CPT 73719Radiology

Mri lower extremity w/dye

CPT code 73719 covers an MRI scan of the lower extremity (leg, ankle, or foot) performed with contrast dye injected into a vein to help visualize soft tissue structures, blood vessels, tumors, or inflammation more clearly.

Showing rates for

National Average

Base Medicare rate

$258.45

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

1.62

PE RVU (NF)

6.27

MP RVU

0.1

Total RVU

7.99

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

NCCI bundling edits

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Billing tips

Always append laterality modifiers (LT/RT) to specify which lower extremity was imaged, as many payers now reject claims without anatomic location
Impact: Prevents automatic denials and resubmission delays that can extend payment cycle by 30-45 days
Document contrast administration details including type, dose, route, and medical necessity in radiology report to support use of contrast code over non-contrast 73718
Impact: 73719 pays approximately $30-50 more than non-contrast 73718; inadequate documentation triggers downcoding
Split bill using 26 and TC modifiers when professional and technical components are performed by different entities to ensure both parties receive proper payment
Impact: Prevents payment disputes and ensures technical component receives $181-193 and professional component receives $65-77
Verify medical necessity with diagnosis codes that support contrast use such as neoplasm evaluation (C40.2x, D48.0), osteomyelitis (M86.x), or vascular malformation (Q27.x)
Impact: Unsupported diagnosis codes trigger LCD violations resulting in 100% payment denial
Check for prior authorization requirements before scheduling as most commercial payers require pre-certification for MRI with contrast
Impact: Failure to obtain authorization results in denial of entire $258.45 charge regardless of medical necessity
Do not bill 73719 with non-contrast 73718 for same extremity on same day unless separate clinical indication is clearly documented with modifier 59
Impact: Bundling edits will deny one code completely; improper modifier 59 use risks audit and potential $258.45 recoupment

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Frequently asked questions

What is the Medicare reimbursement rate for CPT 73719 in 2025?

The 2025 Medicare national average payment rate for CPT 73719 is $258.45 for both facility and non-facility settings, based on 7.99 total RVUs multiplied by the conversion factor of 32.3465.

What is the difference between CPT 73718 and 73719?

CPT 73718 is an MRI of the lower extremity without contrast material, while 73719 includes intravenous contrast dye administration. Code 73719 is used when contrast enhancement is medically necessary to better visualize tumors, infections, vascular structures, or inflammatory processes.

Does CPT 73719 require prior authorization?

Most Medicare Advantage and commercial insurance plans require prior authorization for CPT 73719. Traditional Medicare typically does not require prior authorization but does require medical necessity documentation. Always verify specific payer requirements before scheduling.

Can you bill CPT 73719 with modifier 26 for reading only?

Yes, modifier 26 should be appended to 73719 when the radiologist provides only the professional interpretation and report but does not own the imaging equipment. This splits the reimbursement between professional and technical components.

What diagnosis codes support medical necessity for CPT 73719?

Diagnosis codes supporting contrast-enhanced MRI include soft tissue neoplasms (C49.2x, D21.2x), bone tumors (C40.2x), osteomyelitis (M86.x), complex fractures requiring soft tissue evaluation, vascular malformations (Q27.x), and abscess evaluation (L02.4x). Simple sprains or routine follow-ups typically do not support contrast use.

How many RVUs is CPT code 73719 worth in 2025?

CPT 73719 has a total of 7.99 RVUs in 2025, consisting of 1.62 work RVUs, 6.27 practice expense RVUs (both facility and non-facility), and 0.10 malpractice RVUs.

Do you need to add a laterality modifier to CPT 73719?

Yes, laterality modifiers LT (left) or RT (right) are required for CPT 73719 to specify which lower extremity was imaged. Most payers will deny or reject claims missing appropriate laterality modifiers on unilateral extremity procedures.