How much does Medicare pay for CPT 62304?

Medicare allowed an average of $156.91 per service and paid $121.83 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $762.35, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 62304?

X-ray of lower spinal canal with review by radiologist. It was billed 1,478 times to 1,474 Medicare beneficiaries by 82 providers in 2024.

Does 62304 pay differently in an office than a hospital?

Yes. The allowed amount averaged $234.84 in an office setting and $104.84 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 62304 most?

Diagnostic Radiology, with 1,005 services from 59 clinicians. Next are Physician Assistant, Independent Diagnostic Testing Facility (IDTF), Neurosurgery.

CPT 62304

X-ray of lower spinal canal with review by radiologist

$156.91Medicare-allowed amount per service, averaged across 1,478 services

Providers submitted

$762.35

Asking price, not received

Medicare allowed

$156.91

The fee schedule figure

Medicare paid

$121.83

Balance is patient coinsurance

Providers submitted an average of $762.35 for this code and Medicare allowed $156.91 — 4.9× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $121.83 (78%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $234.84
Hospital / facility: $104.84

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 592 services were billed in an office setting and 886 in a facility.

Services: 1,478
Beneficiaries: 1,474
Providers billing it: 82
Total allowed: $231,913

What Medicare pays for CPT 62304

Across 1,478 services billed by 82 providers to 1,474 beneficiaries, Medicare allowed an average of $156.91 per service. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 62304

Specialty	Services	Beneficiaries	Avg allowed	Providers
Diagnostic Radiology	1,005	1,003	$165.97	59
Physician Assistant	205	204	$95.25	10
Independent Diagnostic Testing Facility (IDTF)	104	104	$241.52	5
Neurosurgery	54	54	$165.09	3
Interventional Radiology	40	39	$112.35	2
Pain Management	36	36	$111.62	1
Nurse Practitioner	34	34	$89.32	2

62304 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
Texas	481	$158.29	$126.67	25
Tennessee	161	$196.37	$169.72	7
North Carolina	93	$190.51	$156.94	7
Georgia	88	$157.28	$125.95	5
Virginia	80	$141.03	$112.49	4
Missouri	67	$108.54	$90.90	3
Oklahoma	54	$106.69	$87.70	3
New York	47	$245.51	$188.10	2
Wyoming	47	$111.56	$85.76	2
Kansas	43	$103.22	$82.86	3
South Carolina	43	$95.68	$85.98	3
Mississippi	42	$105.16	$87.66	2
Kentucky	42	$107.80	$84.84	3
Arkansas	33	$157.16	$125.32	1
Louisiana	23	$109.47	$85.80	1
Alabama	23	$162.13	$133.46	2
Indiana	23	$220.81	$195.81	2
Minnesota	23	$251.84	$196.62	2
California	17	$299.43	$196.85	1
Utah	15	$93.02	$67.01	1
South Dakota	11	$102.66	$84.64	1
Washington	11	$252.30	$159.58	1
Michigan	11	$119.29	$76.13	1

Related codes

62323Injection of substance into lower spine canal$200.33
62321Injection of substance into middle or upper spine canal$215.08
62370Electronic analysis reprogramming and refill of spinal canal drug infu$76.65
62328Removal of spinal fluid$81.96
62369Electronic analysis reprogramming and refill of spinal canal drug infu$78.93
62368Electronic analysis and reprogramming of spinal canal drug infusion pu$39.38
62322Injection of substance into lower spine canal$84.43
62367Electronic analysis of spinal canal drug infusion pump$28.62
62362Insertion of programmable spinal canal drug infusion pump$4222.97
62324Insertion of tube and injection of substance into middle or upper spin$90.95
62350Insertion, revision, or repositioning of spinal canal tube for medicat$922.79

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.