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CPT 73701: CT leg with contrast - Prior Authorization and Price

CPT code 73701 is CT leg with contrast. See what Aetna, Anthem BCBS, Cigna, Medicare, UnitedHealthcare look for before approving it, the conditions their guidelines cover, and what it typically costs.

CPT 73701

CT imaging of the leg conducted with contrast dye.

CT Leg, Hip & Knee
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Payer guidelines that apply

PayerReviewed usingGuidelineSections
Aetna eviCore
Musculoskeletal Imaging Guidelines 2.0.2026, effective Sep 1, 2026
7 that name this code
Anthem BCBS Carelon
Imaging of the extremities effective Sep 19, 2026
Oncologic imaging effective Apr 4, 2026
35 that name this code
Cigna eviCore
Musculoskeletal Imaging Guidelines 2.0.2026, effective Sep 1, 2026
7 that name this code
Medicare CMS
NCD 220.1: Computed Tomography effective Mar 12, 2008
1 that name this code
Original Medicare does not run a prior authorization program for outpatient imaging; claims are judged against the coverage policies above. Medicare Advantage plans set their own prior authorization rules.
UnitedHealthcare UnitedHealthcare / eviCore 7 that name this code

Guidelines collected from the payers' published documents on September 29, 2026. Payers revise these documents during the year. Open the guideline link to confirm the current version before you submit.

Conditions the guidelines address for this study

These are the clinical situations where payer guidelines discuss CT leg with contrast. Each has its own criteria for when the study is considered appropriate.

  • Acute traumatic injuries –not otherwise specified Anthem BCBS
  • Avascular necrosis Anthem BCBS
  • Cancer screening, not otherwise specified Anthem BCBS
  • Colorectal cancer screening Anthem BCBS
  • Congenital or developmental anomalies of the extremity (Pediatric only) Anthem BCBS
  • Fracture Anthem BCBS
  • Hemarthrosis Anthem BCBS
  • Histiocytic Neoplasms Anthem BCBS
  • Indeterminate bone lesion Anthem BCBS
  • Intra-articular loose body Anthem BCBS
  • Juvenile idiopathic arthritis (Pediatric only) Anthem BCBS
  • Knee arthroplasty, presurgical planning Anthem BCBS
  • Labral tear and femoral acetabular impingement – hip Anthem BCBS
  • Legg-Calve-Perthes disease (Pediatric only) Anthem BCBS
  • Ligament tear – knee Anthem BCBS
  • Lisfranc injury Anthem BCBS
  • Lower extremity pain, not otherwise specified Anthem BCBS
  • Meniscal tear/injury Anthem BCBS
  • Morton’s neuroma Anthem BCBS
  • Myositis Anthem BCBS
  • Neuroendocrine Tumors Anthem BCBS
  • Neuropathic osteoarthropathy (Charcot joint) (Adult only) Anthem BCBS
  • Non-specific hip pain, including limping child (Pediatric only) Anthem BCBS
  • Osteochondral lesion (including osteochondritis dissecans, transient dislocation of patella) Anthem BCBS
  • Osteomyelitis Anthem BCBS
  • Paget disease Anthem BCBS
  • Perioperative Imaging (including delayed hardware failure), not otherwise specified Anthem BCBS
  • Pigmented villonodular synovitis Anthem BCBS
  • Plantar fasciitis and fibromatosis Anthem BCBS
  • Septic arthritis Anthem BCBS
  • Slipped capital femoral epiphysis (Pediatric only) Anthem BCBS
  • Soft tissue infection Anthem BCBS
  • Soft tissue mass – not otherwise specified Anthem BCBS
  • Tarsal coalition Anthem BCBS
  • Tarsal tunnel Anthem BCBS
  • Capsular/Synovial and Meniscal Dysfunction Aetna · Cigna · UnitedHealthcare
  • Chondral/Osteochondral Lesions Aetna · Cigna · UnitedHealthcare
  • Foreign and Loose Bodies Aetna · Cigna · UnitedHealthcare
  • Infection Aetna · Cigna · UnitedHealthcare
  • Joint Instability and Dysfunction Aetna · Cigna · UnitedHealthcare

Plus 3 more. Use the search below to find a specific condition.

Typical price

Commercial insurance, median
$864
Middle half of rates: $428 to $1,786
Medicare, hospital outpatient
$179
Facility payment
Medicare, physician fee schedule
$167
National, non-facility

Commercial figures come from negotiated rates published by 1,087 hospitals; Medicare figures from CMS fee schedules. Rates vary widely by hospital and plan. Pricing data from CenterIQ.

Get notified when the rules for this study change

Payers update imaging guidelines several times a year. We will email you when the criteria for CT leg with contrast change.

Frequently asked questions

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