CPT code 72200: SI joint X-ray, fewer than three views2026 Medicare rate & RVUs in Texas

Reports a focused radiographic examination of the sacroiliac joints with fewer than three views, commonly obtained to evaluate localized joint pain or suspected sacroiliitis.

CMS RVU26DEffective Oct 1, 20268 payment localities15K Medicare services in 2024

Medicare pays $31.22–$35.26 for 72200 in the office in Texas, from Beaumont, TX to Austin, TX. Which amount applies depends on the service address.

$31.22–$35.26Office (non-facility)
—Hospital or facility

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

Your location

Medicare pays by the payment locality where the service is performed.

On this page 9 sections
  1. Rate in Texas
  2. What 72200 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. Sources

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 Texas

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

8 payment localities

$31.22 to $35.26

$31.22$33.24$35.26
One dot per payment locality, office / nonfacility. Hover a dot to see the locality; select it to open that rate.

8 of 8 payment localities

72200 office and facility rates by payment locality
Payment localityOfficeFacility
Austin, TX$35.26Unavailable
Beaumont, TX$31.22Unavailable
Brazoria, TX$33.39Unavailable
Dallas, TX$33.58Unavailable
Fort Worth, TX$33.32Unavailable
Galveston, TX$33.47Unavailable
Houston, TX$33.84Unavailable
Rest of Texas$32.27Unavailable

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

Office or facility?

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

RuleCMS valueWhat it means
Global periodXXXThe global surgery concept doesn’t apply.
Multiple procedures0No multiple-procedure reduction.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical1Diagnostic 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.

When to use modifier 26

72200 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 72200

    SI joint X-ray, fewer than three views0.17 wRVU

    $33.73

  • 72202

    SI joint X-ray, three or more views0.22 wRVU

    $38.75+$5.02

  • 72220

    Sacrum X-ray, sacrum and coccyx0.17 wRVU

    $32.06−$1.67

  • 72170

    Pelvis X-ray, one or two views0.17 wRVU

    $28.06−$5.67

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
RVUs for 72200PPRRVU2026_Oct_nonQPP.csv, line 8,072 (RVU26D)

Open CMS sourceHow we calculate rates

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