CPT (Current Procedural Terminology) codes are five-digit numbers that describe every medical service or procedure. Your doctor, hospital, and insurance company use them to communicate exactly what was done. Every line on your medical bill has a CPT code, and knowing the code lets you look up what Medicare pays for that same service.

Why do providers charge so much more than Medicare pays?

Providers set their own "chargemaster" prices, which are essentially list prices. Medicare pays a fixed rate based on the resources each service actually requires (the RVU system for procedures, or the Clinical Lab Fee Schedule for lab tests). Commercial insurers typically pay 150% to 250% of Medicare rates. Uninsured patients are often billed the full chargemaster price, which can be 2x to 30x what Medicare pays.

Can I use Medicare rates to negotiate my bill?

Yes. Medicare rates are the closest thing to a "fair price" benchmark in U.S. healthcare. When negotiating, ask the provider what they accept from Medicare for the same CPT code. Most providers will accept 150% to 200% of Medicare for cash-pay patients, which is still far less than their chargemaster price. Many hospital financial assistance policies also use a multiple of Medicare as their discount floor.

How are Medicare rates calculated?

For most procedures, Medicare uses the Resource-Based Relative Value Scale (RBRVS). Each CPT code gets three RVU components: Work (physician time and skill), Practice Expense (overhead), and Malpractice. These are multiplied by geographic adjustment factors (GPCIs) and a conversion factor ($33.4009 in 2026). Lab tests (80000-89999 range) use a separate Clinical Laboratory Fee Schedule with flat national rates.

CPT 73502

X-Ray of Hip, 2-3 Views

CPT 73502 covers a hip X-ray with 2 to 3 views, frequently ordered for elderly patients after falls, hip pain evaluation, and arthritis assessment. Providers charge an average of $122.41, but Medicare pays only $48.77 in an office setting (2.5x markup). Important: hip X-rays miss 2 to 10% of fractures. If the X-ray is normal but pain persists after a fall, an MRI may be needed, adding $1,000 or more to the total imaging cost.

Updated May 2026Source: CMS Physician Fee Schedule

CPT 73502 at a Glance

Average provider charge: $122.41
Medicare physician fee (office): $48.77
Medicare physician fee (hospital): $21.27 + separate facility fee
Typical markup: 2.5x over Medicare office rate

Views: 2-3 (typically AP pelvis + lateral)
Common reasons: Fall, hip pain, arthritis
Missed fracture rate: 2-10% (may need MRI)
Medicare beneficiaries (2023): 1.07 million

How the Medicare Rate Is Calculated

Medicare prices every procedure using Relative Value Units (RVUs) across three components, then multiplies by a national conversion factor of $33.4009 (2026). Here is the exact math for a 73502 hip X-ray:

Component	What It Covers	Office (Non-Facility)	Hospital (Facility)
Work RVU	Physician time and skill to interpret images	0.21	0.21
Practice Expense RVU	X-ray equipment, technologist, film/digital storage	1.18	0.36
Malpractice RVU	Professional liability insurance	0.04	0.04
Total RVU		1.43	0.61
x $33.4009	2026 conversion factor	$48.77	$21.27

X-ray limitations for hip fractures: Hip X-rays miss 2 to 10% of hip fractures (called occult fractures). If you had a fall, have significant hip pain, and cannot bear weight, but the X-ray appears normal, your doctor may recommend an MRI to detect fractures not visible on X-ray. The total imaging cost can escalate quickly: the initial X-ray ($122 average) plus a follow-up MRI ($1,000 to $3,000) adds up to $1,100 to $3,100 for complete evaluation.

Medicare Rate by State

Medicare adjusts the national rate by location using Geographic Practice Cost Indices (GPCIs). The same hip X-ray pays differently depending on where you live.

Medicare Rate by State (2026)

Medicare adjusts payments by location using Geographic Practice Cost Indices (GPCIs). Select your state to see the adjusted rate.

Sample State Rates (Office Setting)

State	Medicare Pays	Avg. Charge	Markup
Texas (Austin)	$39.84	$122.41	3.1x
California (Los Angeles)	$41.68	$122.41	2.9x
New York (Manhattan)	$41.65	$122.41	2.9x
Florida (Fort Lauderdale)	$40.20	$122.41	3.0x
Ohio	$37.10	$122.41	3.3x
Mississippi	$35.62	$122.41	3.4x
Arkansas	$35.33	$122.41	3.5x
Alaska	$45.77	$122.41	2.7x

Rates shown are for the non-facility (office) setting using 2026 GPCIs and the $33.4009 conversion factor. The average provider charge of $122.41 is the 2023 national average from CMS utilization data. Actual charges vary by provider.

What Insured Patients Actually Pay for a Hip X-Ray

If you have health insurance, your cost depends on your plan design and where the X-ray is performed. Insurers negotiate rates with providers, typically 120% to 200% of the Medicare rate. For a hip X-ray, the negotiated rate is usually $55 to $100 in an office setting.

Your Situation	What You Likely Pay	How It Works
Copay plan (deductible met)	$0 to $30	Many plans cover diagnostic X-rays with a small copay after deductible
Coinsurance plan (deductible met)	$11 to $20	20% of the negotiated rate ($55 to $100)
High-deductible plan (deductible NOT met)	$55 to $122	Full negotiated rate until deductible is met
Medicare Part B	$9.75	20% of the Medicare-approved amount ($48.77)
ER after a fall (any insurance)	$200 to $500+	X-ray often bundled into ER facility fee; total ER visit much higher

ER hip X-rays and facility fees: For patients in the ER after a fall, hip X-rays are typically part of the overall facility fee calculation. You may not see a separate line item for the X-ray on your hospital bill. However, you will likely receive a separate bill from the radiologist who read the X-ray. The combined ER cost for a hip evaluation (facility fee + physician + imaging) often exceeds $1,500 to $3,000.

Should You Use Insurance or Pay Cash?

Hip X-rays are frequently performed in ER settings after falls, where you typically do not have the option to shop around. For non-emergency hip pain evaluation, however, outpatient imaging centers offer significantly lower pricing.

When Cash-Pay Wins

You have chronic hip pain (not a fall) and your doctor wants imaging for arthritis evaluation
Freestanding imaging centers offer hip X-rays for $50 to $80 cash
You have not met your deductible and cash is cheaper than the negotiated rate

When Using Insurance Wins

You fell and need ER evaluation (no realistic alternative in this situation)
The X-ray may lead to MRI or surgery, and you need insurance continuity
You have met your deductible and the X-ray is covered at copay/coinsurance
You are a Medicare beneficiary (your cost is only $9.75 for this X-ray)

Plan for escalating costs: A hip X-ray is often just the beginning. If the X-ray shows a fracture, expect surgery costs ($30,000 to $60,000). If the X-ray is normal but pain persists, expect an MRI ($1,000 to $3,000). If the X-ray shows severe arthritis, hip replacement discussions begin ($30,000 to $50,000). For hip-related concerns, using insurance from the start is almost always the better financial strategy because follow-up costs will quickly exceed any deductible.

Common Billing Problems with Hip X-Rays

Billing bilateral (73522) when only one hip was imaged

CPT 73522 covers bilateral hip X-rays (both sides) and costs more than 73502 (one side). If only one hip was causing pain and only one side was imaged, your bill should show 73502, not 73522. Check your radiology report to confirm whether one or both hips were X-rayed. Bilateral imaging is sometimes clinically appropriate for comparison, but it should be justified by the clinical situation.

Separate radiologist bill after ER visit

After an ER visit for a hip injury, patients often receive the hospital bill (which may include or bundle the X-ray technical component) and then a separate bill from the radiologist weeks later for the professional interpretation. This second bill is legitimate but often arrives 30 to 60 days after the ER visit, catching patients off guard. It is not a duplicate charge. The radiologist bill for the professional component of a hip X-ray is typically $15 to $40.

Pelvis X-ray billed instead of hip X-ray

A pelvis X-ray (CPT 72170, $38 average Medicare rate) images the entire pelvis including both hips. A hip X-ray (73502) focuses on one hip with dedicated views. In the ER, providers sometimes order a pelvis X-ray rather than a focused hip X-ray, which may miss subtle hip fractures that would be visible on dedicated hip views. If you were billed for a pelvis X-ray and a hip X-ray on the same date, verify both were medically necessary and actually performed.

Unnecessary repeat X-rays when transferring between facilities

If you go to urgent care first and then are sent to the ER, the ER may repeat the hip X-ray rather than reviewing the urgent care images. This results in being billed for two sets of hip X-rays. While repeat imaging is sometimes necessary for clinical reasons, you can ask the ER to review the existing images first. If the repeat was not clinically justified, you may be able to dispute the second charge.

Related X-Ray Codes

Code	Description	Medicare (Office)	Avg. Charge
73501	Hip X-ray, 1 view	$32.03	$82.50
73502	Hip X-ray, 2-3 views	$48.77	$122.41
73503	Hip X-ray, 4+ views	$56.12	$145.00
73522	Bilateral hip X-ray, 2-3 views each	$55.48	$155.00
73562	Knee X-ray, 3 views	$42.42	$118.43
72100	Lumbar spine X-ray, 2-3 views	$40.42	$115.91

Frequently Asked Questions

How much does a hip X-ray cost without insurance?

Without insurance, a hip X-ray (CPT 73502, 2-3 views) costs $50 to $300 depending on the facility. Freestanding imaging centers typically charge $50 to $100. Hospital radiology departments charge $150 to $300. In the ER after a fall, the X-ray cost is often bundled into the facility fee, making the total ER visit $1,500 to $3,000+. The national average charge is $122.41, and Medicare pays $48.77 in an office setting.

Can a hip X-ray miss a fracture?

Yes. Hip X-rays miss approximately 2 to 10% of hip fractures, known as occult fractures. These are fractures that are present but not visible on standard X-ray images. If your X-ray is normal but you still have significant hip pain after a fall (especially if you cannot bear weight), your doctor should consider ordering an MRI to detect these hidden fractures. Delaying treatment of an occult hip fracture can lead to complications.

What is the difference between CPT 73502 and 73522?

CPT 73502 covers a unilateral (one side) hip X-ray with 2-3 views. CPT 73522 covers bilateral (both sides) hip X-rays with 2-3 views per side and costs more. If only one hip is causing pain, make sure your provider orders the unilateral code (73502) rather than bilateral (73522). Bilateral imaging is sometimes appropriate for comparison in arthritis patients, but it should be clinically justified.

Will I see a separate charge for a hip X-ray in the ER?

It depends on the hospital's billing practices. Some ERs bundle the technical component of imaging into the overall facility fee, so you may not see a separate line item. However, you will typically receive a separate bill from the radiologist who reads the X-ray (the professional component, usually $15 to $40). Check both your hospital bill and any separate physician group bills to understand the full cost of your ER hip evaluation.

Need Help Lowering a Medical Bill?

CareRoute Bill Defense analyzes the codes on your bill, identifies overcharges and coding errors, and negotiates on your behalf. If you received an unexpected bill after a hip X-ray (especially a large ER bill or charges for bilateral imaging you did not receive), we can help determine what you actually owe.

Learn about Bill Defense