Is CPT 73030 overcharged?

73030: Shoulder X-ray, 2+ views (Imaging)

Approximate Medicare national rate

$35.74

Source: CMS Physician Fee Schedule CY2026, Oct release (national, non-facility). National amount; actual Medicare payment varies by locality. Facility-setting physician rate: $35.74 (hospital facility fee billed separately).

Hospital outpatient facility rate (OPPS, APC 5521)

$88.91

Source: CMS OPPS Addendum B, October 2026. At a hospital you usually get two bills: the facility fee (compare to this) and the physician fee (compare to $35.74).

What's a reasonable charge?

Commercial insurers typically pay roughly 1.5 to 2.5 times Medicare. If you were billed more than $107.22 for 73030, ask for an itemized bill, request the provider's cash price, and dispute the difference.

Check your whole bill

Duplicates and unbundling are often worth more than a single high price. Scan your bill free