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 73630

X-Ray of Foot, Minimum 3 Views

CPT 73630 covers a foot X-ray with at least 3 views, commonly ordered for suspected fractures, foot pain, and bunion evaluation. Providers charge an average of $92.24 for this X-ray, but Medicare pays only $34.07 for the physician fee in an office setting (2.7x markup). The number of views taken directly affects which code is billed and what you pay. If only 2 views were taken, the lower-cost code 73620 should be used instead.

Updated May 2026Source: CMS Physician Fee Schedule

CPT 73630 at a Glance

Average provider charge: $92.24
Medicare physician fee (office): $34.07
Medicare physician fee (hospital): $16.36 + separate facility fee
Typical markup: 2.7x over Medicare office rate

Views: Minimum 3 (AP, lateral, oblique)
Common reasons: Fracture, bunion, foot pain
Lower-cost alternative: 73620 (2 views)
Medicare beneficiaries (2023): 1.13 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 73630 foot X-ray:

Component	What It Covers	Office (Non-Facility)	Hospital (Facility)
Work RVU	Physician time and skill to interpret images	0.17	0.17
Practice Expense RVU	X-ray equipment, technologist, film/digital storage	0.79	0.27
Malpractice RVU	Professional liability insurance	0.04	0.04
Total RVU		1.00	0.48
x $33.4009	2026 conversion factor	$34.07	$16.36

Podiatrist vs. radiology center billing: If your podiatrist has an in-office X-ray machine, they bill the global code (both technical and professional components combined) as a single charge. If you are referred to an external radiology center, you will receive two separate bills: one from the facility and one from the radiologist. The total may be similar, but the split billing often confuses patients who think they are being charged twice.

Medicare Rate by State

Medicare adjusts the national rate by location using Geographic Practice Cost Indices (GPCIs). The same foot 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)	$27.87	$92.24	3.3x
California (Los Angeles)	$29.12	$92.24	3.2x
New York (Manhattan)	$29.12	$92.24	3.2x
Florida (Fort Lauderdale)	$28.12	$92.24	3.3x
Ohio	$25.98	$92.24	3.6x
Mississippi	$24.95	$92.24	3.7x
Arkansas	$24.75	$92.24	3.7x
Alaska	$31.95	$92.24	2.9x

Rates shown are for the non-facility (office) setting using 2026 GPCIs and the $33.4009 conversion factor. The average provider charge of $92.24 is the 2023 national average from CMS utilization data. Actual charges vary by provider.

What Insured Patients Actually Pay for a Foot X-Ray

If you have health insurance, your cost depends on your plan design and whether you have met your deductible. Insurers negotiate rates with providers, typically 120% to 200% of the Medicare rate. For a foot X-ray, the negotiated rate is usually $40 to $70 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 or no cost after deductible
Coinsurance plan (deductible met)	$8 to $14	20% of the negotiated rate ($40 to $70)
High-deductible plan (deductible NOT met)	$40 to $92	Full negotiated rate until deductible is met
Medicare Part B	$6.81	20% of the Medicare-approved amount ($34.07)
Medicaid	$0 to $5	Minimal or no cost-sharing in most states

Diabetic foot exams: If you have diabetes and your doctor orders foot X-rays as part of a diabetic foot evaluation, ensure the X-ray is coded with a diagnosis of diabetes-related foot complication (not routine screening). Insurance is more likely to cover diagnostic imaging tied to a documented medical condition at lower or no cost-sharing than imaging coded as a screening exam.

Should You Use Insurance or Pay Cash?

For a foot X-ray, the decision depends on your deductible status and whether your podiatrist has in-office X-ray. Podiatrists with on-site equipment often offer competitive cash rates because their overhead for X-rays is low.

When Cash-Pay Wins

Your podiatrist offers an in-office X-ray for $40 to $60 cash
You have not met your deductible and the cash rate is below the negotiated rate
You are uninsured and can avoid a hospital radiology department

When Using Insurance Wins

You have already met your deductible (X-ray may be fully covered)
Your plan covers diagnostic imaging with a flat copay regardless of deductible
You need the imaging documented for a potential surgery or follow-up claim
The foot X-ray is part of a diabetes care plan with special coverage provisions

Important: Cash payments do not count toward your insurance deductible or out-of-pocket maximum. If you are likely to need additional imaging or treatment this year (for example, if the X-ray leads to surgery for a fracture or bunion correction), using insurance even at a higher initial cost may be the better long-term decision because it advances you toward your deductible.

Common Billing Problems with Foot X-Rays

Wrong view count code (73630 vs 73620)

CPT 73630 requires a minimum of 3 views. CPT 73620 covers 2 views at a lower cost. If your imaging report lists only 2 views but your bill shows 73630, you are being overcharged. Request the radiology report and count the views described. Common views include AP (top-down), lateral (side), and oblique (angled). All three must appear in the report to justify 73630.

Billing both feet when only one was imaged

If you had pain in one foot, make sure your bill reflects a unilateral study. Some billing systems default to bilateral codes or accidentally duplicate the charge. Check that the code matches what was actually imaged. If you see 73630 listed twice or a bilateral modifier (50) when only one foot was X-rayed, contact the billing department.

Denied coverage for "routine" diabetic screening

If your foot X-ray was ordered as part of a diabetic foot evaluation but your insurance denied coverage, check the diagnosis code on the claim. If it was coded as a routine screening rather than tied to a specific symptom (pain, deformity, suspected fracture), the denial may be a coding issue rather than a coverage issue. Ask your provider to resubmit with the appropriate diagnosis code reflecting your specific foot complaint.

Separate facility and professional bills from radiology center

If your podiatrist referred you to an external radiology center for the X-ray, you will receive two bills: the facility (technical component) and the radiologist (professional component). This is not double-billing. However, if your podiatrist also charged you for an X-ray on the same date, that would be a duplicate. You should only be billed once for the technical component and once for the professional component.

Related X-Ray Codes

Code	Description	Medicare (Office)	Avg. Charge
73620	Foot X-ray, 2 views	$28.38	$76.50
73630	Foot X-ray, 3+ views	$34.07	$92.24
73030	Shoulder X-ray, 2+ views	$35.74	$104.94
73562	Knee X-ray, 3 views	$42.42	$118.43
73502	Hip X-ray, 2-3 views	$48.77	$122.41
72100	Lumbar spine X-ray, 2-3 views	$40.42	$115.91

Frequently Asked Questions

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

Without insurance, a 3-view foot X-ray (CPT 73630) costs $30 to $200 depending on the facility. Podiatrist offices with in-house X-ray typically charge $40 to $80. Hospital radiology departments charge $120 to $250. The national average charge is $92.24, and Medicare pays $34.07 in an office setting.

What is the difference between CPT 73620 and 73630?

CPT 73620 covers a foot X-ray with 2 views, while CPT 73630 requires a minimum of 3 views. The additional view provides more diagnostic information but costs more ($92.24 average vs $76.50 for 73620). Check your imaging report to confirm the actual number of views taken matches the code billed. If only 2 views were performed, you should be billed 73620.

Will insurance cover a foot X-ray for bunions?

Yes, insurance typically covers foot X-rays for bunion evaluation when the X-ray is ordered to assess the severity of a bunion causing pain or functional limitation. The key is that the order must document a medical reason (pain, difficulty walking, progressive deformity) rather than purely cosmetic concerns. Ask your provider to note your symptoms clearly in the order.

Why did I get two bills for a foot X-ray at a radiology center?

When you get a foot X-ray at a radiology center (rather than at your podiatrist office), the imaging is split into two billing components. The facility bills the technical component (taking and processing the images) and the radiologist bills the professional component (reading and interpreting them). At a podiatrist office with on-site X-ray, both components are billed together as a single global charge. Two bills from a radiology center is standard, not an error.

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 your foot X-ray bill includes incorrect view counts, duplicate charges, or unexpected facility fees, we can help determine what you actually owe.

Learn about Bill Defense