How much does Medicare pay for CPT 73564?

Medicare allowed an average of $34.42 per service and paid $24.83 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $130.60, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 73564?

X-ray of knee, 4 or more views. It was billed 1,657,456 times to 1,320,279 Medicare beneficiaries by 20,838 providers in 2024.

Does 73564 pay differently in an office than a hospital?

Yes. The allowed amount averaged $41.27 in an office setting and $11.17 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 73564 most?

Orthopedic Surgery, with 713,191 services from 5,857 clinicians. Next are Diagnostic Radiology, Physician Assistant, Sports Medicine.

CPT 73564

X-ray of knee, 4 or more views

$34.42Medicare-allowed amount per service, averaged across 1,657,456 services

Providers submitted

$130.60

Asking price, not received

Medicare allowed

$34.42

The fee schedule figure

Medicare paid

$24.83

Balance is patient coinsurance

Providers submitted an average of $130.60 for this code and Medicare allowed $34.42 — 3.8× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $24.83 (72%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $41.27
Hospital / facility: $11.17

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 1,280,389 services were billed in an office setting and 377,067 in a facility.

Services: 1,657,456
Beneficiaries: 1,320,279
Providers billing it: 20,838
Total allowed: $57,049,636

What Medicare pays for CPT 73564

Across 1,657,456 services billed by 20,838 providers to 1,320,279 beneficiaries, Medicare allowed an average of $34.42 per service. That is 1.3 services per beneficiary, so this is a code patients typically receive more than once. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 73564

Specialty	Services	Beneficiaries	Avg allowed	Providers
Orthopedic Surgery	713,191	555,956	$45.36	5,857
Diagnostic Radiology	589,475	478,350	$19.51	9,233
Physician Assistant	181,158	147,144	$34.76	2,896
Sports Medicine	54,330	44,001	$45.43	633
Nurse Practitioner	34,236	27,670	$35.25	575
Family Practice	28,844	23,862	$42.67	586
Interventional Radiology	15,206	12,834	$21.33	323
Independent Diagnostic Testing Facility (IDTF)	10,091	7,060	$44.89	167
Internal Medicine	5,885	4,943	$41.91	122
Physical Medicine and Rehabilitation	4,828	3,790	$46.24	116
Portable X-Ray Supplier	3,777	2,263	$25.93	36
Emergency Medicine	3,325	2,925	$40.60	88
Rheumatology	3,239	1,807	$44.71	44
Hand Surgery	1,794	1,443	$44.19	45
Radiation Oncology	1,770	1,318	$20.58	13

73564 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
California	144,362	$38.01	$24.80	1,729
Florida	126,872	$38.83	$29.13	1,275
Texas	102,009	$38.22	$34.97	1,154
Illinois	96,798	$34.47	$24.60	1,045
New York	93,480	$35.93	$23.77	899
Pennsylvania	81,794	$29.43	$23.97	1,071
Virginia	64,568	$33.67	$25.20	729
Ohio	59,227	$27.13	$20.98	720
Massachusetts	55,287	$28.52	$19.05	546
New Jersey	54,962	$41.10	$31.93	659
North Carolina	51,784	$33.57	$30.78	794
Maryland	47,175	$37.68	$30.74	517
Michigan	42,183	$29.40	$22.28	712
Georgia	42,142	$38.07	$33.26	535
Arizona	41,561	$39.28	$28.66	426
South Carolina	37,005	$36.54	$33.25	456
Washington	35,591	$34.31	$23.04	521
Indiana	35,369	$35.41	$27.50	524
Tennessee	31,681	$37.49	$34.02	388
Missouri	30,969	$28.82	$22.29	425
Minnesota	26,317	$26.11	$18.43	540
Wisconsin	26,104	$26.86	$19.27	481
Colorado	25,670	$37.26	$28.41	409
Louisiana	22,993	$31.41	$30.16	273
Oklahoma	21,061	$29.68	$32.15	246
Alabama	20,415	$30.40	$26.67	322
Connecticut	19,292	$38.48	$26.14	275
Iowa	16,143	$28.98	$22.44	261
Mississippi	16,078	$35.29	$33.52	151
Nevada	16,003	$37.13	$27.30	231
Kansas	15,704	$36.85	$29.16	216
Kentucky	15,191	$35.75	$28.76	225
Oregon	13,968	$36.36	$25.28	259
Arkansas	13,879	$32.88	$31.25	154
New Hampshire	13,339	$31.45	$22.43	165
Nebraska	13,322	$36.05	$28.76	202
Idaho	8,852	$20.87	$16.41	143
Montana	8,452	$30.89	$21.74	115
Delaware	8,374	$34.65	$33.88	51
New Mexico	7,992	$29.99	$25.23	92
West Virginia	7,681	$16.14	$13.71	123
Utah	6,677	$36.05	$28.43	134
South Dakota	6,551	$27.00	$19.23	102
Rhode Island	5,356	$39.74	$28.42	81
Maine	4,894	$19.06	$13.71	120
Vermont	4,587	$13.06	$9.16	50
Alaska	4,483	$43.32	$28.57	79
Wyoming	3,756	$34.04	$24.15	65
Hawaii	3,433	$31.45	$20.01	54
North Dakota	3,425	$19.48	$13.91	45
District of Columbia	2,063	$28.30	$18.94	35
Guam	225	$36.50	$23.58	3
AA	127	$16.07	$12.82	2
AP	105	$18.93	$13.45	3
Puerto Rico	93	$18.52	$13.56	4
U.S. Virgin Islands	19	$48.01	$44.76	1

Related codes

73502X-ray of hip, 2-3 views$26.38
73562X-ray of knee$27.47
73560X-ray of knee$18.48
73552X-ray of thigh bone$12.92
73590X-ray of lower leg$10.75
73501X-ray of hip, 1 view$20.45
73522X-ray of both hips$35.14
73521X-ray of both hips$25.89
73565X-ray of both knees while standing$34.99
73523X-ray of both hips$33.99
73503X-ray of hip, minimum of 4 views$47.13
73551X-ray of thigh bone$16.13

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.