How much does Medicare pay for CPT 72050?

Medicare allowed an average of $35.18 per service and paid $25.64 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $146.26, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 72050?

X-ray of upper spine, 4-5 views. It was billed 245,139 times to 234,771 Medicare beneficiaries by 7,830 providers in 2024.

Does 72050 pay differently in an office than a hospital?

Yes. The allowed amount averaged $43.28 in an office setting and $12.51 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 72050 most?

Diagnostic Radiology, with 135,213 services from 4,560 clinicians. Next are Orthopedic Surgery, Physician Assistant, Neurosurgery.

CPT 72050

X-ray of upper spine, 4-5 views

$35.18Medicare-allowed amount per service, averaged across 245,139 services

Providers submitted

$146.26

Asking price, not received

Medicare allowed

$35.18

The fee schedule figure

Medicare paid

$25.64

Balance is patient coinsurance

Providers submitted an average of $146.26 for this code and Medicare allowed $35.18 — 4.2× 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 $25.64 (73%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $43.28
Hospital / facility: $12.51

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. 180,574 services were billed in an office setting and 64,565 in a facility.

Services: 245,139
Beneficiaries: 234,771
Providers billing it: 7,830
Total allowed: $8,623,990

What Medicare pays for CPT 72050

Across 245,139 services billed by 7,830 providers to 234,771 beneficiaries, Medicare allowed an average of $35.18 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 72050

Specialty	Services	Beneficiaries	Avg allowed	Providers
Diagnostic Radiology	135,213	130,852	$26.39	4,560
Orthopedic Surgery	45,897	42,483	$49.81	1,100
Physician Assistant	14,969	14,466	$38.99	551
Neurosurgery	8,746	7,822	$48.81	208
Physical Medicine and Rehabilitation	6,985	6,872	$50.34	238
Nurse Practitioner	6,793	6,544	$38.76	227
Independent Diagnostic Testing Facility (IDTF)	6,773	6,534	$48.04	227
Interventional Radiology	4,141	4,044	$23.72	147
Family Practice	3,464	3,394	$44.43	164
Rheumatology	2,693	2,673	$48.54	70
Pain Management	2,057	2,017	$52.01	56
Internal Medicine	1,642	1,617	$42.65	85
Interventional Pain Management	1,001	993	$49.01	38
Portable X-Ray Supplier	912	692	$41.54	14
Anesthesiology	727	720	$50.07	23

72050 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
California	23,860	$41.99	$26.76	710
Florida	18,467	$42.96	$32.31	497
Texas	15,017	$38.12	$29.04	484
Illinois	12,680	$30.39	$21.60	351
New York	11,423	$40.36	$26.81	351
Pennsylvania	11,163	$28.36	$20.17	371
Ohio	10,910	$19.92	$15.18	306
Virginia	9,479	$33.24	$24.11	273
New Jersey	8,826	$48.89	$32.53	308
Maryland	8,799	$42.88	$28.99	235
North Carolina	7,775	$31.97	$24.32	259
South Carolina	6,658	$35.67	$28.50	195
Georgia	6,564	$37.24	$29.29	237
Massachusetts	6,320	$29.45	$19.96	196
Michigan	6,037	$28.73	$21.61	203
Louisiana	5,967	$38.16	$32.16	159
Arizona	5,899	$40.93	$30.33	171
Tennessee	5,558	$33.55	$27.46	214
Colorado	5,512	$38.21	$27.11	190
Missouri	5,174	$21.75	$16.36	185
Alabama	4,236	$36.25	$31.03	138
Washington	4,208	$34.07	$23.66	156
Indiana	3,593	$31.24	$24.91	137
Oklahoma	2,899	$30.37	$25.47	97
Minnesota	2,842	$33.52	$24.46	111
Nevada	2,673	$43.90	$32.31	97
Kentucky	2,518	$26.65	$20.95	93
Iowa	2,327	$28.74	$22.45	82
Arkansas	2,250	$25.95	$21.53	68
Mississippi	2,089	$30.84	$25.78	80
Wisconsin	1,987	$27.67	$20.13	75
Nebraska	1,985	$34.61	$27.34	76
Connecticut	1,959	$39.59	$27.02	71
Oregon	1,654	$26.37	$18.89	70
Kansas	1,572	$29.94	$23.12	64
West Virginia	1,495	$13.45	$9.66	53
Utah	1,421	$28.14	$21.73	52
Delaware	1,397	$40.97	$30.50	32
New Hampshire	1,332	$28.57	$20.19	52
Alaska	1,032	$45.04	$29.48	34
Rhode Island	982	$39.23	$27.12	41
South Dakota	917	$36.93	$27.21	33
Idaho	897	$21.78	$17.03	37
Montana	807	$20.76	$15.02	35
Wyoming	772	$32.22	$23.13	30
New Mexico	770	$32.34	$24.55	31
Hawaii	734	$36.51	$24.85	17
Maine	549	$16.43	$11.09	26
District of Columbia	496	$26.10	$17.61	14
Vermont	304	$15.17	$11.06	15
North Dakota	217	$18.99	$13.62	11
Guam	46	$49.88	$28.10	3
AA	41	$27.29	$20.82	1
AP	36	$43.88	$30.15	2
Puerto Rico	14	$52.47	$35.91	1

Related codes

72040X-ray of upper spine$23.72
72070X-ray of middle spine$20.40
72082X-ray of entire middle and lower spine$39.67
72072X-ray of middle spine$19.03
72020X-ray of spine$14.55
72052X-ray of upper spine$42.79
72080X-ray of middle and lower spine$22.02
72083X-ray of entire middle and lower spine$38.30
72084X-ray of entire middle and lower spine$47.06
72081X-ray of entire middle and lower spine$28.90
72074X-ray of middle spine$26.65

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.