Monte Carlo N-Particle version 4C (MCNP4C) was used to simulate photon interactions associated with in vivo x-ray fluorescence (XRF) measurement of stable lead in bone. Experimental measurements, performed using a cylindrical anthropometric phantom (i.e., surrogate) of the human leg made from tissue substitutes for muscle and bone, revealed a significant difference between the intensity of the observed and predicted coherent backscatter peak. The observed difference was due to the failure of MCNP4C to simulate photon scatter associated with greater than six inverse angstroms of momentum transfer. The MCNP4C source code, photon directory, and photon library were modified to incorporate atomic form factors up to 7.1 inverse angstroms for the high Z elements defined in the K XRF simulation. The intensity of the predicted coherent photon backscatter peak at 88 keV using the modified code increased from 3.50 x 10(-9) to 8.59 x 10(-7) (roughly two orders of magnitude) and compares favorably with the experimental measurements.