CPT 71046: Chest X-ray, 2 views
What this code means, what it should cost, and how to dispute an overcharge.
Fair Price Reference
What is CPT 71046?
A two-view chest X-ray — the most common X-ray performed in hospitals and clinics.
Typical setting: Hospital, ER, or imaging center.
What CPT 71046 should cost
The Centers for Medicare & Medicaid Services (CMS) pays approximately $32 for CPT 71046 under the 2025 Physician Fee Schedule. This is what the federal government has determined is a reasonable payment for this service.
Private insurance typically pays 1.2–1.8x Medicare rates ($38–$58). Hospital chargemaster prices for CPT 71046 often range from $100 to $500 — a markup of 3.1x to 15.6x over Medicare.
Reality check: Medicare pays $32. Hospital charges of $500+ represent a 15x+ markup.
Common overcharges on CPT 71046
Hospitals frequently bill 2-view chest X-rays at $500–$900. Medicare allowable is $32. Outside a true emergency, a standalone chest X-ray at an independent imaging center is typically $50–$120.
About Radiology billing
Medical imaging has among the largest price variations of any medical service. The same MRI can cost $400 at an independent imaging center or $6,000 at a hospital-owned facility.
Request site-of-service information. Compare the charge against Medicare allowable and typical self-pay rates at independent imaging centers. Dispute any contrast charges not documented in the radiology report.
How to dispute a CPT 71046 overcharge
- Request the itemized bill. You are entitled to a detailed line-by-line bill showing every CPT code billed. Ask in writing.
- Compare to Medicare allowable. If the charge exceeds 150% of Medicare ($48), you have grounds to dispute.
- Request documentation. For E&M codes, ask for the visit note. For procedures, ask for the operative report. The documentation must justify the code billed.
- Send a formal dispute letter. Cite the specific discrepancy between the documentation and the code. Reference Medicare rates and NCCI edits where applicable.
- Follow up in writing. Give the provider 30 days to respond. If they don't, escalate to the state attorney general and insurance commissioner.
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