$37.08–$41.32
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.
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CMS RVU26D · Effective 2026-10-01
72020 Spine X-ray Medicare reimbursement rates in Pennsylvania
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. Compare 72020 office and facility rates across CMS payment localities in Pennsylvania.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 72020 in Pennsylvania?
Pennsylvania has 2 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 2 payment areas shown below, using the same CMS release.
Office / nonfacility
$22.23–$24.67
2 of 2 localities have a supported rate.
Facility setting
No supported rate
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Radiology
About 72020: Single-view spine radiograph
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.
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.
CMS billing rules for 72020
- Professional and technical components
- Diagnostic test with a professional component (modifier 26, interpretation) and a technical component (modifier TC, equipment and staff); billing without a modifier is the global service.
Where the value comes from
- Work RVU0.16 · 23%
- Practice expense (office) RVU0.53 · 75%
- Malpractice RVU0.02 · 3%
92.6K
Medicare services in 2024 · #585 by national volume
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.
72020 compared with similar codes
Office rates for Pennsylvania, from the same CMS release.
$30.92–$34.37
72070 describes a two-view thoracic spine study. The one-view count distinguishes 72020.
$41.19–$45.86
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.
Compare 72020 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
2 of 2 payment localities
Metropolitan Philadelphia →
Office / nonfacility
$24.67
Facility
Unavailable
Rest Of Pennsylvania →
Office / nonfacility
$22.23
Facility
Unavailable
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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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
7,93471555,,Mri angio chest w or w/o dye,R,,1.76,8.12,,8.12,NA,0.13,10.01,10.01,1,XXX,0.00,0.00,0.00,4,0,0,0,0,9,,33.4009,09,0,88,11.23,11.23,0.15
7,93571555,26,Mri angio chest w or w/o dye,R,,1.76,0.62,,0.62,,0.09,2.47,2.47,1,XXX,0.00,0.00,0.00,4,0,0,0,0,9,,33.4009,09,0,88,0.00,0.00,0.00
7,93671555,TC,Mri angio chest w or w/o dye,R,,0.00,7.50,,7.50,NA,0.04,7.54,7.54,1,XXX,0.00,0.00,0.00,4,0,0,0,0,9,,33.4009,02,0,88,10.61,10.61,0.06
7,93772020,,X-ray exam of spine 1 view,A,,0.16,0.53,,0.53,NA,0.02,0.71,0.71,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,2.67,2.67,0.07
7,93872020,26,X-ray exam of spine 1 view,A,,0.16,0.06,,0.06,,0.01,0.23,0.23,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
7,93972020,TC,X-ray exam of spine 1 view,A,,0.00,0.47,,0.47,NA,0.01,0.48,0.48,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,01,0,99,2.61,2.61,0.06
7,94072040,,X-ray exam neck spine 2-3 vw,A,,0.21,0.96,,0.96,NA,0.02,1.19,1.19,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,2.72,2.72,0.04