Imaging · Other

CT scan of the upper extremity (arm, forearm, wrist, elbow, or shoulder) performed without contrast material.

Verified May 8, 2026 · 6 sources ↓

Medicare: $160.66
Total RVUs: 4.81
Global, days
Region: Other

Drawn from CMSMedlearnAAPCMdclarity

Documentation requirements

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

Source · Editorial brief grounded in 6 cited references ↓

Radiology report must explicitly state 'without contrast' — technique documentation alone is insufficient for code selection
Clinical indication or ordering diagnosis must be documented and linked to a supporting ICD-10 code on the claim
Specify which anatomic segment of the upper extremity was imaged (e.g., elbow, forearm, wrist) in the report header
If bilateral studies are performed, document medical necessity for each side separately; use LT/RT modifiers on separate claim lines
Interpreting physician's signature and date must appear on the final report to support professional component billing
If modifier 26 is appended, the ordering and interpreting physician must be distinct from the facility providing the technical service

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

26 Professional component 52 Reduced services 59 Distinct service 76 Repeat, same physician 77 Repeat, another physician 22 Increased complexity LT Left side RT Right side

What this code covers

Source · Editorial summary grounded in 6 cited references ↓

CPT 73200 covers a computed tomography scan of the upper extremity acquired without the use of contrast dye. It applies to any segment of the upper limb — shoulder, arm, elbow, forearm, wrist, or hand — when the clinical question can be answered without IV contrast. Common indications include cortical bone detail, fracture assessment, osseous tumor evaluation, and pre-operative planning where soft-tissue enhancement is not required.

When contrast is needed, bill 73201 instead. When the study begins without contrast and then adds contrast, bill 73202. Choosing the wrong code in the trilogy is the most common coding error on upper extremity CT. The contrast status must be documented in the radiology order and the final report — not inferred from the technique section alone.

For orthopedic surgeons ordering and interpreting in-office or IDTF settings, the professional component (modifier 26) and technical component (TC) split applies. Surgeons billing only the read — for example, reviewing a study acquired at a hospital — append modifier 26. Global billing applies only when the practice owns the equipment and employs the technical staff. The bilateral payment indicator for 73200 means Medicare pays 100% of the fee schedule for each side when performed bilaterally, not the 150% rule that applies to surgical procedures.

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU	0.98
Practice expense RVU	3.75
Malpractice RVU	0.08
Total RVU	4.81
Medicare national rate	$160.66
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	$160.66
HOPD (APC 5522) Hospital outpatient department	$106.81

Common denial reasons

The recurring reasons claims for CPT 73200 get rejected.

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

Wrong contrast code selected — 73201 or 73202 billed when documentation supports a without-contrast-only study
Missing or unsupported ICD-10 diagnosis — payers deny when the clinical indication doesn't align with the imaged body part
Unbundling the CT guidance code when 73200 was ordered specifically to guide a same-session interventional procedure integral to that procedure
Professional component billed globally by a surgeon who does not own the imaging equipment or employ technical staff
Bilateral claim submitted without LT/RT modifiers or without separate medical necessity documentation for each side

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 6 cited references ↓

01What is the difference between 73200, 73201, and 73202?

73200 is without contrast. 73201 is with contrast. 73202 is without contrast followed by with contrast in the same session. Bill the code that matches the actual protocol performed — do not upgrade or downgrade based on preference.

02When should an orthopedic surgeon append modifier 26 to 73200?

Append modifier 26 when the surgeon interprets the CT but did not own or operate the equipment used to acquire it — for example, reading a hospital-acquired study in the office. Bill globally only when your practice owns the scanner and employs the tech staff.

03Can 73200 be billed bilaterally, and how?

Yes. Bill on two separate claim lines using modifier LT on one and RT on the other. Medicare pays 100% of the fee schedule amount per side — the 150% bilateral surgery rule does not apply to this diagnostic code.

04Is 73200 separately billable when ordered to guide a same-session procedure?

Not if the CT imaging is integral to the interventional procedure performed that day. Per NCCI policy, radiologic guidance included in or required for a procedural code cannot be separately reported. If the CT is a standalone diagnostic study ordered independent of any same-day intervention, it is separately reportable with modifier 59 if payer edits apply.

05What ICD-10 codes are commonly paired with 73200 in orthopedic settings?

Common pairings include fracture assessment codes (S-series), bone tumor surveillance (D48.0, C40-series), osteomyelitis (M86-series), and post-traumatic deformity evaluation (M21-series). The diagnosis must correspond to the specific anatomic segment imaged or payers will deny for mismatched site.

06Does 73200 have a global period?

No. 73200 carries a XXX global indicator, meaning no standard global period applies. E&M services on the same date are not restricted by global period rules for this code, though payer-specific bundling edits may still apply.

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 contrast status, anatomic segment imaged, and clinical indication directly from dictation — the three fields most likely to cause a code mismatch denial. When a surgeon dictates a post-study interpretation, the scribe flags whether the note supports global billing or professional-component-only billing based on the setting documented, preventing the most common 73200 overpayment audit trigger.

See how Mira captures CPT 73200 documentation