Billing code 72100: Lumbar spine X-rayMedicare rate & RVUs

Medicare pays $40.42 for 72100 nationally in the office. Local office rates run $35.48–$55.34.

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

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

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

109 of 109 payment localities

72100 rates by state

Office rate range in each state. Select a state to see its payment localities.

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.

Payment rules and modifiers for 72100

The CMS indicators that decide how 72100 is paid alongside other services.

What modifiers do to the payment

When to use modifier 26

72100 compared with similar codes

How to choose

72110Lumbar spine X-ray

Count the views in a standard series. Two or three views support 72100; four or more, often including bilateral obliques, support 72110.

72114Spine X-ray

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-ray

72120 covers two or three bending views taken alone. 72100 covers a two- or three-view standard lumbosacral series, typically AP and lateral.

72131Lumbar CT

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.

Codes related to 72100

Related codes aren’t interchangeable: bill the code that matches the service performed.

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

Open CMS sourceHow we calculate rates