CPT code 73525 – Hip arthrography radiologic examination

Key takeaways

CPT code 73525 is the radiological supervision and interpretation of a hip arthrogram, billed once per hip.

The needle and contrast injection go on their own line as 27093, or 27095 when anesthesia is used.

Fluoroscopic guidance is part of the arthrogram imaging, so 77002 is not reported with 73525.

A missing RT or LT modifier, or a diagnosis on the wrong side, is a common reason 73525 claims are denied.

Pabau, the practice management platform we build, pre-fills 73525 claims from the patient record and checks required fields before they are sent.

CPT code 73525 covers the imaging, not the injection

CPT code 73525 is the code for the radiological supervision and interpretation of a hip arthrogram. Its official AMA CPT code set descriptor reads Radiologic examination, hip, arthrography, radiological supervision and interpretation.

During the study, a physician places a needle in the hip joint, injects contrast, and captures images that outline the joint. 73525 pays for supervising and reading those images. The injection goes on a separate line, as 27093 when no anesthesia is given or 27095 when it is.

That split shapes the whole claim. Fluoroscopy used to guide the needle is part of the arthrogram imaging, so 77002 is not reported on top of 73525.

What 73525 includes, and what goes on its own line

73525 covers the radiological supervision and interpretation component of hip arthrography. Knowing what sits inside and outside the code prevents both underbilling and unbundling errors.

Included in 73525

• Radiologic imaging of the hip joint after contrast injection, including the fluoroscopy used during the study
• Radiological supervision of the arthrogram procedure
• Interpretation and written report by the supervising physician or radiologist

Reported on its own line

• The arthrography injection (27093 or 27095): 27093 covers the injection without anesthesia, and 27095 covers it with anesthesia. Arthrocentesis codes 20610 and 20611 do not describe this injection, so they don’t belong on an arthrogram claim.
• Contrast media supply: Payer-specific. Some commercial plans reimburse contrast separately through a HCPCS supply code, while others bundle it. Check each payer contract before billing.

One code stays off the claim entirely. The CPT note under 77002 lists 73525 among the arthrography codes it must not be reported with, because fluoroscopy is part of the arthrogram imaging. The two lines below are the whole claim for a conventional hip arthrogram.

73525 vs 73501-73503: Contrast decides the code

Plain hip radiographs are coded 73501 to 73503, by view count, with no contrast and no injection. 73525 applies only when intra-articular contrast was injected for an arthrogram.

A two-view film of one hip, for example, is 73502, not 73525. The older plain-film code 73510 was deleted on January 1, 2016.

Billing a plain-film code when contrast was injected misrepresents the service. Billing 73525 when no contrast went in is upcoding. The procedure note has to confirm whether intra-articular contrast was given.

Bilateral hip arthrograms are paid per side, not at 150%

CPT code 73525 is unilateral, so one unit covers one hip. When both hips are examined in the same session, payers differ on the format they want.

• Modifier 50 (bilateral procedure): Some payers want 73525-50 on a single line.
• Separate RT and LT lines: Many payers want 73525-RT on one line and 73525-LT on a second line instead.

Medicare lists 73525 with bilateral indicator 3 on the fee schedule. The usual 150% bilateral adjustment does not apply, so each side is paid at 100%. When only one hip is examined, append RT or LT. A single-hip claim with no side modifier is a common denial trigger.

Modifiers for 73525 come down to side and who reads the study

Modifier selection for CPT code 73525 depends on laterality and on who bills which component. The table below covers the options you will use.

The 26/TC split applies when the radiologist and the facility bill separately. The radiologist appends 26 to 73525 for the interpretation, and the facility appends TC for the technical service. Never bill the global code and the split components for the same study.

Modifier 59 does not rescue 77002 on this claim. The CPT note bars 77002 with 73525, so a distinct-service modifier does not make it billable.

Documentation that holds up when a payer audits 73525

Thin procedure notes are a frequent cause of 73525 denials. Payers expect a record that supports both the procedure and the diagnosis billed. A defensible arthrogram claim rests on these elements.

• Physician order: A signed order with the indication for hip arthrography and the ordering provider’s NPI
• Clinical indication: A linked ICD-10-CM diagnosis code on the claim that supports medical necessity
• Informed consent: A pre-procedure note confirming the patient was counseled on the procedure, risks, and alternatives
• Injection note: The needle approach, contrast type and volume, the patient’s tolerance, and any complications, which support 27093 or 27095
• Imaging report: The radiologist’s interpretation of the arthrogram images, which supports 73525
• Laterality: The hip examined, named in both notes so it matches the modifier on the claim

A note that says only “hip arthrogram performed” won’t survive an audit. It needs the contrast volume, the approach, and the side. Good medical billing compliance means building these fields into your note templates, so none are skipped at the point of care.

ICD-10 codes for 73525 must match the side you bill

Every claim for CPT code 73525 needs at least one ICD-10-CM code that establishes medical necessity. The side in the diagnosis code must match the side modifier on the CPT line.

A right-hip diagnosis such as M25.551 paired with 73525-LT is a mismatch that invites a denial. These diagnosis codes come up most often with hip arthrography.

Use the most specific code available. Pain codes (M25.55x) fit when no definitive diagnosis exists yet. Once the arthrogram confirms a condition, use that diagnosis on later claims.

How Medicare and other payers reimburse 73525

Medicare reimbursement for CPT code 73525 is set each year through the CMS Medicare Physician Fee Schedule (MPFS).

Rates vary by locality because of geographic practice cost indices (GPCIs). Since the figures change every calendar year, this article does not quote a dollar amount. Use the CMS look-up tool for your locality’s current rate.

Keep these reimbursement points in mind:

• Facility and non-facility rates differ. The non-facility (office) rate is typically higher, because it covers overhead that a hospital or outpatient facility would otherwise absorb.
• Professional and technical components are paid separately. With modifier 26, only the interpretation is reimbursed. The TC rate covers equipment, staff, and supplies, and the global rate covers both.
• Contrast media reimbursement varies. Some payers pay for contrast through a HCPCS supply code, while others bundle it into the procedure. Check your payer contracts.
• Medicare Advantage plans set their own rates. These can differ from traditional Medicare rates, and some plans have their own modifier rules.

For RVU-based calculations, the FastRVU 2026 RVU lookup tool shows the work, practice expense, and malpractice RVUs for 73525. Apply your locality’s conversion factor to estimate the rate.

Prior authorization for 73525 depends on the plan

Whether CPT code 73525 needs prior authorization depends entirely on the payer. Traditional Medicare generally does not require it for diagnostic radiology codes. Medicare Advantage and many commercial plans often do.

When a plan does require authorization, the request typically needs:

• The ordering physician’s NPI and specialty
• The facility’s NPI and place of service code
• The CPT codes (27093 or 27095, plus 73525) and the planned side
• The primary ICD-10-CM diagnosis code supporting medical necessity
• Clinical notes showing conservative treatment was tried or is not appropriate

Skipping authorization when a plan requires it is one of the most avoidable denials. The denial arrives fast, and the appeal is slow. Build the authorization check into scheduling, before the procedure date.

Why 73525 claims get denied, and the fix for each

Denials on 73525 tend to repeat, which makes them preventable. These are the patterns orthopedic and radiology billing teams run into.

• Missing or incorrect laterality modifier: Bill RT or LT for one hip, and use the payer’s bilateral format for both. A unilateral claim with no side modifier is rejected as incomplete. Fix: add a side check to your pre-submission review.
• No prior authorization when required: Medicare Advantage and commercial plans often require it for arthrography. A claim without it is denied as non-covered and is hard to win on appeal. Fix: confirm authorization at scheduling, not at billing.
• Vague procedure documentation: Payers auditing medical necessity expect the hip, the contrast, the injection technique, and the findings. Generic notes fail audits. Fix: use a structured arthrography note template.
• Diagnosis code does not support medical necessity: A low-specificity code such as M25.50, pain in unspecified joint, won’t satisfy most payer edits for arthrography. Fix: use the side-specific code that matches the procedure.
• 77002 or the wrong injection code on the claim: Billing 77002 alongside 73525 gets the line denied, because fluoroscopy is part of the arthrogram imaging. Billing 20610 or 20611 in place of 27093 or 27095 is the same kind of error. Fix: check the arthrography injection code (27093/27095) and drop 77002.
• Wrong place of service code: Facility and non-facility rates differ. Billing POS 11 for a hospital outpatient procedure creates a rate mismatch and a denial. Fix: match the POS to where the service took place.
• 73525 billed without contrast: If the note does not confirm intra-articular contrast, the payer will deny 73525 as not matching the service. Fix: confirm the contrast is documented before coding 73525.

Good denial management workflows catch these patterns at the front end. The same modifier tends to go missing, or the same POS error recurs, across many claims. Reviewing the medical billing denial codes on your remittances for 73525 shows which error is most frequent in your practice.

Before you submit: A 73525 claim checklist

A hip arthrogram reaches the payer as two lines built from two notes. The injection note supports 27093 or 27095, and the radiologist’s report supports 73525. If either note is thin, its line is the one that comes back denied.

Run these checks on every hip arthrogram claim before it leaves the practice:

• The injection line reads 27093, or 27095 if anesthesia was given, and never 20610 or 20611.
• 73525 carries RT or LT, or the payer’s bilateral format.
• 77002 is not on the claim for a conventional arthrogram.
• The side in the diagnosis code matches the side modifier.
• Both notes record the hip examined, and the injection note records contrast type and volume.
• Prior authorization is on file where the plan requires it.
• Modifier 26 or TC is appended when the radiologist and the facility bill separately.

How claims management software keeps 73525 claims moving

A hip arthrogram claim draws on the injection note and the radiology report. When a biller rekeys both into a claim form, the side, the injection code and the diagnosis are the details that slip.

Pabau’s claims management software pre-fills the claim from the patient record and the appointment. Built-in CPT and ICD-10 lookup libraries let billers find 27093, 73525 or M25.551 by code or description. Before you press Send, Pabau checks that the required fields are complete, then submits the claim through Claim.MD.

Eligibility checks, claim tracking and ERA posting sit in the same system. When a 73525 line comes back denied, the remittance shows which line failed and why. Your billers still make the coding calls.

They fix a denied claim from the patient’s record instead of a spreadsheet. Running claims through a clean claim process like this cuts first-pass rejections and shortens the wait for payment.

Send cleaner hip arthrogram claims

Pabau pre-fills claims from the patient record, checks required fields before submission, and tracks each claim through Claim.MD to the remittance. See how it fits an orthopedic or imaging billing workflow.

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Conclusion

Treat a hip arthrogram as two services on one claim. Bill the injection as 27093 or 27095, bill the images as 73525 with the right side, and leave 77002 off.

Denials on this code usually trace back to that split going wrong, or to a side that doesn’t match the diagnosis. Fix your injection note and report templates once, and the coding follows the documentation.

The coding judgment stays with your team. Pabau handles the claim around it, from pre-fill to required-field checks to the remittance. Book a demo to see how it fits your imaging billing workflow.

Continue your research

Sending claims to US payers? How the Claim.MD clearinghouse works explains how electronic claim routing gets a claim from your system to the payer.

Want to understand what happens when claims are rejected? Electronic remittance advice (ERA) guide covers how to read 835 remittances and act on CARC denial codes.

Doing an MR or CT arthrogram instead? CPT code 77002 explains when fluoroscopic guidance is billed on its own line.

Was the hip injection therapeutic, with no arthrogram? CPT code 20610 covers major joint injections and aspirations.

Looking for billing software built for clinical practices? Best medical billing software for US practices reviews the top platforms handling CPT-based claim workflows.

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