$45.43
73562 covers exactly three views of one knee. If four or more distinct projections are obtained, use 73564.
On this page
CMS RVU26D · Effective 2026-10-01
73564 Knee X-ray Medicare reimbursement rates in Connecticut
Plain radiographs of one knee taken in at least four distinct views, reported for evaluation of arthritis, injury, patellar concerns, or knee replacement position. Compare 73564 office and facility rates across CMS payment localities in Connecticut.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 73564 in Connecticut?
Connecticut has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$52.93
1 of 1 localities have a supported rate.
Payment area: Connecticut
One mapped payment locality.
Facility setting
No supported rate
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Radiology
About 73564: Knee radiograph, four or more views
Plain radiographs of one knee taken in at least four distinct views, reported for evaluation of arthritis, injury, patellar concerns, or knee replacement position.
This study obtains four or more distinct radiographic views of one knee. A series may combine AP and lateral views with oblique, tangential patellar, tunnel, or standing weight-bearing views. Orthopedic, sports medicine, and primary care clinicians order these images to evaluate osteoarthritis, fractures, patellar alignment, or knee replacement position. Technologists acquire the images in physician offices, imaging centers, and hospital outpatient departments; a radiologist or treating physician interprets them.
Select the code by counting distinct views obtained of each knee. The imaging record should identify the views or their number; a label such as “complete knee” alone does not establish the count. One or two views are reported with 73560, and three with 73562. Modifier 26 identifies the separately billed interpretation and report, while modifier TC identifies the separately billed imaging equipment, staff, and supplies. Billing without either modifier represents the global service. When four or more views are obtained of both knees, count and report each knee separately; CMS pays each side at 100% when performed bilaterally.
CMS billing rules for 73564
- Professional and technical components
- Diagnostic test with a professional component (modifier 26, interpretation) and a technical component (modifier TC, equipment and staff); billing without a modifier is the global service.
- Bilateral procedures
- Each side is paid separately at 100% when performed bilaterally.
Where the value comes from
- Work RVU0.21 · 14%
- Practice expense (office) RVU1.25 · 84%
- Malpractice RVU0.02 · 1%
1.8M
Medicare services in 2024 · #89 by national volume
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
73564 compared with similar codes
Office rates for Connecticut, from the same CMS release.
$36.84
73560 covers one or two views of a knee. Four or more documented views of that knee support 73564.
$45.11
73565 covers standing AP imaging of both knees. 73564 covers four or more distinct views of a knee, reported for each knee imaged.
$125.52
73580 covers radiologic supervision and interpretation of knee arthrography using intra-articular contrast. 73564 covers a plain radiographic knee study with four or more views.
Compare 73564 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Connecticut →
Office / nonfacility
$52.93
Facility
Unavailable
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 73564 in Connecticut.
PPRRVU2026_Oct_nonQPP.csv
8,219
- Code
- 73564
- Physician work
- 0.21
- Practice expense
- 1.25
- Malpractice
- 0.02
GPCI2026.csv
38
- Locality
- Connecticut
- Physician work
- 1.020
- Practice expense
- 1.077
- Malpractice
- 1.210
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.21 | × 1.020 | 0.2142 |
| Practice expense | 1.25 | × 1.077 | 1.3462 |
| Malpractice | 0.02 | × 1.210 | 0.0242 |
| Total RVUs | 1.5846 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Connecticut$52.93
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.21 | 1.02 |
| Practice expense | 1.25 | 1.077 |
| Malpractice | 0.02 | 1.21 |
(0.21 × 1.02 + 1.25 × 1.077 + 0.02 × 1.21) × $33.4009 = $52.93
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
73564 billing questions
How are views counted to choose this code over 73562?
Count distinct projections of the same knee documented in the imaging record. Three views support 73562, and four or more support 73564; repeat images of the same projection do not add a view.
How is this reported when both knees get four or more views?
Document the view count for each knee and report the bilateral service with side-specific claim information. CMS pays each side separately at 100%.
When should modifier 26 or TC be appended?
Use 26 for a separately billed interpretation and report, such as a physician reading images acquired by a hospital outpatient department. Use TC for separately billed image acquisition; bill globally when the billing entity furnishes both components.
Is a bilateral standing AP view the same as this code?
No. Code 73565 describes standing AP imaging of both knees. Code 73564 requires at least four distinct views of each knee reported.
Can a treating orthopedist bill the interpretation?
Yes, if the orthopedist interprets the knee images and documents a report. Modifier 26 identifies that professional component when another entity furnishes the imaging.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
8,21673562,,X-ray exam of knee 3,A,,0.18,1.07,,1.07,NA,0.02,1.27,1.27,1,XXX,0.00,0.00,0.00,0,3,0,0,0,9,,33.4009,09,0,99,2.72,2.72,0.04
8,21773562,26,X-ray exam of knee 3,A,,0.18,0.09,,0.09,,0.01,0.28,0.28,1,XXX,0.00,0.00,0.00,0,3,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
8,21873562,TC,X-ray exam of knee 3,A,,0.00,0.98,,0.98,NA,0.01,0.99,0.99,1,XXX,0.00,0.00,0.00,0,3,0,0,0,9,,33.4009,09,0,99,2.63,2.63,0.03
8,21973564,,X-ray exam knee 4 or more,A,,0.21,1.25,,1.25,NA,0.02,1.48,1.48,1,XXX,0.00,0.00,0.00,0,3,0,0,0,9,,33.4009,09,0,99,3.28,3.28,0.04
8,22073564,26,X-ray exam knee 4 or more,A,,0.21,0.11,,0.11,,0.01,0.33,0.33,1,XXX,0.00,0.00,0.00,0,3,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
8,22173564,TC,X-ray exam knee 4 or more,A,,0.00,1.14,,1.14,NA,0.01,1.15,1.15,1,XXX,0.00,0.00,0.00,0,3,0,0,0,9,,33.4009,01,0,99,3.17,3.17,0.03
8,22273565,,X-ray exam of knees,A,,0.16,1.08,,1.08,NA,0.02,1.26,1.26,1,XXX,0.00,0.00,0.00,0,2,0,0,0,9,,33.4009,09,0,99,2.72,2.72,0.04
3501112,CA,70,YUBA CITY,1.017,1.096,0.536
3601112,CA,75,REST OF CALIFORNIA,1.017,1.096,0.536
3704112,CO,01,COLORADO,1.012,1.064,0.781
3813102,CT,00,CONNECTICUT,1.020,1.077,1.210
3912202,DC,01,DC + MD/VA SUBURBS,1.054,1.178,1.113
4012102,DE,01,DELAWARE,1.005,0.988,0.899
4109102,FL,03,FORT LAUDERDALE,1.000,1.013,1.808