Radiologic examination of the humerus (upper arm bone), requiring a minimum of 2 views.
Verified May 8, 2026 · 6 sources ↓
- Medicare
- $32.06
- Total RVUs
- 0.96
- Global, days
- Region
- Shoulder
Documentation requirements
What must appear in the operative or office note to support the claim.
Source · Editorial brief grounded in 6 cited references ↓
- Clinical indication must specify the symptom, mechanism of injury, or diagnosis driving the study (e.g., 'fall on outstretched arm, rule out humeral shaft fracture').
- Radiology report must confirm a minimum of 2 views were obtained and name the projections (e.g., AP and lateral).
- Laterality must be documented — left, right, or bilateral — to support LT/RT modifier assignment.
- Ordering provider's name and NPI must appear on the order to establish medical necessity.
- If comparison views of the contralateral humerus are obtained, document the clinical reason for bilateral imaging.
- ICD-10 diagnosis code must map to a condition affecting the humerus; shoulder-joint or elbow-specific diagnoses without humeral involvement invite scrutiny.
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 6 cited references ↓
CPT 73060 covers a plain-film X-ray series of the humerus — the long bone running from the shoulder joint to the elbow — with a minimum of 2 views required. The study is ordered to evaluate fractures, dislocations, cortical lesions, bone tumors, arthritis, or congenital abnormalities of the upper arm. Common projections include AP and lateral; oblique or comparison views may be added based on clinical indication without changing the code.
This code sits within the upper extremity diagnostic radiology family alongside 73020 (shoulder, 1 view), 73030 (shoulder, complete), and 73090 (forearm, 2 views). 73060 is specific to the humeral shaft and the bone itself — it does not capture the shoulder joint or elbow joint in isolation. If the clinical question involves the glenohumeral joint, shoulder codes apply; if it involves the elbow, use 73080.
Billing splits between professional and technical components using modifier 26 (interpretation only) or TC (equipment and technologist only) when the radiologist and facility bill separately. Laterality modifiers LT and RT are expected by most payers when a single extremity is imaged. The global period is XXX, meaning the standard surgical global rules do not apply — each encounter bills independently.
RVU & reimbursement
Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.
Source · CMS Physician Fee Schedule, RVU26A · January 2026
| Work RVU | 0.16 |
| Practice expense RVU | 0.78 |
| Malpractice RVU | 0.02 |
| Total RVU | 0.96 |
| Medicare national rate | $32.06 |
| 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 | $32.06 |
HOPD (APC 5521) Hospital outpatient department | $88.91 |
Common denial reasons
The recurring reasons claims for CPT 73060 get rejected.
Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓
- Missing or incorrect laterality modifier — most payers require LT or RT on unilateral extremity imaging and will reject or deny without it.
- ICD-10 mismatch — shoulder-joint diagnoses (e.g., glenohumeral arthritis codes) paired with 73060 trigger medical necessity denials; the diagnosis must implicate the humeral bone or shaft.
- Insufficient view count documented — if the radiology report only confirms 1 view, payers may deny or down-code; the minimum is 2 views.
- Duplicate billing conflict — 73060 billed same-day as 73030 or 73080 without modifier 59 or XS to establish that distinct anatomic regions were imaged.
- Missing professional component split — freestanding radiology groups billing global when the facility owns the equipment, or vice versa, generate claim mismatches.
Frequently asked questions
Source · Generated from the editorial pipeline, verified against 6 cited references ↓
01Does 73060 require exactly 2 views, or can more be taken?
02When should I use 73060 versus 73030 (shoulder X-ray)?
03Can 73060 be billed bilaterally?
04How do modifier 26 and TC split work for 73060?
05What ICD-10 codes are appropriate pairings for 73060?
06Is modifier 76 or 77 appropriate if a second humerus X-ray is taken the same day?
Sources & references
Editorial content was developed using the following public sources. Last verified May 8, 2026.
- 01CMS Physician Fee Schedule 2026
- 02aapc.comhttps://www.aapc.com/codes/cpt-codes/73060
- 03mdclarity.comhttps://www.mdclarity.com/cpt-code/73060
- 04cms.govhttps://www.cms.gov/medicare/coding-billing/ncci-medicaid
- 05cms.govhttps://www.cms.gov/files/document/chapter9cptcodes70000-79999final11.pdf
- 06lakemedicalimaging.comhttps://www.lakemedicalimaging.com/wp-content/uploads/2014/12/Updated-CPT-X-Ray.pdf
Mira AI Scribe
Mira's AI scribe captures the dictated clinical indication (mechanism, symptom, suspected diagnosis), number and type of views obtained, laterality, and the interpreting radiologist's findings from the operative or clinic note. That structured capture prevents the two most common 73060 denials: a missing laterality modifier and an ICD-10 code that doesn't map to humeral pathology.
See how Mira captures CPT 73060 documentation