CPT 73723Radiology

Mri joint lwr extr w/o&w/dye

CPT code 73723 is used when a doctor orders an MRI scan of a joint in the lower body (like a knee, ankle, or hip) that is performed twice: once without contrast dye and again after injecting contrast dye into a vein to get clearer images.

Showing rates for

National Average

Base Medicare rate

$377.48

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

2.15

PE RVU (NF)

9.37

MP RVU

0.15

Total RVU

11.67

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 for bilateral joints (knee, ankle, hip) as many payers will auto-deny claims lacking anatomic specificity
Impact: Prevents initial denial and 30-45 day payment delay; reduces administrative costs of resubmission by approximately $25-40 per claim
Document clear medical necessity for BOTH non-contrast and contrast phases in the order, as contrast addition increases complexity and some payers require pre-authorization for 73723 versus 73721
Impact: Reduces denial rate by 35-40% compared to claims with generic orders; contrast justification prevents downcoding to 73721 which pays approximately $100 less
For hospital outpatient settings, verify that both technical and professional components are billed correctly - facilities bill the technical component to institutional claim while radiologist bills professional component separately
Impact: Prevents revenue leakage of 40-50% when only one component is billed; ensures full $377.48 reimbursement is captured between both claims
When billing 73723 with other E/M services on the same date, ensure separate documentation establishes that the decision for MRI was made during that encounter or append modifier 25 to the E/M if appropriate
Impact: Protects E/M reimbursement which may be bundled or reduced without proper documentation; preserves additional $75-200 depending on E/M level
Verify authorization requirements before scheduling as many commercial payers require pre-authorization for contrast-enhanced MRI and will deny the entire $377.48 claim retroactively without it
Impact: Prevents 100% claim denial; pre-authorization compliance improves first-pass claim acceptance rate to above 95%

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Frequently asked questions

What is the difference between CPT 73721 and 73723?

CPT 73721 is for MRI of a lower extremity joint without contrast material only, while 73723 includes imaging both without contrast AND with intravenous contrast. Code 73723 reimburses at $377.48 compared to approximately $275 for 73721, reflecting the additional imaging sequences and contrast administration required.

Does Medicare pay the same rate for 73723 in hospital vs office settings?

Yes, for CPT 73723 the 2025 Medicare rate is $377.48 in both facility and non-facility settings, which is unusual as many codes have different rates. However, this represents the combined technical and professional component - these are typically billed separately in hospital settings.

Can I bill 73723 for bilateral joints on the same date?

Yes, you can bill 73723 twice with RT and LT modifiers when both right and left joints are imaged separately (e.g., both knees). Add modifier 59 to the second code to indicate a distinct service. However, verify payer policy as some may require modifier 50 instead or may have bilateral imaging restrictions.

What diagnosis codes support medical necessity for 73723?

Diagnosis codes that typically support 73723 include suspected or confirmed joint infection (M00.x-M01.x), bone tumors (C40.x, D16.x), avascular necrosis (M87.x), inflammatory arthritis (M05.x-M14.x), internal derangement (M23.x for knee), and complex trauma. Generic pain codes alone may result in denial or request for non-contrast imaging first.

Do I need prior authorization for CPT 73723?

Prior authorization requirements vary by payer. Most Medicare Advantage plans and many commercial insurers require pre-authorization for contrast-enhanced MRI studies including 73723. Original Medicare typically does not require pre-auth but does require medical necessity. Always verify with the specific payer before scheduling.

How many RVUs is CPT code 73723 worth in 2025?

CPT 73723 has a total of 11.67 RVUs in 2025, consisting of 2.15 work RVUs, 9.37 practice expense RVUs, and 0.15 malpractice RVUs. When multiplied by the 2025 conversion factor of 32.3465, this equals the Medicare payment rate of $377.48.

Can CPT 73723 be billed with an office visit on the same day?

Yes, 73723 can be billed with an E/M service on the same day if the E/M represents a significant, separately identifiable service. The decision to order the MRI may be made during the visit, but the E/M must be documented as separate from the imaging interpretation. Modifier 25 is typically not required on the imaging code but may be needed on the E/M depending on payer requirements.