How much does Medicare pay for CPT 72052?

Medicare allowed an average of $42.79 per service and paid $31.69 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $175.33, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 72052?

X-ray of upper spine, 6 or more views. It was billed 23,742 times to 22,931 Medicare beneficiaries by 965 providers in 2024.

Does 72052 pay differently in an office than a hospital?

Yes. The allowed amount averaged $52.73 in an office setting and $14.19 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 72052 most?

Diagnostic Radiology, with 12,942 services from 603 clinicians. Next are Orthopedic Surgery, Independent Diagnostic Testing Facility (IDTF), Physical Medicine and Rehabilitation.

CPT 72052

X-ray of upper spine, 6 or more views

$42.79Medicare-allowed amount per service, averaged across 23,742 services

Providers submitted

$175.33

Asking price, not received

Medicare allowed

$42.79

The fee schedule figure

Medicare paid

$31.69

Balance is patient coinsurance

Providers submitted an average of $175.33 for this code and Medicare allowed $42.79 — 4.1× 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 $31.69 (74%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $52.73
Hospital / facility: $14.19

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. 17,618 services were billed in an office setting and 6,124 in a facility.

Services: 23,742
Beneficiaries: 22,931
Providers billing it: 965
Total allowed: $1,015,920

What Medicare pays for CPT 72052

Across 23,742 services billed by 965 providers to 22,931 beneficiaries, Medicare allowed an average of $42.79 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 72052

Specialty	Services	Beneficiaries	Avg allowed	Providers
Diagnostic Radiology	12,942	12,675	$31.83	603
Orthopedic Surgery	3,611	3,388	$58.77	110
Independent Diagnostic Testing Facility (IDTF)	1,369	1,329	$54.35	57
Physical Medicine and Rehabilitation	1,259	1,189	$57.07	37
Rheumatology	713	696	$61.99	21
Neurosurgery	709	604	$56.35	20
Physician Assistant	535	527	$50.09	19
Nurse Practitioner	440	437	$45.65	20
Interventional Radiology	308	289	$31.86	17
Pain Management	266	249	$57.43	11
Internal Medicine	236	215	$58.34	9
Osteopathic Manipulative Medicine	221	209	$57.91	2
Family Practice	210	205	$53.12	10
General Practice	194	191	$55.32	3
Dentist	171	171	$55.64	1

72052 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
Florida	3,256	$53.98	$40.66	113
California	2,514	$51.97	$34.48	105
Texas	2,107	$37.76	$29.27	81
Arizona	1,247	$53.40	$40.04	49
Virginia	1,209	$47.04	$35.53	34
New York	1,134	$42.88	$28.83	57
Ohio	1,088	$18.53	$13.73	42
New Jersey	1,072	$59.37	$40.27	49
Illinois	965	$30.78	$23.30	49
Maryland	831	$46.55	$32.09	32
North Carolina	817	$35.62	$28.67	32
Missouri	717	$28.02	$21.88	31
Georgia	707	$33.81	$26.18	34
Pennsylvania	598	$43.35	$32.69	26
Louisiana	595	$47.58	$40.38	19
Michigan	567	$34.09	$26.09	24
Alabama	424	$33.09	$27.91	18
Oklahoma	390	$46.68	$39.32	8
Kentucky	354	$36.33	$28.30	16
Tennessee	353	$38.33	$29.50	17
Massachusetts	339	$27.00	$18.63	11
West Virginia	210	$13.84	$9.55	14
New Hampshire	209	$49.92	$31.95	6
Kansas	178	$51.94	$40.58	5
Indiana	171	$44.37	$35.27	8
New Mexico	168	$29.35	$21.77	9
South Carolina	166	$16.34	$12.78	10
Minnesota	165	$27.78	$20.91	8
Washington	135	$46.13	$33.67	9
Arkansas	122	$43.49	$36.79	5
Mississippi	118	$44.75	$37.78	3
Colorado	111	$38.09	$29.16	6
Wisconsin	96	$14.40	$10.27	4
Connecticut	91	$43.30	$30.74	5
Nebraska	68	$50.55	$41.71	3
Wyoming	60	$50.16	$36.67	3
Hawaii	57	$56.26	$37.22	2
Utah	50	$55.63	$42.02	3
Iowa	49	$13.81	$8.55	2
Delaware	44	$61.53	$41.80	2
Rhode Island	37	$37.02	$26.53	2
Montana	33	$14.30	$9.94	2
District of Columbia	25	$48.29	$35.19	1
Puerto Rico	25	$15.96	$11.98	2
Idaho	22	$13.36	$9.49	1
Nevada	20	$56.43	$47.54	1
Maine	16	$52.85	$41.44	1
Alaska	12	$69.82	$44.67	1

Related codes

72040X-ray of upper spine$23.72
72050X-ray of upper spine$35.18
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
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.