automatic denial of the lesser code ($31.05 loss)

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Frequently asked questions

What is the Medicare reimbursement rate for CPT code 73600 in 2025?

The 2025 Medicare national average reimbursement rate for CPT 73600 is $31.05 for both facility and non-facility settings. This rate is based on 0.96 total RVUs multiplied by the 2025 conversion factor of 32.3465. Actual payment may vary by geographic locality based on the Medicare Administrative Contractor (MAC) adjustment factors.

How many views are required to bill CPT code 73600 for an ankle X-ray?

CPT code 73600 requires a minimum of two views of the ankle. The most common views are anteroposterior (AP) and lateral, though other combinations such as AP, mortise, and lateral may be obtained. If three or more views are obtained, consider using CPT 73610 instead, which is designated for complete ankle X-ray examinations with higher reimbursement.

Do I need to use a laterality modifier when billing CPT 73600?

Yes, you should append modifier RT (right) or LT (left) to CPT 73600 to indicate which ankle was imaged. While not all payers historically required laterality modifiers for diagnostic imaging, most Medicare Administrative Contractors and commercial payers now require them for claims processing. Failing to include laterality can result in claim denials or requests for additional information.

Can I bill CPT 73600 for both ankles on the same day?

Yes, when bilateral ankle X-rays are medically necessary and performed on the same date of service, bill CPT 73600 twice with appropriate laterality modifiers: 73600-RT for the right ankle and 73600-LT for the left ankle. Each service should be billed on a separate line item. Total reimbursement would be $62.10 (2 x $31.05) assuming both meet medical necessity requirements.

What is the difference between CPT 73600 and 73610 for ankle X-rays?

CPT 73600 is for a minimum ankle X-ray (minimum two views), while CPT 73610 represents a complete ankle X-ray examination (typically three or more views). CPT 73610 has higher reimbursement due to additional views. These codes are mutually exclusive - you should bill only the code that accurately reflects the number of views obtained. Never bill both codes for the same ankle on the same date.

How do I bill CPT 73600 when the radiologist is in a different location from where the X-ray was taken?

When the technical and professional components are performed in different settings, split the billing using modifiers. The facility where the X-ray equipment and technologist are located bills 73600-TC (technical component). The radiologist who interprets the images bills 73600-26 (professional component). Together, these components equal the global reimbursement of $31.05, split between technical and professional services.

What are common diagnosis codes used with CPT 73600 to establish medical necessity?

Common ICD-10 codes paired with 73600 include: S93.4 (sprain of ankle), S82.8 (fracture of lower leg), M25.57 (pain in ankle and joints of foot), M19.07 (primary osteoarthritis of ankle and foot), R26.2 (difficulty in walking), and M25.37 (ankle instability). The diagnosis code must support the medical necessity for ankle imaging based on the patient's clinical presentation, and should be as specific as possible including laterality when applicable.