CPT 73610Radiology

X-ray exam of ankle

CPT code 73610 covers a standard x-ray examination of the ankle, typically performed to diagnose fractures, sprains, arthritis, or other bone and joint abnormalities.

Showing rates for

National Average

Base Medicare rate

$35.26

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

0.17

PE RVU (NF)

0.9

MP RVU

0.02

Total RVU

1.09

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

NCCI bundling edits

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Billing tips

Always append laterality modifiers (RT or LT) to prevent automatic denials; most payers require these for all extremity imaging as of 2025
Impact: Prevents 15-25% denial rate for missing laterality information, avoiding resubmission delays of 30-45 days
Bill the complete code (73610) rather than individual views; this code includes minimum three views and should not be reported per view
Impact: Prevents downcoding or denial; billing per view can trigger audit flags and result in full claim denial
When billing in a hospital setting, verify whether you are billing facility or non-facility rate based on place of service; both rates are identical at $35.26 for 73610
Impact: For this code specifically, no financial difference, but establishes correct billing practice patterns for other codes with rate differentials
Document medical necessity clearly in the order and indication; ankle pain alone may be insufficient for some commercial payers who apply Ottawa Ankle Rules criteria
Impact: Reduces denial rate by approximately 8-12% for medical necessity challenges, particularly for non-traumatic indications
Separate professional (26) and technical (TC) billing correctly based on ownership model; if you own equipment and provide interpretation, bill globally without modifier
Impact: Ensures full $35.26 reimbursement when appropriate; incorrect modifier use can reduce payment by 30-70%
When performing bilateral ankle x-rays, bill 73610-RT and 73610-LT separately with modifier 59 on the second line to bypass NCCI edits
Secures payment for both ankles ($70.52 total) versus single ankle payment if billed incorrectly

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Frequently asked questions

What is the Medicare reimbursement rate for CPT code 73610 in 2025?

The 2025 Medicare national average reimbursement for CPT 73610 is $35.26 for both facility and non-facility settings. This is based on 1.09 total RVUs multiplied by the 2025 conversion factor of 32.3465.

How many views are included in CPT code 73610?

CPT 73610 represents a complete ankle x-ray examination that typically includes a minimum of three views (anteroposterior, lateral, and mortise views). You should not bill this code multiple times for individual views; it is an all-inclusive code for the complete ankle examination.

Do I need to use a modifier when billing CPT 73610?

Yes, you must append laterality modifiers RT (right) or LT (left) to specify which ankle was examined. If billing only the professional or technical component, you also need modifier 26 or TC respectively. For bilateral ankle x-rays, bill 73610-RT and 73610-LT separately.

Can CPT 73610 be billed with an E/M code on the same day?

Yes, CPT 73610 can be billed with an E/M service on the same date if the evaluation and management service is significant and separately identifiable from the decision to order the x-ray. Append modifier 25 to the E/M code and ensure documentation supports a distinct service.

What is the difference between CPT 73610 and 73600?

CPT 73610 is a complete ankle x-ray (minimum 3 views), while CPT 73600 is a limited ankle x-ray (less than 3 views). Code 73610 reimburses at $35.26 compared to the lower rate for 73600, and you should select the code based on the number of views actually obtained.

What diagnosis codes are typically used with CPT 73610?

Common ICD-10 codes paired with 73610 include S93.40 (ankle sprain), S82.899 (ankle fracture), M25.579 (ankle pain), M19.079 (ankle arthritis), and R26.2 (difficulty walking). The diagnosis must support medical necessity for the imaging study.

How do I bill for bilateral ankle x-rays using CPT 73610?

Bill bilateral ankle x-rays as two separate line items: 73610-RT for the right ankle and 73610-LT for the left ankle. Add modifier 59 to the second line to indicate a distinct procedural service and prevent bundling. Total reimbursement would be $70.52 (2 × $35.26) if both are medically necessary and documented.