CPT code 72200: SI joint X-ray, fewer than three views2026 Medicare rate & RVUs in California
Reports a focused radiographic examination of the sacroiliac joints with fewer than three views, commonly obtained to evaluate localized joint pain or suspected sacroiliitis.
Medicare pays $36.15–$46.16 for 72200 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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What 72200 covers
This code describes a focused X-ray examination of the sacroiliac joints using fewer than three views. It is commonly used when pain is localized near the SI joints or imaging is needed to assess suspected sacroiliitis or other joint changes. A technologist acquires the images in an outpatient imaging department, hospital, or office with radiographic equipment; a physician, often a radiologist, interprets the study and documents the findings.
Select this code based on the number of views performed: fewer than three supports this service, while three or more views point to the higher-view sibling code. The imaging report and order should support the SI-joint focus and the views obtained. The global service is billed without a component modifier. Modifier 26 identifies the physician’s interpretation, while modifier TC identifies the technical service, including equipment and staff; CMS separately prices these modifiers.
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 72200 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
$36.15 to $46.16
29 of 29 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield, CA | $36.21 | Unavailable |
| Chico, CA | $36.15 | Unavailable |
| El Centro, CA | $36.15 | Unavailable |
| Fresno, CA | $36.15 | Unavailable |
| Hanford, CA | $36.15 | Unavailable |
| Los Angeles, CA | $38.76 | Unavailable |
| Madera, CA | $36.15 | Unavailable |
| Marin County, CA | $45.14 | Unavailable |
| Merced, CA | $36.15 | Unavailable |
| Modesto, CA | $36.15 | Unavailable |
| Napa, CA | $42.47 | Unavailable |
| Oxnard, CA | $38.63 | Unavailable |
| Redding, CA | $36.15 | Unavailable |
| Rest of California | $36.15 | Unavailable |
| Riverside, CA | $36.37 | Unavailable |
| Sacramento, CA | $38.09 | Unavailable |
| Salinas, CA | $37.96 | Unavailable |
| San Benito County, CA | $46.16 | Unavailable |
| San Diego, CA | $38.97 | Unavailable |
| San Francisco, CA | $45.12 | Unavailable |
| San Luis Obispo, CA | $37.33 | Unavailable |
| Santa Clara County, CA | $46.06 | Unavailable |
| Santa Cruz, CA | $39.43 | Unavailable |
| Santa Maria, CA | $38.13 | Unavailable |
| Santa Rosa, CA | $39.84 | Unavailable |
| Stockton, CA | $36.15 | Unavailable |
| Vallejo, CA | $42.44 | Unavailable |
| Visalia, CA | $36.15 | Unavailable |
| Yuba City, CA | $36.15 | Unavailable |
How the 72200 rate is calculated
Each of 72200’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 · 72200
RVUs × geographic indexes × conversion factor
Work0.17
0.17 RVUs× 1.000 GPCI
Practice expense0.82
0.82 RVUs× 1.000 GPCI
Malpractice0.02
0.02 RVUs× 1.000 GPCI
Adjusted RVUs
1.0100
Conversion factor
$33.4009
Medicare rate
$33.73
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 72200
The CMS indicators that decide how 72200 is paid alongside other services.
CMS payment indicators · 72200
SI joint X-ray, fewer than 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
72200 without 26 · national office
$33.73
SI joint X-ray, fewer than three views
72200-26 · Professional component
$8.35
Pays only the interpretation and report.
72200 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 72202SI joint X-rayThree or more views
- Both codes cover SI-joint radiography; select 72200 for fewer than three views and 72202 for three or more.
- 72220Sacrum X-raySacrum and coccyx
- 72200 examines the sacroiliac joints, while 72220 is directed to the sacrum and coccyx.
- 72170Pelvis X-rayOne or two views
- 72200 is a focused SI-joint study; 72170 is a pelvis radiograph. Use the code matching the documented examination.
72200 billing questions
When should 72200 be used instead of 72202?
Choose 72200 when the SI-joint examination includes fewer than three views. Three or more views correspond to 72202.
What does the unmodified code represent?
It represents the global service, including both image acquisition and physician interpretation. Use modifier 26 for the professional interpretation or TC for the technical service when billing those portions separately.
What documentation supports 72200?
The order and imaging record should identify the SI joints as the examination focus and document the views performed. The interpretation should include the physician’s findings.
Is an X-ray of the sacrum or tailbone the same service?
No. 72200 focuses on the sacroiliac joints; 72220 describes imaging of the sacrum and coccyx. Select according to the body area examined.
Which modifier identifies the radiologist’s interpretation?
Modifier 26 identifies the professional interpretation. Modifier TC identifies the technical portion, including imaging equipment and staff.
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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