Billing code 72020: Spine X-rayMedicare rate & RVUs in Maine
Report a single-view spine radiograph when one image is obtained to assess or localize a spinal level, rather than a multiview or entire-spine study.
Medicare pays $22.05–$23.31 for 72020 in the office in Maine, from Rest Of Maine to Southern Maine. 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 72020 covers
This service covers a diagnostic X-ray examination of the spine consisting of one view. It may be used to assess a spinal finding or to localize a vertebral level, including when a clinician needs a single image during a procedure. A radiologist or other qualified practitioner interprets the image; imaging staff perform the technical work in an office, hospital, or other imaging setting.
Select the code when the documented examination is limited to one spine view; use a regional or entire-spine code when the study covers that defined area or includes more views. The record should identify the spinal level or region, the view obtained, the clinical reason, and the interpretation. Medicare recognizes professional and technical components: modifier 26 identifies interpretation, modifier TC identifies equipment and staff, and billing without either modifier represents the global service.
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 72020 pays more and less in Maine
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Maine | $22.05 | Unavailable |
| Southern Maine | $23.31 | Unavailable |
How the 72020 rate is calculated
Each of 72020’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 · 72020
RVUs × geographic indexes × conversion factor
Work0.16
0.16 RVUs× 1.000 GPCI
Practice expense0.53
0.53 RVUs× 1.000 GPCI
Malpractice0.02
0.02 RVUs× 1.000 GPCI
Adjusted RVUs
0.7100
Conversion factor
$33.4009
Medicare rate
$23.71
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 72020
The CMS indicators that decide how 72020 is paid alongside other services.
CMS payment indicators · 72020
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
72020 without 26 · national office
$23.71
Spine X-ray
72020-26 · Professional component
$7.68
Pays only the interpretation and report.
72020 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 72040Cervical spine X-ray
- 72040 is for a cervical spine study with two or three views. Use 72020 for a single-view spine study rather than a multiview cervical examination.
- 72070Thoracic spine X-ray
- 72070 describes a two-view thoracic spine study. The one-view count distinguishes 72020.
- 72081Spine X-ray
- 72081 is specifically for a single-view examination of the entire spine. Use 72020 when the study is a single spine view but is not documented as covering the entire spine.
72020 billing questions
When should 72020 be chosen instead of a multiview spine code?
Use 72020 when the documented spine examination consists of one view. Choose the applicable regional or entire-spine code when the study has more views or covers the entire spine.
Can this code describe a single image used to localize a spinal level?
Yes, a single-view image may be used for spinal-level localization. The documentation should identify the level or region and the reason for imaging.
How are the professional and technical services reported?
Report modifier 26 for the interpretation and modifier TC for the equipment and staff. Without either modifier, the claim represents the global service.
What should the imaging record include?
Document the spinal level or region, that one view was obtained, the clinical indication, and the interpretation. These details support the single-view code selection.
Is 72020 appropriate for a single view of the entire spine?
For a single view of the entire spine, compare 72081, which specifically describes an entire-spine examination. Use 72020 for a single-view spine examination that is not documented as an entire-spine study.
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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