Imaging · Shoulder

73040

Fluoroscopic shoulder arthrography with radiological supervision and interpretation — full radiographic/fluoroscopic imaging of the shoulder joint using contrast material.

Verified May 8, 2026 · 5 sources ↓

Medicare
$134.61
Total RVUs
4.03
Global, days
Region
Shoulder
Drawn from CMSBraccoreimbursementEmednyFindacode

Documentation requirements

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

Source · Editorial brief grounded in 5 cited references ↓

  • Indication for arthrogram (e.g., suspected rotator cuff tear, labral pathology, adhesive capsulitis evaluation)
  • Documentation that a full fluoroscopic arthrogram series was performed — not just needle-placement scout images
  • Formal written radiology interpretation report with findings, impression, and supervising radiologist signature
  • Laterality documented explicitly (right, left, or bilateral)
  • Contrast agent used, volume injected, and confirmation of intra-articular placement
  • Distinction noted if 23350 (injection) and 77002 (fluoro guidance) are billed on the same date — each has a separate reportable role

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

What this code covers

Source · Editorial summary grounded in 5 cited references ↓

73040 is the radiographic and fluoroscopic arthrogram of the shoulder — not a scout image, not a check shot for needle placement. The code requires a complete fluoroscopic imaging series of the shoulder joint with contrast, plus formal radiological supervision and interpretation. It is distinct from 23350 (the injection procedure itself) and from CT arthrogram (73201) or MR arthrogram (73222). All three modalities require 23350 for the injection; only 73040 is paired when the imaging is purely radiographic/fluoroscopic.

The most common coding error with 73040 is reporting it when contrast is injected solely to confirm needle position before CT or MRI. One or two scout images to verify intra-articular placement do not constitute an arthrogram under this code. If the patient goes directly to CT or MRI after injection, bill 23350 (plus 77002 if fluoro guidance was used) alongside 73201 or 73222 — not 73040.

Bilateral shoulder arthrograms are uncommon but reportable with modifier 50. When the radiologist performs only the supervision and interpretation and a separate facility owns the equipment, split billing with modifier 26 (professional component) and TC (technical component) applies. LT/RT are standard for unilateral laterality documentation. Global period is XXX, meaning no global surgical package applies — pre- and post-service work is captured in the RVU.

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU0.53
Practice expense RVU3.46
Malpractice RVU0.04
Total RVU4.03
Medicare national rate$134.61
Global perioddays

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

SettingMedicare rate (national)
Office (PFS non-facility)
Procedure performed in physician's office
$134.61
HOPD (APC 5572)
Hospital outpatient department
$356.43

Common denial reasons

The recurring reasons claims for CPT 73040 get rejected.

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

  • 73040 submitted when only scout/check images were taken before CT or MR arthrogram — payers treat this as unbundling; correct pairing is 23350 + 73201 or 73222
  • Missing or unsigned formal radiology interpretation report — no report, no 73040
  • Laterality modifier absent when payer requires LT or RT for unilateral shoulder studies
  • Modifier 26 or TC missing when professional and technical components are billed by separate entities
  • Medical necessity not supported — no ICD-10 diagnosis linking to clinical need for contrast arthrography over standard plain films

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 5 cited references ↓

01What's the difference between 73040 and 23350?
23350 is the injection procedure for shoulder arthrography — used regardless of whether the follow-on imaging is fluoroscopic, CT, or MRI. 73040 is the fluoroscopic/radiographic imaging and interpretation component, billed only when a full radiographic arthrogram series is performed. For CT arthrogram, pair 23350 with 73201; for MR arthrogram, pair 23350 with 73222.
02Can I bill 73040 and 73222 together when contrast is injected before an MRI?
No. If the imaging is MR arthrogram, bill 23350 + 73222 (plus 77002 if fluoro guidance was used for injection). 73040 is reserved for cases where a full fluoroscopic arthrogram series is actually performed and interpreted — not just a needle check before the patient moves to the MRI suite.
03How do I split-bill 73040 when the radiologist and facility are separate entities?
The radiologist bills 73040-26 for professional supervision and interpretation. The facility bills 73040-TC for equipment, supplies, and technical staff. Both claims reference the same date of service and the same patient encounter.
04Is modifier 50 appropriate if both shoulders are examined?
Yes. Bilateral shoulder arthrograms on the same date are reportable with modifier 50. Some payers prefer two line items with LT and RT instead — verify payer preference before submitting, as payment methodology differs.
05What ICD-10 codes typically support medical necessity for 73040?
Common supporting diagnoses include rotator cuff pathology (M75.1x), labral tear (S43.xx), glenohumeral instability (M25.31x), adhesive capsulitis (M75.0x), and post-surgical shoulder evaluation. Payers expect the diagnosis to justify contrast arthrography specifically, not just shoulder imaging in general.
06Does 73040 carry a global period?
No. 73040 has a global period of XXX, meaning it is not subject to the standard global surgical package rules. Pre- and post-service physician work is factored into the RVU directly.
07Can 77002 be billed with 73040?
Yes, when fluoroscopic guidance is used to direct needle placement for the contrast injection, 77002 is separately reportable alongside 23350 and 73040. Confirm the fluoroscopic guidance is documented in the procedure note — guidance integral to the injection without separate documentation is not billable.

Mira AI Scribe

Mira's AI scribe captures the specific imaging modality performed (full fluoroscopic arthrogram series vs. needle-placement scout only), laterality, contrast agent and volume, intra-articular confirmation, and the interpreting radiologist's findings and impression. This prevents the most common 73040 denial: submitting the code when only a scout image was acquired before CT or MRI, which auditors flag as upcoding. The scribe also flags when 23350 and 77002 should accompany the claim.

See how Mira captures CPT 73040 documentation

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