Summary & Overview
CPT 73560: Knee X‑ray, One or Two Views
CPT code 73560 denotes a diagnostic radiographic exam of the knee using one or two X‑ray views intended to identify fractures, joint swelling, or sources of pain. This common musculoskeletal imaging code is widely used across emergency departments, outpatient clinics, and radiology centers for initial evaluation of acute and subacute knee complaints. Nationally, knee radiography is a high‑volume service with implications for acute care workflows, imaging resource allocation, and guideline‑based use to limit unnecessary radiation exposure.
Key payers included in this analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of clinical context for imaging the knee, typical sites of service, and common billing considerations. The publication also summarizes benchmark metrics and policy updates relevant to payer coverage and medical necessity expectations, and it outlines how 73560 fits into care pathways for traumatic and nontraumatic knee pain.
This brief equips clinicians, coding staff, and policy analysts with the clinical description and operational context for CPT code 73560, enabling clearer communication about when single‑ or two‑view knee radiography is indicated and how it is categorized for billing and administrative purposes.
Billing Code Overview
CPT code 73560 describes an radiologic examination of the knee consisting of one or two X‑ray images to evaluate for fracture, swelling, or causes of knee pain. The procedure captures targeted, static radiographs intended to visualize bony structures and joint spaces of the knee.
Service type: Diagnostic X‑ray imaging
Typical site of service: Radiology department, hospital outpatient imaging center, or outpatient clinic imaging suite
Clinical & Coding Specifications
Clinical Context
A 28-year-old male presents to an urgent care clinic after twisting his right knee while playing soccer. He reports immediate pain, localized swelling, and difficulty bearing weight. The clinician performs a focused history and physical exam, documents point tenderness over the lateral joint line and mild effusion, and orders plain radiographs to evaluate for acute fracture or other bony abnormality. The radiology technologist obtains one or two views of the right knee per the clinician’s request. Images are transmitted to the interpreting provider (radiologist or qualified clinician) who documents findings in the medical record and issues a report. The ordering clinician uses the radiology report to determine next steps (e.g., immobilization, referral to orthopedics, MRI if soft-tissue injury suspected). Typical site of service is an urgent care clinic, emergency department, outpatient radiology facility, or hospital imaging department. Service type: diagnostic radiology — limited knee radiographic examination using one or two views documented under 73560.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing only the interpreting physician’s service separate from the technical component. |