Billing code 73560: Knee X-rayMedicare rate & RVUs in Virginia
Plain radiographic exam of one knee with one or two projections, typically AP and lateral, for knee pain, injury, arthritis assessment, or postoperative follow-up.
Medicare pays $33.72–$39.82 for 73560 in the office in Virginia, from Virginia to Dc + Md/Va Suburbs. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 73560 covers
This study captures one or two distinct radiographic views of a single knee, most often an anteroposterior and a lateral projection. Orthopedic surgeons, primary care physicians, urgent care clinicians, and emergency clinicians order it to look for fractures, effusion, joint space narrowing, osteophytes, loose bodies, or hardware position after surgery. A radiologic technologist acquires the images in an office, imaging center, or hospital, and a radiologist or the treating physician interprets them and documents a written report.
Code selection depends on the number of views of one knee. One or two views fall here, while three views or four or more views move to the higher codes. The report should state the views obtained, findings, and impression. The service splits into a professional component (modifier 26, interpretation) and a technical component (modifier TC, equipment and staff); billing without a modifier claims the global service, which is typical when an office owns the equipment and reads its own films. When both knees receive separate unilateral examinations, report each knee with RT or LT. CMS pays each side separately at 100%.
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.
Where 73560 pays more and less in Virginia
| Payment locality | Office | Facility |
|---|---|---|
| Dc + Md/Va Suburbs | $39.82 | Unavailable |
| Virginia | $33.72 | Unavailable |
How the 73560 rate is calculated
Each of 73560’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 73560
RVUs × geographic indexes × conversion factor
Work0.16
0.16 RVUs× 1.000 GPCI
Practice expense0.85
0.85 RVUs× 1.000 GPCI
Malpractice0.02
0.02 RVUs× 1.000 GPCI
Adjusted RVUs
1.0300
Conversion factor
$33.4009
Medicare rate
$34.40
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 73560
The CMS indicators that decide how 73560 is paid alongside other services.
CMS payment indicators · 73560
Knee X-ray
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 3 | Each side paid at 100% (no 150% cap). |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 1 | Diagnostic test with separate professional (26) and technical (TC) components. |
What modifiers do to the payment
Modifier 26 · payment effect
With and without the modifier
73560 without 26 · national office
$34.40
Knee X-ray
73560-26 · Professional component
$8.02
Pays only the interpretation and report.
73560 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 73562Knee X-ray
- Choose 73562 when exactly three projections of one knee are documented, often AP, lateral, and an oblique or patellar view; 73560 is limited to one or two views.
- 73564Knee X-ray
- Use 73564 for four or more views of one knee, such as a complete series with tunnel and sunrise views; 73560 covers only one or two.
- 73565Knee X-ray
- 73565 is a single standing AP image capturing both knees together for comparison; 73560 images one knee, and separate unilateral examinations are reported per side.
- 73590Lower-leg X-ray
- 73590 images the tibia and fibula shafts of the lower leg; 73560 is centered on the knee joint itself.
73560 billing questions
When should a knee film be reported with this code instead of the three-view or four-view codes?
Count the distinct projections of the same knee documented in the report. One or two views, such as AP and lateral, belong here; three views go to 73562 and four or more views to 73564.
How are separate films of both knees reported?
Report the unilateral examination separately for each knee, identified with RT and LT. CMS pays each side at 100%.
Is a single standing AP view of both knees on one image reported with this code?
No. A bilateral standing anteroposterior view capturing both knees together is reported with 73565. Do not automatically bill 73560 for additional views taken during the same knee examination.
When is modifier 26 or TC appended?
Append 26 when the physician only interprets the images, such as a radiologist reading hospital films, and TC when the entity only supplies equipment and technologist. An office that both takes and reads the films bills the global service without a modifier.
Can the ordering physician bill an interpretation if a radiologist also reads the film?
Medicare generally pays one interpretation per study, the one that contributes to the patient's diagnosis and is documented in a formal report. A brief review noted in an E/M note does not support a separate 26 claim.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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