Three-view radiographic examination of the knee joint, capturing anteroposterior, lateral, and a third angle such as a sunrise or oblique view.
Verified May 8, 2026 · 7 sources ↓
- Medicare
- $42.42
- Total RVUs
- 1.27
- Global, days
- Region
- Knee
Documentation requirements
What must appear in the operative or office note to support the claim.
Source · Editorial brief grounded in 7 cited references ↓
- Radiology report must name each view obtained (e.g., AP, lateral, sunrise/merchant, oblique) — 'standard views' is not sufficient
- Order or requisition must specify clinical indication (pain, trauma, suspected fracture, arthritis evaluation)
- Number of views captured must match the billed code — three views for 73562, not two, not four
- Laterality must be documented when LT or RT modifier is appended
- Interpreting provider's identity and credentials must appear on the radiology report when billing the professional component
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 7 cited references ↓
73562 covers a three-view knee X-ray — typically AP, lateral, and one additional view (sunrise, oblique, or tunnel depending on clinical indication). It sits between 73560 (one or two views) and 73564 (complete series, four or more views). The three-view series is the workhorse for evaluating acute knee pain, post-trauma assessment, early arthritis workup, and pre-operative planning when a full series isn't yet warranted.
View count is the gating factor for code selection. If only two views are captured, bill 73560. If four or more are taken, bill 73564. Billing 73562 when the imaging record reflects only two views is one of the most common audit triggers in outpatient orthopedic radiology. Document the specific views obtained — AP, lateral, sunrise, etc. — in the radiology report or operative note.
For bilateral imaging ordered as a single standing study, 73565 is the correct code, not two units of 73562. When both knees are imaged separately in the same session (e.g., affected knee three views, contralateral knee two views for comparison), bill the appropriate code for each side with LT and RT modifiers.
RVU & reimbursement
Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.
Source · CMS Physician Fee Schedule, RVU26A · January 2026
| Work RVU | 0.18 |
| Practice expense RVU | 1.07 |
| Malpractice RVU | 0.02 |
| Total RVU | 1.27 |
| Medicare national rate | $42.42 |
| 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 | $42.42 |
HOPD (APC 5521) Hospital outpatient department | $88.91 |
Common denial reasons
The recurring reasons claims for CPT 73562 get rejected.
Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓
- View count mismatch: imaging report lists two views but 73562 (three views) was billed
- Wrong code for bilateral standing study: two units of 73562 billed instead of 73565
- Missing laterality modifier when payer requires LT or RT for unilateral knee imaging
- Duplicate claim: 73562 billed same day as 73564 on the same knee without distinct documentation
- Bundling denial when billed alongside a same-day knee arthroscopy without modifier 59 establishing a separate, distinct imaging encounter
Frequently asked questions
Source · Generated from the editorial pipeline, verified against 7 cited references ↓
01What is the difference between 73560, 73562, and 73564?
02When should I use 73565 instead of billing 73562 twice for both knees?
03Do I need modifier LT or RT on 73562?
04Can 73562 be billed on the same day as a knee arthroscopy?
05When does modifier 26 apply to 73562?
06What ICD-10 codes are most commonly paired with 73562?
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/73562
- 03medibillmd.comhttps://medibillmd.com/blog/cpt-code-73562/
- 04lakemedicalimaging.comhttps://www.lakemedicalimaging.com/wp-content/uploads/2014/12/Updated-CPT-X-Ray.pdf
- 05payerprice.comhttps://payerprice.com/rates/73562-CPT-fee-schedule
- 06nhhealthcost.nh.govhttps://nhhealthcost.nh.gov/costs/medical/result/x-ray-of-knee-3-views
- 07cms.govhttps://www.cms.gov/files/document/04-chapter4-ncci-medicare-policy-manual-2025finalcleanpdf.pdf
Mira AI Scribe
The Mira AI Scribe captures the specific views obtained during the encounter — AP, lateral, and any additional view such as sunrise or oblique — directly from dictation. It flags when fewer than three views are documented before the claim is submitted, preventing the most common 73562 denial: a billed three-view series with only two views on record.
See how Mira captures CPT 73562 documentation