CPT 73650Radiology

X-ray exam of heel

CPT code 73650 covers an X-ray examination of the heel (calcaneus), which creates images to diagnose fractures, bone spurs, heel pain, or other foot conditions. This is a common diagnostic imaging procedure ordered for patients with heel injuries or chronic foot pain.

Showing rates for

National Average

Base Medicare rate

$27.49

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)

0.67

MP RVU

0.02

Total RVU

0.85

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 many payers now require this for extremity imaging
Impact: Prevents 10-15% denial rate for missing laterality modifiers; ensures first-pass claim acceptance
Split bill with 26 and TC modifiers when professional and technical services are provided by different entities
Impact: Ensures accurate reimbursement split; prevents overpayment recovery audits worth up to $27.49 per claim
Document medical necessity clearly with specific ICD-10 codes linking to heel pain, trauma, or clinical indication
Impact: Reduces medical necessity denials by 20-30%; supports the $27.49 payment
Bill same day as office visit only when X-ray is separately identifiable and medically necessary beyond the E/M service
Impact: Avoids bundling issues; maintains separate $27.49 reimbursement in addition to E/M payment
Ensure minimum two views are documented in the radiology report to meet code requirements
Impact: Prevents downcoding or denials; single view may require use of a different, lower-paying code
For bilateral heel imaging, bill 73650 twice with RT and LT modifiers rather than using modifier 50
Impact: Some payers reimburse bilateral at 150% ($41.24) versus two separate claims at 200% ($54.98)

Common denials

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Frequently asked questions

What is the Medicare reimbursement rate for CPT 73650 in 2025?

The 2025 Medicare national average reimbursement rate for CPT 73650 is $27.49 for both facility and non-facility settings. This is based on 0.85 total RVUs multiplied by the 2025 conversion factor of 32.3465.

How many views are required to bill CPT 73650?

CPT 73650 requires a minimum of two views of the heel. Common projections include lateral and axial (calcaneal) views. If only a single view is obtained, this may not meet code requirements and could result in denial or require use of an alternative code.

Do I need to use a laterality modifier with CPT 73650?

Yes, most Medicare contractors and commercial payers require laterality modifiers RT (right) or LT (left) with CPT 73650. Failure to include laterality modifiers is an increasingly common cause of claim denials or requests for additional information.

Can I bill CPT 73650 bilaterally for both heels?

Yes, for bilateral heel X-rays, bill CPT 73650 twice on separate lines with RT modifier on one line and LT modifier on the other line. Some payers accept modifier 50 for bilateral procedures, but separate line billing with laterality modifiers is generally preferred and may result in higher reimbursement.

What is the difference between CPT 73650 and 73660?

CPT 73650 is for X-ray examination of the heel (calcaneus) with minimum two views, while CPT 73660 covers X-ray examination of the foot with minimum two views. Code selection depends on the anatomical area examined and documented medical necessity - 73650 focuses specifically on the heel bone.

When should I use modifier 26 with CPT 73650?

Use modifier 26 when billing only the professional component (physician interpretation and report) of the X-ray, such as when a radiologist interprets images taken at a different facility. The facility that provided the equipment and technical staff would bill 73650-TC for the technical component.

What ICD-10 codes support medical necessity for CPT 73650?

Common supporting diagnoses include M77.3 (calcaneal spur), S92.0 (fracture of calcaneus), M79.671/M79.672 (pain in right/left foot), M25.571/M25.572 (pain in right/left ankle and joints of foot), and codes for heel trauma, plantar fasciitis, or post-procedural follow-up. The diagnosis must justify the medical necessity for imaging.