CPT Code for X-Ray: Body Area, Views and Modifiers

There is no single CPT code for an X-ray. Plain X-ray codes sit in the diagnostic radiology section of CPT (the 70000s) and are chosen by the body area imaged and, for most areas, by the number of views taken. A chest X-ray, for example, is 71045, 71046, 71047 or 71048 depending on whether one, two, three, or four or more views were taken. The code has to match the views the report documents, not the views that were ordered.

The rules below are Medicare's, from the CMS fee schedule files, the Medicare Claims Processing Manual and the National Correct Coding Initiative (NCCI) policy manual. Other payers set their own policies, so check the payer's policy for the date of service. What an X-ray is paid, and what a patient owes, depends on the payer, the plan and the locality; for Medicare, use the Physician Fee Schedule look-up.

How are X-ray codes organized?

By body area first, then by the extent of the study. Some common examples, described in our own words:

All of these are active codes in the 2026 Medicare fee schedule (RVU26D). For areas split into a shorter and a complete study, the CPT descriptor sets the minimum number of views for each, so check it against the views in the report.

X-rays taken with contrast, fluoroscopy, CT, MRI and ultrasound all have their own code families. For MRI of the knee or ankle, see the guide to CPT code 73721.

How do you pick the right X-ray code?

1. Start from the report. Count the views actually taken and documented. If the order says "complete" but the report shows two views, code two views.
2. Code each body area separately. A chest X-ray and a hand X-ray on the same day are two codes.
3. Report each side. For a single-side code such as 73560 done on both knees, Medicare expects each side reported (RT and LT); the fee schedule prices each side separately for these codes. A code that already describes both sides, such as 73565, is reported once.
4. Don't add separate codes for parts of the study. Under NCCI, all the radiographs needed to complete a study are included in its code, and preliminary or delayed films in a contrast study aren't reported separately.

Unlike MRI and CT, plain X-ray codes are not subject to Medicare's multiple procedure payment reduction for imaging (their multiple procedure indicator is 0 in the 2026 file).

How do the 26 and TC modifiers work for X-rays?

X-ray codes carry PC/TC indicator 1: each has a professional component (the physician's interpretation and written report) and a technical component (the equipment, staff and supplies).

• No modifier (global): the same practice took the X-ray and read it.
• Modifier 26: only the reading. For a Medicare hospital patient, the hospital is paid for the technical component, and the reading physician bills with modifier 26.
• Modifier TC: only the technical side, when a different physician reads the study.

A practice that takes an X-ray and has it read by an outside radiologist bills TC; the radiologist bills 26. Billing the global code when someone else read the film pays for work the practice didn't do.

What are the FX and FY modifiers?

Two Medicare modifiers identify older X-ray technology, and each reduces payment for the technical component:

• FX marks an X-ray taken using film. Medicare reduces the technical component by 20%.
• FY marks an X-ray taken using computed radiography, meaning cassette-based imaging plates. The reduction has been 10% since 2023.

Digital radiography needs neither. If your equipment is film or computed radiography, the modifier is required on every affected claim.

Which diagnosis codes support an X-ray?

The diagnosis explains why the X-ray was needed. Under the ICD-10-CM outpatient guidelines, when the order says "rule out" or "possible", code the signs or symptoms that prompted the study. When the X-ray has been interpreted and the final report is available at the time of coding, code the confirmed diagnosis. Match laterality to the side imaged.

X-rays taken during fracture care are billed separately from the fracture treatment: Medicare's global surgical package doesn't include diagnostic tests or diagnostic radiology. See the guide to arm fracture treatment codes.

How do CPT codes affect what a patient pays for an X-ray?

The code tells the insurer which study was done; the plan's allowed amount for that code, and the patient's deductible, copay or coinsurance, set what the patient owes. Each code has its own allowed amount, so a four-view study and a single-view study aren't priced the same, and a reading by an outside radiologist can arrive as a separate bill.

Patients who want to check an X-ray charge can:

• ask for an itemized bill, which lists the CPT code and the side (RT or LT);
• compare the number of views billed with what they remember or what the report says;
• ask the provider's billing office, then the insurer, about anything that doesn't match.

Patients who aren't using insurance can ask for a good faith estimate before the X-ray. Under federal rules, providers must give one on request, or when the service is scheduled at least 3 business days ahead. A patient needs that estimate if they later want to dispute the bill.

Where do X-ray claims go wrong?

• Views: a code chosen from the order, not from the views documented in the report.
• Components: a global claim when someone else read the study, or a missing 26 or TC modifier.
• Film or computed radiography billed without FX or FY.
• Sides: both sides on one line without the RT and LT modifiers the payer expects.
• Diagnosis: a "rule out" condition coded as confirmed, or a diagnosis that doesn't support the study.

For billing support with imaging claims, see Highview's imaging center billing service.

Sources

• CMS, PFS Relative Value Files, RVU26D: 2026 status of the X-ray codes listed; PC/TC indicator 1; multiple procedure and bilateral indicators.
• CMS, Medicare Claims Processing Manual, Chapter 13, sections 20.1, 20.2, 20.2.5 and 20.2.6: professional and technical components, hospital patients, the FX and FY modifiers and their reductions.
• CMS, Medicare Claims Processing Manual, Chapter 12, section 40.1: diagnostic tests and radiology excluded from the global surgical package.
• CMS, Medicare NCCI Policy Manual, Chapter 9 (radiology, effective January 1, 2026): all radiographs needed to complete a study are included; preliminary and delayed films.
• CMS, HCPCS quarterly update (October 2026 file): modifiers 26, TC, FX and FY.
• CMS and NCHS, ICD-10-CM Official Guidelines for Coding and Reporting, FY 2027, Section IV.H and IV.K.
• CMS, What is a good faith estimate? (No Surprises Act).
• CMS, Search the Physician Fee Schedule.