Summary & Overview
CPT 71045: Chest X-ray, Single View
CPT code 71045 is a nationally recognized billing code for a single-view chest radiologic examination, a fundamental diagnostic imaging procedure used to assess a wide range of chest conditions. This code is integral to clinical workflows in outpatient hospital and office settings, serving as a first-line imaging tool for symptoms such as chest pain, shortness of breath, and suspected pneumonia. The publication covers key payers including Aetna, Blue Cross Blue Shield, Cigna Health, Medicare, and UnitedHealthcare, providing a comprehensive overview of payer coverage and policy considerations.
Readers will gain insight into the clinical context of 71045, including its role in diagnostic radiology, typical sites of service, and its relationship to other chest and abdominal imaging codes. The summary also highlights relevant modifiers and associated taxonomies, offering clarity on billing components and professional versus technical services. Benchmarks and policy updates are discussed to inform stakeholders about current trends and requirements for this essential radiology service. The publication is designed to support healthcare professionals, administrators, and policy analysts in understanding the national landscape for chest radiologic examinations and their reimbursement.
CPT Code Overview
CPT code 71045 represents a radiologic examination of the chest with a single view. This procedure is commonly performed as part of diagnostic imaging to evaluate conditions affecting the lungs, heart, and chest wall. The service type is Radiology / Diagnostic Imaging, and it is typically provided in an outpatient hospital or office setting (such as Place of Service 11). This code is widely used in clinical practice for initial assessment and follow-up of various chest-related symptoms and conditions.
Clinical & Coding Specifications
Clinical Context
A patient presents to an outpatient hospital or office setting with symptoms such as chest pain, shortness of breath, or suspected pneumonia. The clinician orders a radiologic examination of the chest, single view (71045), to evaluate for possible lung pathology, heart size, or other abnormalities. The workflow typically involves the radiology technologist performing the chest X-ray, followed by a radiologist interpreting the image and providing a report to the referring provider.
Coding Specifications
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Modifiers:
- Modifier
26: Used to indicate the professional component, which covers the interpretation and report by the radiologist. - Modifier
TC: Used to indicate the technical component, which covers the use of equipment and performance of the X-ray by the technologist.
- Modifier
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Provider Taxonomies:
| Taxonomy Code | Specialty Name |
|---|---|
2085R0200X | Diagnostic Radiology |
- Specialty Representation:
- Diagnostic Radiology: Providers specializing in imaging and interpretation of radiologic studies.
Related Diagnoses
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R07.9: Chest pain, unspecified- Relevant for patients presenting with chest pain, prompting evaluation for cardiac or pulmonary causes.
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J18.9: Pneumonia, unspecified organism- Used when pneumonia is suspected, as chest X-ray helps confirm diagnosis and assess severity.
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R91.8: Other nonspecific abnormal finding of lung field- Applied when prior imaging or clinical exam suggests abnormal lung findings requiring further investigation.
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J44.9: Chronic obstructive pulmonary disease, unspecified- Used for patients with known or suspected COPD, as chest X-ray assists in evaluating disease progression or complications.
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R06.02: Shortness of breath- Relevant for patients with dyspnea, where chest X-ray is performed to rule out pulmonary or cardiac causes.
Related CPT Codes
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71046: Radiologic examination, chest; 2 views- Used when a two-view chest X-ray is clinically indicated for more comprehensive evaluation than a single view.
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71047: Radiologic examination, chest; 3 views- Ordered when additional views are needed to clarify findings or assess specific areas of the chest.
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71048: Radiologic examination, chest; 4 or more views- Utilized for complex cases requiring multiple views for thorough assessment.
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74018: Radiologic examination, abdomen; 1 view- Sometimes performed in conjunction with chest X-rays to evaluate abdominal symptoms or conditions that may overlap with chest pathology.
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Clinical Workflow Relation:
- Codes
71046,71047, and71048are alternatives to71045when more views are required. 74018may be used together with chest X-ray codes if both chest and abdominal imaging are needed.
- Codes
National Reimbursement Benchmarks
Commercial payers nationally reimburse CPT code 71045 at higher mean rates than Medicare. The average commercial rate (BUCA) is $22.34, while Medicare's mean rate is $17.59. Among individual commercial payers, Cigna has the highest mean rate at $25.70, and Aetna the lowest at $20.25.
Rate dispersion, measured by the difference between the 75th and 25th percentiles, varies across payers. Aetna shows the tightest range ($8.67), while Cigna exhibits the widest ($16.83), indicating greater variability in Cigna's rates. Medicare's range is $15.00, also reflecting significant dispersion.
The table and chart below present a full breakdown of national mean rates and percentile values for each payer.
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.