Imaging · Foot & ankle

73590

Two-view radiographic examination of the tibia and fibula (lower leg), between the knee and ankle.

Verified May 8, 2026 · 5 sources ↓

Medicare
$31.40
Total RVUs
0.94
Global, days
Region
Foot & ankle
Drawn from CMSCgsmedicareBedrockbilling

Documentation requirements

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

Source · Editorial brief grounded in 5 cited references ↓

  • Clinical indication documenting why lower leg X-ray was ordered (e.g., pain, trauma, suspected fracture, post-op implant check)
  • Number of views obtained — minimum two views required to support the code
  • Radiologist or supervising physician interpretation with a signed, dated written report
  • Laterality documented — left, right, or bilateral — to support modifier LT, RT, or 50 as applicable
  • In IDTF settings: supervising provider credential (board-certified radiologist, orthopaedic surgeon, or podiatrist) documented per CMS IDTF requirements

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

26 Professional component 50 Bilateral procedure 52 Reduced services LT Left side RT Right side 22 Increased complexity 76 Repeat, same physician 77 Repeat, another physician

What this code covers

Source · Editorial summary grounded in 5 cited references ↓

73590 covers a minimum two-view X-ray of the lower leg — the tibia and fibula — excluding the knee and ankle joints themselves. It's the go-to code for evaluating tibial and fibular shaft pathology: stress fractures, acute fractures, healing checks, cortical lesions, periosteal reactions, and post-operative implant surveillance. The XXX global period means no pre- or post-service work is bundled in; each encounter bills independently.

Billing splits by component: the technical component (TC) covers acquisition and equipment; the professional component (modifier 26) covers the radiologist's or supervising physician's interpretation and report. When billed globally (no modifier), both components are captured together — typical when an orthopedic surgeon owns the equipment and reads the film in-office. In an IDTF setting, CMS requires a board-certified radiologist, orthopedic surgeon, or podiatrist as the supervising/interpreting provider, with a general radiographer or medical physicist performing the technical work.

Don't use 73590 when imaging includes the ankle or knee joint — 73562/73564 (knee series) or 73600/73610 (ankle) are the correct codes for joint-inclusive views. If stress fracture evaluation warrants additional views beyond two, modifier 22 with clear documentation of medical necessity supports the upcharge.

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU0.16
Practice expense RVU0.76
Malpractice RVU0.02
Total RVU0.94
Medicare national rate$31.40
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
$31.40
HOPD (APC 5521)
Hospital outpatient department
$88.91

Common denial reasons

The recurring reasons claims for CPT 73590 get rejected.

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

  • Missing or unsigned interpretation report — technical component paid but professional component denied
  • Wrong code selected when views include the ankle or knee joint — use 73600/73610 or 73562/73564 instead
  • Laterality missing on claim — payer unable to adjudicate bilateral versus unilateral service
  • Medical necessity not supported by diagnosis code — fracture follow-up or vague pain codes without supporting clinical documentation
  • IDTF credential mismatch — supervising provider type not approved by Medicare for 73590 at that facility

Frequently asked questions

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

01How many views are required to bill 73590?
A minimum of two views is required. If only one view is obtained, append modifier 52 to indicate a reduced service and document the clinical reason a second view was not feasible.
02Can 73590 be billed the same day as an E/M visit?
Yes. 73590 has a XXX global period, so it is not bundled into any E/M visit. No modifier 25 is needed on the E/M unless a separate, significant evaluation unrelated to the imaging order is required by your payer. The imaging code itself bills independently without a modifier.
03When do I use modifier 26 versus billing 73590 globally?
Use modifier 26 when you're billing only the professional component — interpretation and report — and the technical work was performed by a separate entity (e.g., a hospital or imaging center). Bill globally (no modifier) when your practice owns the equipment and employs the technologist. Bill with modifier TC if you're the facility capturing only the technical component.
04What code do I use if the X-ray includes the ankle joint?
Switch to 73600 (two-view ankle) or 73610 (minimum three-view ankle). 73590 covers the tibial and fibular shafts only. Imaging that captures the ankle mortise belongs under the ankle family of codes. Audit teams flag 73590 claims where the report describes ankle joint evaluation.
05Can 73590 be billed bilaterally?
Yes. Append modifier 50 for a bilateral exam performed at the same session, or use LT and RT on separate line items per payer preference. Confirm bilateral medical necessity in the clinical documentation — comparison views require a documented clinical reason.
06What are the IDTF supervisor requirements for 73590?
Per CMS Article A58559, an IDTF billing 73590 must have a board-certified radiologist, orthopaedic surgeon, or podiatrist as the supervising/interpreting provider. The technical work must be performed by a general radiographer or medical physicist. Failing to meet these credentials is a payment forfeiture, not just a documentation issue.
07Is 73590 subject to NCCI bundling edits with other lower extremity imaging codes?
Yes — NCCI Procedure-to-Procedure edits apply. Billing 73590 with overlapping lower extremity imaging codes for the same anatomical region on the same date will trigger a bundling denial unless a modifier is appropriate and supported by documentation of a distinct clinical reason for each study. Check the CMS NCCI PTP lookup before combining codes.

Sources & references

Editorial content was developed using the following public sources. Last verified May 8, 2026.

  1. 01CMS Physician Fee Schedule 2026
  2. 02
    cms.gov
    https://www.cms.gov/medicare-coverage-database/view/article.aspx?articleid=58559&ver=30&=
  3. 03
    cms.gov
    https://www.cms.gov/files/document/2025nccimedicarepolicymanualcompletepdf.pdf
  4. 04
    cgsmedicare.com
    https://www.cgsmedicare.com/medicare_dynamic/j15/partb/ptpb/ptp.aspx
  5. 05
    bedrockbilling.com
    https://bedrockbilling.com/static/cci/73590

Mira AI Scribe

Mira's AI scribe captures the clinical indication, number of views obtained, laterality, and the interpreting provider's findings from dictation — populating the written report fields that CMS and IDTF auditors check first. That prevents the two most common denials: an unsigned or missing interpretation report and a laterality mismatch between the claim and the medical record.

See how Mira captures CPT 73590 documentation

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