CPT 73020: Single View X‑ray of the Shoulder
CPT code 73020 denotes a single view radiographic examination of the shoulder. As a common diagnostic imaging code, it is routinely used in emergency departments, outpatient radiology suites, and ambulatory imaging centers to evaluate acute shoulder pain, suspected fractures, and dislocations. This code matters nationally because shoulder radiography represents a high‑volume, low‑complexity service with implications for imaging utilization, coding compliance, and claims processing.
Key payers covered in typical analyses include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find benchmarks for utilization and reimbursement patterns, coding and billing considerations relevant to single‑view shoulder X‑rays, and clinical context describing when a single view is appropriate versus multiview imaging. The publication also summarizes common modifiers used in practice and highlights areas where payers commonly apply medical necessity or bundling edits.
This report is intended for clinicians, billing professionals, and policy analysts looking for a concise reference on CPT code 73020, presenting clinical purpose, service settings, payer scope, and information needed for accurate claim submission and reporting.
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Billing Code Overview
CPT code 73020 reports a single view X‑ray of the shoulder. This service is an imaging diagnostic procedure used to capture a single radiographic view to evaluate shoulder anatomy, commonly employed for acute injury assessment, suspected fracture, dislocation, or focal shoulder pain.
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Service type: Single‑view radiographic imaging of the shoulder
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Typical site of service: Outpatient radiology department, hospital radiology, ambulatory imaging center, or emergency department
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Clinical & Coding Specifications
Clinical Context
A 45-year-old construction worker presents to an outpatient radiology clinic and reports acute right shoulder pain after a fall onto the outstretched hand. The clinician documents focal lateral shoulder tenderness, limited active range of motion, and concern for possible fracture or dislocation. Orders include a single-view radiograph of the right shoulder to evaluate bone alignment, suspected clavicle or proximal humerus fracture, and to screen for dislocation. The radiology technologist performs one AP (internal/external rotation as appropriate) single view shoulder X-ray, documents laterality with modifier RT, acquires the image in the outpatient imaging suite, and forwards the exam to the interpreting radiologist. The radiologist provides an official report describing fracture presence/absence, alignment, and any acute osseous abnormality. Typical site of service: outpatient radiology department or ambulatory imaging center. Service type: diagnostic plain radiography (single view).
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
RT | Right side | Use when imaging the right shoulder to indicate laterality. |
LT | Left side | Use when imaging the left shoulder to indicate laterality. |
26 | Professional component | Use when billing only the interpreting physician’s service separate from the technical component. |
TC | Technical component | Use when billing only equipment, technologist, and facility resources for the radiograph. |
50 | Bilateral procedure | Use when both shoulders are imaged in the same encounter (rare for single-view code). |
59 | Distinct procedural service | Use when a separate, distinct radiographic service is performed on the same date that is not normally bundled. |
76 | Repeat procedure by same provider | Use when the same provider repeats the single-view shoulder radiograph for clinical reasons on the same day. |
77 | Repeat procedure by another provider | Use when a different provider repeats the shoulder radiograph on the same day. |
52 | Reduced services | Use when a limited or incomplete single-view study is performed and full service is not provided. |
53 | Discontinued procedure | Use when the radiograph was started but discontinued for patient safety or other valid reason. |
26 | Professional component | Use when reporting only the radiologist’s interpretation (repeat entry for emphasis in split billing). |
QK | Medical direction of two or more qualified individuals | Use when the physician directs multiple qualified individuals in services that include radiology oversight as applicable. |
QX | Servicing practitioner enrolled in Medicare program | Use when the performing practitioner meets program requirements for non-physician practitioners. |
XE | Separate encounter | Use when the service was performed during a separate encounter from another procedure on the same day. |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
| 2085R0200X | Diagnostic Radiology | Most common specialty interpreting and ordering shoulder radiographs. |
| 2086S0202X | Orthopedic Surgery | Orthopedists commonly order and interpret images to guide fracture/dislocation management. |
| 207L00000X | Family Medicine | Often orders initial plain films in urgent care or outpatient settings. |
| 207R00000X | Emergency Medicine | Frequently orders single-view shoulder X-rays for acute trauma evaluation. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
S42.2X0A | Fracture of shaft of clavicle, initial encounter for closed fracture | Single-view shoulder X-ray may be used to evaluate suspected clavicle fracture after trauma. |
S42.20XA | Fracture of clavicle, unspecified, initial encounter for closed fracture | Used when clavicle fracture is suspected and imaging is obtained to confirm. |
S42.21XA | Fracture of lateral end of clavicle, initial encounter for closed fracture | Single view can help identify lateral clavicle fractures. |
S43.001A | Anterior dislocation of right shoulder, initial encounter | Single-view radiograph may be an initial imaging to assess for dislocation or reduction placement. |
M75.1 | Rotator cuff tear or rupture, not specified as traumatic | Single-view X-ray can be used to evaluate bony abnormalities or degenerative changes associated with cuff pathology. |
M75.100 | Unspecified rotator cuff tear or rupture of unspecified shoulder | Radiographs help rule out osseous causes of shoulder pain prior to advanced imaging. |
M75.9 | Shoulder lesion, unspecified | General shoulder pain indication for plain radiography to screen for fracture, arthritis, or other bony pathology. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
73030 | Shoulder; minimum of two views | Performed when additional views (two or more) are required to fully evaluate suspected fracture or dislocation following a single view. |
73040 | Shoulder; complete, minimum of three views | Used when a comprehensive shoulder series is indicated for detailed assessment of complex trauma or preoperative planning. |
73060 | Shoulder; two or three views, each with special techniques (e.g., scapular Y) | Applied when specialized projections are necessary to assess alignment or glenoid involvement. |
72040 | Radiologic examination, scapula; complete, minimum of two views | Performed when scapular injury is suspected in addition to shoulder evaluation. |
73090 | Radiologic examination, clavicle; minimum of two views | Performed when clavicle fracture is suspected along with shoulder trauma; may be ordered after or alongside the shoulder single view. |