How much does Medicare pay for CPT 72074?

Medicare allowed an average of $26.65 per service and paid $19.48 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $91.19, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 72074?

X-ray of middle spine, minimum of 4 views. It was billed 1,971 times to 1,856 Medicare beneficiaries by 84 providers in 2024.

Does 72074 pay differently in an office than a hospital?

Yes. The allowed amount averaged $33.83 in an office setting and $11.47 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 72074 most?

Diagnostic Radiology, with 1,283 services from 67 clinicians. Next are Nurse Practitioner, Internal Medicine, Independent Diagnostic Testing Facility (IDTF).

CPT 72074

X-ray of middle spine, minimum of 4 views

$26.65Medicare-allowed amount per service, averaged across 1,971 services

Providers submitted

$91.19

Asking price, not received

Medicare allowed

$26.65

The fee schedule figure

Medicare paid

$19.48

Balance is patient coinsurance

Providers submitted an average of $91.19 for this code and Medicare allowed $26.65 — 3.4× 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 $19.48 (73%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $33.83
Hospital / facility: $11.47

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. 1,338 services were billed in an office setting and 633 in a facility.

Services: 1,971
Beneficiaries: 1,856
Providers billing it: 84
Total allowed: $52,527

What Medicare pays for CPT 72074

Across 1,971 services billed by 84 providers to 1,856 beneficiaries, Medicare allowed an average of $26.65 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 72074

Specialty	Services	Beneficiaries	Avg allowed	Providers
Diagnostic Radiology	1,283	1,258	$20.61	67
Nurse Practitioner	207	190	$36.48	2
Internal Medicine	158	123	$40.00	1
Independent Diagnostic Testing Facility (IDTF)	128	125	$39.32	8
Portable X-Ray Supplier	98	74	$32.82	2
Orthopedic Surgery	68	57	$38.99	2
Emergency Medicine	17	17	$44.19	1
Family Practice	12	12	$47.17	1

72074 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
Arizona	516	$37.31	$28.37	8
Texas	157	$23.54	$18.46	9
Florida	154	$30.90	$22.53	9
Ohio	140	$11.83	$8.71	5
Illinois	118	$23.90	$18.19	5
Maryland	104	$27.64	$20.37	3
New Mexico	93	$11.77	$7.94	4
California	79	$35.40	$25.06	6
Alabama	79	$35.88	$32.98	3
North Carolina	69	$16.31	$13.21	4
New York	57	$40.61	$26.51	4
New Jersey	41	$12.30	$8.22	3
Louisiana	38	$36.94	$33.28	1
West Virginia	35	$11.19	$7.60	3
Georgia	34	$10.20	$8.64	2
Michigan	34	$11.29	$7.85	2
Mississippi	32	$38.45	$31.14	1
Delaware	31	$11.55	$8.50	1
Virginia	30	$41.61	$28.89	2
Iowa	29	$11.37	$7.31	2
Wisconsin	18	$10.63	$8.73	1
Kentucky	18	$11.06	$7.18	1
Minnesota	15	$11.62	$8.06	1
Indiana	15	$11.61	$9.12	1
Arkansas	12	$10.86	$9.11	1
New Hampshire	12	$10.98	$7.53	1
South Carolina	11	$10.25	$6.77	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
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

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.