CPT 73615Radiology

Contrast x-ray of ankle

CPT code 73615 represents a specialized x-ray examination of the ankle joint performed after contrast material (dye) is injected into the joint space to visualize internal structures more clearly.

Showing rates for

National Average

Base Medicare rate

$120.65

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

0.54

PE RVU (NF)

3.15

MP RVU

0.04

Total RVU

3.73

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
Impact: Prevents automatic denial; approximately 15-20% of claims without laterality modifiers are rejected or delayed
Verify pre-authorization requirements as many payers require prior authorization for arthrography procedures
Impact: Failure to obtain pre-auth results in automatic denial; can delay payment by 30-60 days during appeal process
Bill contrast material separately using HCPCS codes (e.g., Q9966-Q9967) when performed in non-facility setting
Impact: Can add $20-50 to total reimbursement depending on contrast type and volume used
Document medical necessity for arthrography versus standard radiographs or MRI in the clinical indication
Impact: Reduces denial rate by approximately 25%; most payers require justification for why standard imaging is insufficient
Split bill professional and technical components (26/TC modifiers) only when services are actually performed in separate locations
Impact: Improper component splitting can trigger audit; combined billing yields full $120.65 versus reduced component rates
Do not bill 73615 with same-day ankle injection codes (20605) as the injection is included in the arthrography procedure
Impact: Unbundling violation will result in denial of the separate injection code and potential recoupment of $50-75

Common denials

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Frequently asked questions

What is the Medicare reimbursement rate for CPT 73615 in 2025?

The 2025 Medicare national average reimbursement for CPT 73615 is $120.65 for both facility and non-facility settings. This rate is based on 3.73 total RVUs multiplied by the 2025 conversion factor of 32.3465.

Does CPT 73615 require prior authorization from Medicare or commercial payers?

Medicare typically does not require prior authorization for 73615, but many Medicare Advantage and commercial payers do require pre-authorization for arthrography procedures. Always verify authorization requirements with the specific payer before scheduling the procedure to avoid denials.

Can I bill CPT 73615 with an ankle injection code on the same day?

No, you should not bill ankle joint injection code 20605 separately when performing arthrography (73615) because the contrast injection is an integral part of the arthrography procedure and is considered bundled. Billing both codes together will result in a denial for unbundling.

What modifiers are required when billing CPT 73615?

At minimum, you must append laterality modifiers RT (right) or LT (left) to specify which ankle was examined. Additionally, use modifier 26 for professional component only or TC for technical component only if the service is split-billed between physician and facility.

How do I bill for the contrast material used in ankle arthrography?

In non-facility settings, contrast material can be billed separately using appropriate HCPCS codes (such as Q9966-Q9967 for low osmolar contrast). In facility settings, contrast is typically included in the facility charge and should not be separately billed by the physician.

What documentation is needed to support medical necessity for CPT 73615?

Documentation must include the clinical indication explaining why arthrography is necessary versus standard x-rays or MRI, prior imaging results if available, specific symptoms or findings being evaluated (such as suspected ligament tear or osteochondral defect), and how the arthrography findings will impact treatment decisions.

What are the work RVUs and practice expense RVUs for CPT 73615?

For 2025, CPT 73615 has 0.54 work RVUs, 3.15 practice expense RVUs (both facility and non-facility), and 0.04 malpractice RVUs, totaling 3.73 total RVUs. These values are from the CMS Medicare Physician Fee Schedule RVU25A released December 23, 2024.