CT scan of an upper extremity performed with intravenous contrast only, used when the clinician needs to see soft tissue enhancement, infection, or a mass in the arm.
- Medicare
- $199.40
- Work RVU
- 1.13
- Global, days
- Region
- Multi-region
Documentation requirements
What must appear in the operative or office note to support the claim.
Source · Editorial brief grounded in 3 cited references ↓
- Order stating the clinical question and why contrast is needed
- Contrast agent, route, and dose in the technologist or radiology record
- Anatomic region and laterality scanned
- Signed interpretation with findings and impression
- Prior authorization number matching 73201 when the payer requires one
Applicable modifiers
Modifiers commonly billed with this code.
Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual
What this code covers
Source · Editorial summary grounded in 3 cited references ↓
73201 is CT of the upper extremity with contrast material only. 73200 is without contrast, and 73202 is without contrast followed by with contrast. Pick the code that matches what the technologist actually did, not what was ordered. A scan ordered with contrast that was run without it because of kidney function gets 73200.
Orthopedic practices rarely need IV contrast for bone work. Most fracture and nonunion CTs are non-contrast. 73201 shows up more for suspected abscess, osteomyelitis with soft tissue extension, tumor workup, or a postoperative fluid collection. A CT arthrogram is a different setup. The contrast goes into the joint, not the vein, and it is coded with the arthrography injection plus a CT code. CPT counts intra-articular contrast as contrast, so a CT arthrogram with only post-injection images is 73201, and one with images before and after the injection is 73202.
Most commercial plans require prior authorization for upper extremity CT through a radiology benefit manager. The authorization has to match the exact code. If the study changes from 73200 to 73201 on the day of the scan, update the authorization before the claim goes out or expect a denial.
RVU & reimbursement
Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.
Source · CMS Physician Fee Schedule, RVU26A · January 2026
Work RVU vs. total RVU
The work RVU (1.13) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (5.97) adds practice overhead and malpractice, and is what drives the Medicare payment below.
| Work RVU | 1.13 |
| Practice expense RVU | 4.75 |
| Malpractice RVU | 0.09 |
| Total RVU | 5.97 |
| Medicare national rate | $199.40 |
| Global period | days |
Payment by site of service
Medicare pays different rates by setting. HOPD typically pays substantially more than ASC for the same procedure.
Source · CMS OPPS Addendum B·ASC HCPCS payment rates·2026
| Setting | Medicare rate (national) |
|---|---|
Office (PFS non-facility) Procedure performed in physician's office | $199.40 |
HOPD (APC 5572) Hospital outpatient department | $356.43 |
Common denial reasons
The recurring reasons claims for CPT 73201 get rejected.
Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓
- Prior authorization obtained for 73200 but 73201 billed
- No contrast documented in the record
- Diagnosis does not support the need for contrast
- Missing laterality or 26/TC split on a facility claim
- CT arthrogram coded as non-contrast 73200 even though contrast was injected into the joint
Frequently asked questions
Source · Generated from the editorial pipeline, verified against 3 cited references ↓
01What is the difference between 73200, 73201, and 73202?
02How do I code a CT arthrogram of the shoulder or elbow?
03Does CT upper extremity need prior authorization?
Sources & references
Editorial content was developed using the following public sources.
Mira Scribe
Mira Scribe notes spell out the clinical question behind the CT order, such as suspected abscess or tumor, so the medical necessity for a contrast study is clear to the payer.
See how Mira captures CPT 73201 documentation