Imaging · Knee

Radiologic examination of both knees in the standing, weight-bearing anteroposterior position — a single code that covers both sides simultaneously.

Verified May 8, 2026 · 6 sources ↓

Medicare: $42.09
Total RVUs: 1.26
Global, days
Region: Knee

Drawn from CMSAAPCGomedicalbilling

Documentation requirements

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

Source · Editorial brief grounded in 6 cited references ↓

Physician order must specify bilateral standing anteroposterior views — not just 'knee X-ray'
Medical necessity documented for imaging both knees, not just the symptomatic side
Radiology report must confirm weight-bearing (standing) position was used for the AP projection
If billed alongside a unilateral knee X-ray code, separate clinical indication for each side must be documented
Ordering diagnosis must link to both knees when 73565 is the sole code billed

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

26 Professional component 59 Distinct service 76 Repeat, same physician 77 Repeat, another physician XS Separate structure

What this code covers

Source · Editorial summary grounded in 6 cited references ↓

73565 is the correct code when a standing anteroposterior view is taken of both knees on a single film. The weight-bearing position is the defining clinical feature: it loads the joint and reveals compartment narrowing that non-weight-bearing views miss. Because the code descriptor inherently covers both knees, no LT/RT or modifier 50 is required.

Code selection within the knee X-ray family hinges on view count and laterality. 73565 is appropriate only when the standing AP is the sole study ordered — or when there is documented medical necessity to image both knees. If the standing AP is added to a unilateral multi-view study, it becomes an additional view that rolls into 73560, 73562, or 73564 depending on total view count. If the right knee is being imaged only for comparison with a symptomatic left knee, do not bill 73565; bill only the symptomatic side.

73565 has four documented NCCI bundling edit pairs. The most commonly triggered edit occurs when 73565 is billed same-day with 73562 or 73564 for the same encounter without a modifier establishing a distinct clinical reason. Run your claim through an NCCI scrubber before submission. When separate medical necessity exists for both a multi-view unilateral study and bilateral standing views, modifier 59 or XS on the lower-column code supports the distinct service.

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	1.08
Malpractice RVU	0.02
Total RVU	1.26
Medicare national rate	$42.09
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	$42.09
HOPD (APC 5521) Hospital outpatient department	$88.91

Common denial reasons

The recurring reasons claims for CPT 73565 get rejected.

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

Bilateral code billed when only the symptomatic side had documented medical necessity — comparison views do not support 73565
73565 billed same-day with 73562 or 73564 without a modifier, triggering NCCI bundling edit
Modifier 50 or LT/RT appended unnecessarily — 73565 already describes both knees and does not require anatomical modifiers
Missing or non-specific radiology order (e.g., 'knee X-ray') when a standing bilateral view requires explicit physician direction
ICD-10 diagnosis code reflects unilateral pathology only, creating a mismatch with a bilateral imaging code

Frequently asked questions

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

01Do I append modifier 50, LT, or RT to 73565?

No. 73565 describes both knees by definition. Appending 50, LT, or RT is incorrect and will cause claim errors or payment reductions. Bill the code once, no anatomical modifier.

02Can I bill 73565 and 73564 together for the same encounter?

Only if there is separate documented medical necessity for each study and you attach modifier 59 or XS to the lower-column code. Without a modifier, the NCCI edit will bundle 73562/73564 into 73565 and reduce payment to a single allowable.

03The physician ordered the right knee and added the left for comparison. Can I bill 73565?

No. Comparison views do not establish medical necessity for the contralateral side. Bill only the symptomatic side using 73560, 73562, or 73564 based on view count. Do not add 73565.

04When is the standing AP view counted as an additional view rather than billed as 73565?

When it is performed as part of a unilateral multi-view study. A standing AP added to an AP and lateral of the left knee makes that a three-view study — bill 73562-LT. The standing AP is absorbed into the view count, not billed separately as 73565.

05Which modifier splits the technical and professional components of 73565?

Modifier 26 for the professional component (interpretation only) and TC for the technical component (equipment and technologist). Use 26 when your orthopedic group interprets images taken at a hospital or imaging center that bills separately for the technical work.

06What ICD-10 codes most commonly support 73565 medical necessity?

Bilateral osteoarthritis codes (M17.0, M17.11–M17.12 combined when both sides are symptomatic), bilateral knee pain (M25.561–M25.562), and deformity codes involving both knees are typical. A unilateral diagnosis code paired with 73565 is a common mismatch that triggers denial.

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 standing weight-bearing position, bilateral clinical indication, and ordering diagnosis from dictation — then flags when the note documents symptoms in only one knee, preventing a 73565 claim that will deny for lack of bilateral medical necessity. It also detects same-day unilateral knee X-ray codes and prompts the biller to confirm whether an NCCI modifier is needed before submission.

See how Mira captures CPT 73565 documentation