CPT code 72100: Lumbar spine X-ray, two or three views2026 Medicare rate & RVUs in California
Plain-film radiographic exam of the lumbosacral spine with two or three views, typically AP and lateral, for low back pain, trauma, or postoperative checks.
Medicare pays $43.37–$55.34 for 72100 in the office in California, from Chico, CA to San Benito County, CA. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
What 72100 covers
This study images the lumbar vertebrae and lumbosacral junction with two or three plain radiographic views. A common set is an AP and a lateral, sometimes with a coned-down lateral spot of L5-S1 as the third view. Primary care, orthopedic, spine, emergency, and pain management clinicians may order it for back pain, suspected fracture, spondylolisthesis, degenerative change, or hardware position after fusion. A radiologic technologist acquires the images in an office, imaging center, emergency department, or hospital outpatient department; a radiologist or treating physician interprets them.
Code selection depends on the views actually obtained. A standard series with four or more views is reported with 72110; a complete study including bending views requires at least six views for 72114, while bending views alone are reported with 72120. Modifier 26 identifies the professional interpretation and signed report; modifier TC identifies the equipment, supplies, and technologist portion. When the same billing entity provides both portions, it reports the global service without either modifier. For hospital films, the reading physician typically reports modifier 26, while the hospital bills for image acquisition. The report should identify the views and findings.
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
Where 72100 pays more and less in California
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
29 payment localities
$43.37 to $55.34
29 of 29 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield, CA | $43.43 | Unavailable |
| Chico, CA | $43.37 | Unavailable |
| El Centro, CA | $43.37 | Unavailable |
| Fresno, CA | $43.37 | Unavailable |
| Hanford, CA | $43.37 | Unavailable |
| Los Angeles, CA | $46.47 | Unavailable |
| Madera, CA | $43.37 | Unavailable |
| Marin County, CA | $54.14 | Unavailable |
| Merced, CA | $43.37 | Unavailable |
| Modesto, CA | $43.37 | Unavailable |
| Napa, CA | $50.94 | Unavailable |
| Oxnard, CA | $46.32 | Unavailable |
| Redding, CA | $43.37 | Unavailable |
| Rest of California | $43.37 | Unavailable |
| Riverside, CA | $43.59 | Unavailable |
| Sacramento, CA | $45.69 | Unavailable |
| Salinas, CA | $45.53 | Unavailable |
| San Benito County, CA | $55.34 | Unavailable |
| San Diego, CA | $46.74 | Unavailable |
| San Francisco, CA | $54.12 | Unavailable |
| San Luis Obispo, CA | $44.77 | Unavailable |
| Santa Clara County, CA | $55.25 | Unavailable |
| Santa Cruz, CA | $47.29 | Unavailable |
| Santa Maria, CA | $45.74 | Unavailable |
| Santa Rosa, CA | $47.78 | Unavailable |
| Stockton, CA | $43.37 | Unavailable |
| Vallejo, CA | $50.90 | Unavailable |
| Visalia, CA | $43.37 | Unavailable |
| Yuba City, CA | $43.37 | Unavailable |
How the 72100 rate is calculated
Each of 72100’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 72100
RVUs × geographic indexes × conversion factor
Work0.21
0.21 RVUs× 1.000 GPCI
Practice expense0.98
0.98 RVUs× 1.000 GPCI
Malpractice0.02
0.02 RVUs× 1.000 GPCI
Adjusted RVUs
1.2100
Conversion factor
$33.4009
Medicare rate
$40.42
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 72100
The CMS indicators that decide how 72100 is paid alongside other services.
CMS payment indicators · 72100
Lumbar spine X-ray, two or three views
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 1 | Diagnostic test with separate professional (26) and technical (TC) components. |
What modifiers do to the payment
Modifier 26 · payment effect
With and without the modifier
72100 without 26 · national office
$40.42
Lumbar spine X-ray, two or three views
72100-26 · Professional component
$10.69
Pays only the interpretation and report.
72100 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 72110Lumbar spine X-rayMinimum of four views
- Count the views in a standard series. Two or three views support 72100; four or more, often including bilateral obliques, support 72110.
- 72114Spine X-raySix or more views
- 72114 requires a complete lumbosacral study including bending views, with at least six views total. Do not select it solely because flexion and extension images were added to a two-view study.
- 72120Lumbar X-rayBending views only
- 72120 covers two or three bending views taken alone. 72100 covers a two- or three-view standard lumbosacral series, typically AP and lateral.
- 72131Lumbar CTWithout contrast
- 72131 is a noncontrast lumbar CT used when cross-sectional detail is needed, such as further evaluation of a suspected fracture. 72100 is a two- or three-view plain radiographic exam.
72100 billing questions
When do lumbar spine films move from 72100 to 72110?
72100 covers two or three views. For a standard series with four or more views, such as AP, lateral, and both obliques, report 72110; a complete bending study with at least six views is reported with 72114.
Do AP and lateral views plus flexion and extension qualify for 72114?
Not by themselves. 72114 requires a complete study including bending views with at least six views total; 72120 describes two or three bending views taken alone.
Which modifier does a radiologist reading hospital films use?
The radiologist appends modifier 26 for the interpretation and report, while the hospital bills for image acquisition. An office that provides both the imaging and interpretation bills the global service without a component modifier.
Does a coned-down L5-S1 spot film count as a separate view?
Yes. A distinct spot lateral of the lumbosacral junction counts toward the view total, so AP, lateral, and spot lateral make a three-view study under 72100.
Can the treating physician bill an interpretation if the radiologist also reads the films?
A brief review of the images by the ordering physician does not support a separate modifier 26 claim. A separately reported interpretation requires its own medically necessary, signed written report.
What documentation supports 72100?
The record should include the clinical indication, images, and a signed written report identifying the two or three views obtained, findings, and impression.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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