CPT 73020
Global XXX ActiveX-ray exam of shoulder
CPT 73020 Billing & Documentation Guide
CPT code 73020 (X-ray exam of shoulder) is classified under Radiology with a global period indicator of XXX. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 0.15, a non-facility practice expense RVU of 0.48, and a malpractice RVU of 0.02, a total non-facility RVU of 0.65 and facility RVU of 0.65. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $22.42, though rates vary from $19.13 to $29.04 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 73020, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 73020 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
No global period (E/M and other non-procedural services)
MUE Limit (Medically Unlikely Edits)
Submitting more than 2 units of 73020 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 73020
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 0.15 | 0.15 |
| Practice Expense RVU | 0.48 | 0.48 |
| Malpractice RVU | 0.02 | 0.02 |
| Total RVU | 0.65 | 0.65 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 73020
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $24.52 | $24.52 | $23.02 - $29.04 | 29 |
| Florida | $22.4 | $22.4 | $21.34 - $23.39 | 3 |
| Georgia | $21.12 | $21.12 | $20.11 - $22.12 | 2 |
| Illinois | $21.79 | $21.79 | $20.69 - $22.69 | 4 |
| Michigan | $21.01 | $21.01 | $20.4 - $21.61 | 2 |
| North Carolina | $20.4 | $20.4 | $20.4 - $20.4 | 1 |
| New York | $24.04 | $24.04 | $20.71 - $25.63 | 5 |
| Ohio | $20.32 | $20.32 | $20.32 - $20.32 | 1 |
| Pennsylvania | $21.48 | $21.48 | $20.36 - $22.59 | 2 |
| Texas | $21.44 | $21.44 | $20.22 - $22.57 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 73020
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 73020 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 36591 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 36592 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 96523 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 0349T | Column 2 (secondary), bundled into primary | Yes | Misuse of Column Two code with Column One code |
| 0594T | Column 2 (secondary), bundled into primary | Yes | HCPCS/CPT procedure code definition |
| 20696 | Column 2 (secondary), bundled into primary | Yes | HCPCS/CPT procedure code definition |
| 20697 | Column 2 (secondary), bundled into primary | Yes | HCPCS/CPT procedure code definition |
| 73030 | Column 2 (secondary), bundled into primary | Yes | HCPCS/CPT procedure code definition |
| 73040 | Column 2 (secondary), bundled into primary | Yes | Standards of medical/surgical practice |
| 76006 | Column 2 (secondary), bundled into primary | Yes | More extensive procedure |
Frequently Asked Questions, CPT 73020
What does CPT code 73020 mean? +
CPT code 73020 represents: X-ray exam of shoulder. It's in the Radiology category with a global period of XXX.
What is the Medicare reimbursement for CPT 73020? +
The 2026 Medicare national average non-facility payment for CPT 73020 is $22.42. Rates range from $19.13 to $29.04 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 73020? +
Radiology codes rely heavily on the professional/technical split: modifier 26 (professional component only) and TC (technical component only). Also common: 50 (bilateral imaging), 76 (repeat by same physician), 77 (repeat by different physician), and LT/RT for laterality.
What bundling edits apply to CPT 73020? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
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