CPT 71045: Chest X-Ray Single View Billing Guide (2026)

What Is CPT Code 71045?

CPT code 71045 reports a radiologic examination of the chest using a single view, most commonly a portable AP film. It is used to evaluate the lungs, heart silhouette, and chest wall when one projection is sufficient. The code may be billed globally or split into a professional component (modifier 26) and a technical component (modifier TC) depending on who owns the equipment and who interprets the study.

• Single view only: 71045 reports one chest view. Two views is CPT 71046, three views is 71047, and four or more is 71048. The code must match the views documented in the study.
• Component billing: Append modifier 26 for the radiologist’s interpretation alone, modifier TC for the equipment and technical work, or no modifier when one provider furnishes both the read and the technical service.
• Medical necessity required: Medicare pays 71045 only when a documented clinical indication supports the study. A routine screening chest X-ray on an asymptomatic patient is not a covered service.

What CPT 71045 Covers and When to Use It

Since 2018, the AMA has organized chest X-ray CPT codes by the number of views obtained during the study. CPT 71045 is the single-view chest X-ray, and it is one of the highest-volume radiology codes in both emergency and inpatient settings. The typical use cases are portable AP films ordered in the emergency department or ICU, post-procedure line and tube placement verification, and quick clinical follow-ups where a single projection answers the ordering provider’s question.

When the imaging study captures more than one view, the code changes. Report the code that matches the views actually performed and documented. Billing a higher-view code without the supporting image list and technique statement is one of the most common radiology audit triggers, and across the billing companies we vet, it is the single most frequent reason a radiology practice gets flagged for chart review on chest imaging.

The same view-count logic governs other X-ray families throughout radiology billing. If a clinical scenario calls for cross-sectional imaging instead, the chest CT study falls under a separate code set starting with CPT 71250 for CT chest without contrast. Choosing the right modality code before submission prevents mismatches that delay payment.

What Is Modifier 26 on CPT 71045?

Modifier 26 reports the professional component of CPT 71045: the radiologist’s interpretation and signed written report. It is used when the physician reads the chest X-ray but does not own or operate the imaging equipment. Modifier TC reports the technical component, covering the equipment, the technologist, and the supplies. When a single provider furnishes both the interpretation and the technical service, 71045 is billed globally with no modifier attached.

The payment split runs roughly 40 percent to the professional component and 60 percent to the technical component, based on the RVU allocation in the Medicare Physician Fee Schedule. For a deeper breakdown of how this split works across all radiology codes, see our full modifier 26 professional component billing guide.

In practice, a hospital appends TC while the reading radiologist bills 26, and a freestanding imaging center that owns its equipment and reads its own films bills globally. The most common component-billing denial is a duplicate claim: the facility submits a global claim while the radiologist also bills modifier 26, which triggers an overpayment flag on both sides. One question we hear constantly from practice managers is why their imaging revenue keeps getting clawed back in post-payment audits, and the answer almost always traces to this exact scenario. Define component responsibility contractually so only one form of the claim goes out for each study.

How Much Does CPT 71045 Reimburse?

Medicare pays CPT 71045 from the Physician Fee Schedule based on total relative value units multiplied by the annual conversion factor, which sits at roughly $33 per RVU in 2026, then adjusted for geographic locality through the GPCIs. CPT 71045 carries a low work RVU of approximately 0.22, reflecting the straightforward single-view read. As a national average, the global payment runs about $12 to $16 in a facility setting and roughly $23 to $27 in a non-facility setting. The professional-only portion under modifier 26 captures approximately 40 percent of that total.

Commercial payers often reimburse above Medicare rates, and Medicaid rates vary by state. Because the conversion factor and RVUs update every January 1, always verify the current MPFS for your locality and place of service before relying on any published figure. In our experience matching providers with billing partners, the practices that lose the most on 71045 are high-volume ED groups that never verified whether their contracted commercial rates kept pace with the annual MPFS update. At hundreds of single-view films per month, even a one-dollar shortfall compounds fast.

Does CPT 71045 Have a Frequency Limit?

CPT 71045 has no fixed numeric frequency limit under Medicare. Coverage is driven by medical necessity rather than a set number of studies per period, so a chest X-ray is payable whenever a documented clinical indication supports it. A routine screening of an asymptomatic patient, however, is not covered regardless of how infrequently it is ordered.

When a study is repeated the same day, append modifier 76 if the same physician performs the repeat, or modifier 77 if a different physician performs it. Without these modifiers, the second claim looks like a duplicate submission and denies automatically.

Medicare operationalizes coverage through its Chest X-Ray LCD and the associated billing and coding article, which list covered indications and the ICD-10 logic that supports medical necessity. Some commercial payers layer their own utilization edits or prior authorization requirements on high-frequency imaging, but there is no universal cap across payers. The documentation must show why each study was clinically warranted. For the broader framework of how radiology imaging standards interact with payer coverage, see our overview of guidelines from the American College of Radiology.

Top Reasons CPT 71045 Claims Get Denied

Most 71045 denials trace back to a short list of avoidable errors. Across the billing companies we vet, these six issues account for the vast majority of chest X-ray claim rejections. Fix them before submission and the code runs clean.

• Billing the wrong view count. Reporting CPT 71046 for two views when only a single AP view is documented, or the reverse, is the most common audit trigger on chest imaging. The code must match the number of views in the image list.
• Duplicate component billing. A facility global claim plus a radiologist modifier 26 claim flags an overpayment on both sides. Only one form of the claim should go out for each study, and that responsibility should be defined contractually.
• Missing the interpretation report. Professional-component billing under modifier 26 requires a signed, written radiologist interpretation on file. The image alone is not sufficient. If the report is not documented at the time of billing, the claim will deny on audit.
• Coding a screening study. A chest X-ray ordered on an asymptomatic patient with no documented clinical indication is not covered by Medicare. The diagnosis must support a medical reason for the study.
• Mismatched diagnosis code. The ICD-10 code on the claim must match the documented indication and the payer’s LCD coverage logic. A vague or unsupported diagnosis triggers a medical-necessity denial.
• Omitting a repeat modifier. A same-day repeat study submitted without modifier 76 or 77 looks like a duplicate claim and denies automatically. Providers often come to us after losing revenue on repeat portable films simply because nobody appended the modifier before the claim went out.

How to Bill CPT 71045 Correctly

Billing 71045 cleanly requires getting four elements right before the claim leaves the practice. This is a high-volume, low-dollar code, which means individual denials look small but the aggregate loss across a busy radiology practice or ED adds up to significant revenue leakage over a quarter.

• Confirm the view count against the image record. Verify that the study captured a single view before reporting 71045. If the technologist shot a PA and lateral, the correct code is 71046.
• Assign the correct component modifier. Bill modifier 26 for the interpretation only, TC for the technical service only, or no modifier when one provider owns both. Never submit a global claim and a modifier 26 claim for the same study.
• Pair the claim with a supported ICD-10 code. Use the diagnosis that matches the documented clinical indication and satisfies the payer’s LCD. Common supported diagnoses include chest pain, cough, dyspnea, suspected pneumonia, and post-procedure line verification.
• Append repeat modifiers for same-day studies. If the patient has a second chest X-ray the same day, append modifier 76 for the same interpreting physician or 77 for a different physician. This prevents an automatic duplicate denial.

The most common issue we see providers run into is treating 71045 as too simple to get wrong. Because the per-claim dollar amount is low, billing teams often skip the verification steps they apply to higher-value imaging studies. The result is a steady drip of preventable denials that nobody notices until the quarterly revenue report comes in short.

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