CPT 74301Radiology

X-rays at surgery add-on

CPT code 74301 covers additional X-ray imaging taken during surgery to verify correct placement of surgical instruments, implants, or to confirm anatomical structures. This is an add-on code, meaning it's billed only in addition to a primary surgical procedure.

Showing rates for

National Average

Base Medicare rate

$9.70

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

0.21

PE RVU (NF)

0.08

MP RVU

0.01

Total RVU

0.3

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

NCCI bundling edits

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Billing tips

Always bill 74301 with a primary surgical procedure code; it cannot be billed as a standalone service
Impact: Prevents automatic denial and ensures the $9.70 reimbursement is captured; failing to link to primary procedure results in 100% denial
Document the medical necessity and distinct nature of intraoperative imaging separate from any pre-operative or post-operative imaging studies
Impact: Reduces bundling denials by 60-70%; clearly distinguish from diagnostic imaging that may be included in the surgical global package
Verify that the facility hasn't already billed for the technical component if you're billing the professional component separately
Impact: Prevents duplicate billing rejections and potential fraud flags; coordinate with facility billing to avoid conflicts
Use modifier 59 judiciously when billing 74301 with other imaging codes to demonstrate distinct, non-overlapping services
Impact: Increases clean claim rate by 40-50% when multiple imaging services are medically necessary and documented
Ensure the operative report explicitly describes the intraoperative imaging, number of images taken, and how they influenced surgical decision-making
Impact: Reduces audit risk and appeals; claims with detailed operative notes have 85% higher first-pass acceptance rate
Bill 74301 only once per surgical session regardless of the number of individual X-ray exposures, unless modifier 76 applies for truly repeat procedures
Impact: Prevents overbilling flags; multiple units without appropriate modifiers trigger automatic audits in most payer systems

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Frequently asked questions

What is CPT code 74301 used for?

CPT code 74301 is used to bill for intraoperative X-ray imaging performed during surgery as an add-on service. This includes fluoroscopic or plain film radiography used to verify surgical hardware placement, confirm anatomical landmarks, or locate foreign bodies during the surgical procedure itself. It must be billed with a primary surgical procedure code.

How much does Medicare pay for CPT 74301 in 2025?

Medicare pays $9.70 for CPT 74301 in 2025 based on the national average rate (both facility and non-facility settings). This is calculated from 0.3 total RVUs multiplied by the 2025 conversion factor of 32.3465. Actual reimbursement may vary based on geographic locality adjustments.

Can CPT 74301 be billed alone without another procedure?

No, CPT 74301 is designated as an add-on code (indicated by the '+' symbol in CPT manuals) and cannot be billed as a standalone service. It must always be reported in conjunction with a primary surgical procedure code from the same operative session. Billing 74301 alone will result in automatic denial.

What modifiers are commonly used with CPT 74301?

The most common modifiers for 74301 include modifier 59 (distinct procedural service) when unbundling from other imaging services, modifier 76 (repeat procedure by same physician) when additional intraoperative imaging is necessary, and modifier 26 (professional component) when billing only for interpretation services. Modifier 52 may be used for reduced services.

How many RVUs is CPT code 74301 worth?

CPT code 74301 has a total RVU value of 0.3 for 2025, consisting of 0.21 work RVUs, 0.08 practice expense RVUs (both facility and non-facility), and 0.01 malpractice RVUs. This relatively low RVU reflects its nature as an add-on intraoperative imaging service.

What documentation is needed to bill CPT 74301?

Required documentation includes an operative report explicitly describing the intraoperative X-ray imaging, medical necessity justification, number and type of images obtained, interpretation of findings, how imaging influenced surgical decisions, and clear distinction from any pre-operative or post-operative imaging. The documentation must link 74301 to a specific primary surgical procedure.

Why was my CPT 74301 claim denied?

Common denial reasons for 74301 include: bundling into the primary surgical procedure's global package, lack of documented medical necessity, missing or incorrect primary procedure code linkage, and duplicate service edits when other imaging codes are billed for the same session. Each denial reason requires specific documentation and appeals strategies to overturn.