Imaging · Shoulder

Single-view radiographic examination of the shoulder joint

Verified May 8, 2026 · 4 sources ↓

Medicare: $21.71
Total RVUs: 0.65
Global, days
Region: Shoulder

Drawn from CMSCgsmedicare

Documentation requirements

What must appear in the operative or office note to support the claim.

Source · Editorial brief grounded in 4 cited references ↓

Number of views obtained must be explicitly stated — one view supports 73020; two or more require 73030
Clinical indication or ordering diagnosis documented in the requisition or order
Formal written radiology interpretation with findings, impression, and supervising/interpreting physician signature
If billing modifier 26, documentation must confirm physician performed the interpretation distinct from the technical acquisition
For post-procedure imaging, note whether the study was performed to assess procedure completeness — this determines professional component payability

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

26 Professional component LT Left side RT Right side 52 Reduced services 77 Repeat, another physician

What this code covers

Source · Editorial summary grounded in 4 cited references ↓

CPT 73020 covers a one-view radiograph of the shoulder. It is the lowest-tier shoulder imaging code and is appropriate only when a single projection is obtained. If two or more views are captured in the same session, 73030 (minimum two views, complete exam) is the correct code — billing 73020 plus 73030 together for a multi-view study is an NCCI violation. Per the 2026 NCCI Policy Manual, when two or more views are taken, 73030 with one unit of service replaces both codes.

The global period is XXX, meaning no pre- or post-operative services are bundled. Modifier 26 applies when the interpreting physician bills the professional component separately from the technical component (common in hospital outpatient and portable x-ray supplier settings). The technical component is reported with modifier TC. When the same provider owns the equipment and performs the interpretation, bill the global code without either modifier.

Orthopedic surgeons ordering or supervising shoulder films in-office will encounter this code most often in post-reduction checks and single-projection pre-op screening scenarios. Post-procedure imaging professional components are not separately payable per NCCI Chapter 9 — only the technical component may be billed when imaging is performed to assess completeness of a procedure such as fracture reduction.

RVU & reimbursement

Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU	0.15
Practice expense RVU	0.48
Malpractice RVU	0.02
Total RVU	0.65
Medicare national rate	$21.71
Global period	days

Payment by site of service

Medicare pays different rates by setting. HOPD typically pays substantially more than ASC for the same procedure.

Source · CMS OPPS Addendum B·ASC HCPCS payment rates·2026

Setting	Medicare rate (national)
Office (PFS non-facility) Procedure performed in physician's office	$21.71
HOPD (APC 5521) Hospital outpatient department	$88.91

Common denial reasons

The recurring reasons claims for CPT 73020 get rejected.

Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓

Unbundling: 73020 and 73030 billed together for the same shoulder on the same date — NCCI bundles these; use 73030 alone for multi-view studies
Professional component denied when post-procedure check imaging is billed with modifier 26 — NCCI bars separate professional component payment for post-reduction or post-procedure imaging
Bilateral billing without LT/RT modifiers when separate studies are ordered for each shoulder on the same date
Missing or unsigned interpretation report triggers medical necessity and documentation denials on audit
Site-of-service mismatch between the place of service on the claim and the modifier (26 vs. TC vs. global)

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 4 cited references ↓

01When should I use 73020 instead of 73030?

Use 73020 only when a single view of the shoulder is obtained. The moment two or more projections are taken in the same session, 73030 is the correct code. Billing 73020 and 73030 together for a multi-view study violates NCCI edits per the 2026 NCCI Policy Manual — 73030 subsumes 73020.

02Can the professional component of a post-reduction shoulder x-ray be billed separately?

No. Per NCCI Chapter 9 (2026), when imaging is performed to assess completeness of a procedure such as a fracture reduction, the professional component is not separately payable. Only the technical component may be reported in that scenario.

03How do I bill a shoulder x-ray when the radiologist interprets it but the orthopedic practice owns the equipment?

The orthopedic practice bills the technical component with modifier TC. The radiologist or interpreting physician bills the professional component with modifier 26. Neither bills the global code in this split-billing arrangement.

04Do I need LT or RT modifiers on 73020?

Yes, when the side is clinically relevant and both shoulders are imaged on the same date. Append LT or RT to distinguish each service. Many payers require laterality modifiers to process bilateral same-day claims without denial.

05Is 73020 ever appropriate for an orthopedic surgeon to bill directly, or is this radiology-only?

Orthopedic surgeons can bill 73020 with modifier 26 when they personally interpret the image and generate a formal written report. The top billing specialties per CMS data include Orthopedic Surgery alongside Diagnostic Radiology and Portable X-Ray Suppliers.

06What diagnosis codes commonly support 73020?

Shoulder pain (M25.511/512), acute trauma (fracture or dislocation ICD-10 codes at the shoulder), post-operative follow-up, and suspected foreign body are typical supporting diagnoses. The ICD-10 code must match the clinical indication documented in the order — a mismatch is a common audit trigger.

Sources & references

Editorial content was developed using the following public sources. Last verified May 8, 2026.

Mira AI Scribe

Mira's AI scribe captures the number of projections obtained, the clinical indication driving the order, and whether the study is a post-procedure check or a standalone diagnostic exam. It flags the view count at the point of coding so the coder selects 73020 vs. 73030 correctly before claim submission — preventing the most common NCCI unbundling denial on shoulder imaging.

See how Mira captures CPT 73020 documentation