Billing code 72040: Cervical spine X-rayMedicare rate & RVUs in Guam
Reports a plain radiographic examination of the cervical spine with two or three views, commonly ordered to evaluate neck pain, stiffness, or injury.
Medicare pays $43.86 for 72040 in the office in Guam (Hawaii, Guam). 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.
On this page 9 sections
What 72040 covers
This service is a plain X-ray examination of the cervical spine, capturing two or three views to assess the neck vertebrae and alignment. It is commonly ordered for symptoms such as neck pain or stiffness and for evaluation after an injury. A radiologic technologist typically acquires the images in an imaging department, hospital, or physician office; a radiologist or other qualified physician interprets them and documents findings.
Select this code when the completed cervical spine examination contains two or three views; use the documented views obtained rather than the number requested. The record should identify the cervical spine, the images acquired, and the clinical reason for the study, with an interpretation supporting the professional service. CMS recognizes professional and technical components: report modifier 26 for interpretation, modifier TC for equipment and staff, or neither modifier when billing the global service. The professional and technical components are separately priced when billed with their respective 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.
72040 in Hawaii, Guam
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam | $43.86 | Unavailable |
How the 72040 rate is calculated
Each of 72040’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 · 72040
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 0.21Practice expense 0.96Malpractice 0.02
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 72040
The CMS indicators that decide how 72040 is paid alongside other services.
CMS payment indicators · 72040
Cervical spine X-ray
| 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
72040 without 26 · national office
$39.75
Cervical spine X-ray
72040-26 · Professional component
$10.35
Pays only the interpretation and report.
72040 compared with similar codes
Compare codes
72040 vs 72020 vs 72050 vs 72052: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 72020Spine X-ray
- 72020 describes a single-view spine X-ray. Choose 72040 when two or three cervical spine views are obtained.
- 72050Neck spine X-ray
- 72050 is for four- or five-view cervical spine imaging; 72040 is for two or three views.
- 72052Cervical X-ray
- 72052 applies to cervical spine examinations with six or more views, rather than the two- or three-view study reported with 72040.
72040 billing questions
How is this code distinguished from the four- or five-view cervical spine code?
Use 72040 for a cervical spine examination with two or three views. When the completed study has four or five views, compare with 72050.
Does 72040 include the radiologist's interpretation?
The global service includes both image acquisition and interpretation. A professional-only claim uses modifier 26; a technical-only claim uses modifier TC.
What documentation supports the view count?
Document the cervical spine study and the views actually acquired. The report should also identify the clinical reason and include the interpretation when the professional service is billed.
Can 72040 be reported for a one-view cervical spine study?
No. The one-view spine code, 72020, is the relevant comparison when only one view is performed; 72040 describes two or three cervical spine views.
Is this code appropriate for thoracic spine imaging?
No. 72040 is specific to the cervical spine. Thoracic spine studies use codes for that region, with selection based on the views 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
Show the CMS file lines behind this rate
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