CPT 73040: Shoulder Arthrogram Imaging Supervision and Interpretation
CPT code 73040 represents imaging supervision and interpretation for a shoulder arthrogram, a fluoroscopic procedure in which contrast material and/or air are injected into the shoulder joint and a series of X‑rays are taken to evaluate joint structures. This code is used solely for the physician’s or qualified provider’s supervision and interpretation component of the arthrogram rather than for the injection or technical services. Nationally, shoulder arthrography is an important diagnostic tool for evaluating pathology such as degenerative joint disease, adhesive capsulitis, cartilage or labral tears, and other intra‑articular abnormalities.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of clinical indications and service context for use of CPT code 73040, common payer considerations, and the types of benchmarks typically reported for imaging supervision and interpretation services. The publication outlines how this code is positioned relative to related procedural and technical components and summarizes what to expect in terms of sites of service and clinical scenarios where the code is applicable.
This summary is intended for a national audience and provides concise context for policy, billing, and clinical staff who manage or review shoulder arthrography imaging supervision and interpretation reporting.
Sign up for cpt 73040 policy alerts
Get alerted when payer policies referencing 73040 are released or updated.
Billing Code Overview
CPT code 73040 describes imaging supervision and interpretation of a shoulder joint arthrogram. The procedure involves injection of contrast material and/or air into the shoulder joint followed by a series of X‑rays to visualize contrast flow and evaluate joint structures for conditions such as arthritis, adhesive capsulitis (frozen shoulder), cartilage tears, and other intra‑articular abnormalities.
Service Type: Imaging supervision and interpretation (arthrogram of the shoulder)
Typical Site of Service: Hospital outpatient radiology department, ambulatory imaging center, or outpatient clinic where fluoroscopic arthrography is performed
Clinical & Coding Specifications
Clinical Context
A 58-year-old patient presents with chronic anterior shoulder pain, limited range of motion, and progressive stiffness despite conservative management. Physical exam suggests possible adhesive capsulitis or a suspected labral or rotator cuff tear. The orthopedic surgeon orders a shoulder arthrogram to evaluate intra-articular structures. In the radiology suite, the patient is positioned on an X-ray table. Under sterile technique, the radiologist or qualified proceduralist injects iodinated contrast (and/or air) into the glenohumeral joint using fluoroscopic guidance. A series of dedicated radiographic views are obtained as contrast outlines the joint capsule, labrum, articular cartilage, and capsule-labral junction. The interpreting physician performs imaging supervision and interpretation of the arthrogram images, documents findings such as contrast extravasation, capsular contracture, labral tears, or cartilage defects, and issues a formal report. Billing for imaging supervision and interpretation only is reported with 73040 when the provider performs the interpretation and supervision portion but does not bill for the technical component (imaging equipment, technologist) separately or when the technical component is billed by another entity.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | When billing only the physician interpretation and supervision for the arthrogram (professional component). |
TC | Technical component | When billing only the technical component (equipment, technologist) — not typically appended to 73040 which represents supervision/interpretation. |
59 | Distinct procedural service | When another separate and distinct procedure is performed on the same day that is not normally reported with the arthrogram. |
76 | Repeat procedure by same physician | When the same provider repeats the arthrogram procedure later the same day. |
77 | Repeat procedure by another physician | When a different provider repeats the procedure the same day. |
50 | Bilateral procedure | When both shoulders are studied and documentation supports bilateral service billing rules. |
52 | Reduced services | When the procedure was partially reduced or less than typically required. |
53 | Discontinued procedure | When the procedure is started but discontinued due to extenuating circumstances. |
76 | Repeat procedure by same physician | When the same physician repeats the imaging interpretation or procedure later the same day (listed when applicable). |
62 | Two surgeons | When two surgeons work together as co-surgeons for a related surgical intervention (rare for arthrogram alone). |
| Taxonomy Code | Specialty | Notes |
|---|---|---|
207RP0000X | Orthopedic Surgery | Orthopedic surgeons frequently order and interpret shoulder arthrograms or supervise them for preoperative planning. |
2085P0200X | Diagnostic Radiology | Radiologists commonly perform the injection, fluoroscopic guidance, and interpretation of shoulder arthrograms. |
163WL0500X | Sports Medicine | Sports medicine physicians perform and interpret arthrograms in athletes and active adults. |
207L00000X | Physical Medicine & Rehabilitation | PM&R specialists may use arthrography for diagnostic evaluation of joint pain and stiffness. |
Related Diagnoses
| ICD-10 Code | Description | Clinical Relevance |
|---|---|---|
M75.00 | Adhesive capsulitis of unspecified shoulder | Common indication to evaluate capsular contracture and reduced joint volume with arthrography. |
M75.11 | Incomplete rotator cuff tear or rupture of right shoulder, partial thickness | Arthrogram can help detect rotator cuff tears and delineate tear extent. |
M75.12 | Incomplete rotator cuff tear or rupture of left shoulder, partial thickness | Same relevance for left-sided pathology. |
M19.011 | Primary osteoarthritis, right shoulder | To assess cartilage surface and joint space abnormalities related to arthritis. |
S43.431A | Superior glenoid labrum lesion of right shoulder, initial encounter | Labral tears are visualized when contrast outlines labral defects. |
S43.432A | Superior glenoid labrum lesion of left shoulder, initial encounter | Left-sided labral pathology evaluated with arthrography. |
M75.20 | Bursitis of shoulder, unspecified | Differentiates intra-articular pathology versus periarticular bursitis when symptoms overlap. |
Related CPT Codes
| CPT Code | Description | Relationship to This Procedure |
|---|---|---|
73030 | Radiologic examination, shoulder; complete, minimum of 2 or 3 views | Often obtained before or after the arthrogram for baseline anatomic assessment and comparison. |
73050 | Stress radiographs, shoulder | May be performed in conjunction for instability assessment when indicated. |
73040 | Injection procedure; shoulder arthrogram — imaging supervision and interpretation | Primary code for physician supervision and interpretation of the shoulder arthrogram. |
73020 | Radiologic examination, shoulder; single view | May be used when only a single radiographic view is necessary in the workup surrounding an arthrogram. |
73095 | Radiology guidance for needle placement (fluoroscopic) | Used when fluoroscopic guidance for intra-articular injection is performed and billed as a separate guidance service when appropriate. |