How much does Medicare pay for CPT 72080?

Medicare allowed an average of $22.02 per service and paid $16.47 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $94.13, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 72080?

X-ray of middle and lower spine, 2 views. It was billed 14,191 times to 11,897 Medicare beneficiaries by 602 providers in 2024.

Does 72080 pay differently in an office than a hospital?

Yes. The allowed amount averaged $27.04 in an office setting and $9.87 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 72080 most?

Diagnostic Radiology, with 5,400 services from 287 clinicians. Next are Orthopedic Surgery, Physician Assistant, Portable X-Ray Supplier.

CPT 72080

X-ray of middle and lower spine, 2 views

$22.02Medicare-allowed amount per service, averaged across 14,191 services

Providers submitted

$94.13

Asking price, not received

Medicare allowed

$22.02

The fee schedule figure

Medicare paid

$16.47

Balance is patient coinsurance

Providers submitted an average of $94.13 for this code and Medicare allowed $22.02 — 4.3× 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 $16.47 (75%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $27.04
Hospital / facility: $9.87

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. 10,043 services were billed in an office setting and 4,148 in a facility.

Services: 14,191
Beneficiaries: 11,897
Providers billing it: 602
Total allowed: $312,486

What Medicare pays for CPT 72080

Across 14,191 services billed by 602 providers to 11,897 beneficiaries, Medicare allowed an average of $22.02 per service. That is 1.2 services per beneficiary, so this is a code patients typically receive more than once. 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 72080

Specialty	Services	Beneficiaries	Avg allowed	Providers
Diagnostic Radiology	5,400	4,990	$13.58	287
Orthopedic Surgery	3,397	2,604	$32.26	124
Physician Assistant	1,332	1,086	$24.17	59
Portable X-Ray Supplier	821	593	$18.31	13
Neurosurgery	637	467	$28.78	17
Nurse Practitioner	621	511	$22.20	23
Pain Management	451	322	$23.13	14
Anesthesiology	373	322	$29.65	10
Physical Medicine and Rehabilitation	302	241	$33.36	13
Interventional Radiology	228	215	$9.73	11
Independent Diagnostic Testing Facility (IDTF)	120	89	$26.35	6
Radiation Oncology	86	75	$15.54	4
Interventional Pain Management	78	62	$33.30	3
Endocrinology	57	57	$22.05	2
Rheumatology	56	56	$29.50	3

72080 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	1,151	$26.09	$17.15	55
South Carolina	1,059	$26.11	$21.26	35
North Carolina	838	$26.05	$21.05	36
Florida	630	$30.19	$22.75	29
Maryland	608	$20.07	$14.51	17
Texas	585	$26.32	$20.21	27
Virginia	585	$22.89	$17.28	21
Ohio	555	$17.84	$13.57	21
Pennsylvania	533	$17.46	$12.78	23
New York	522	$25.00	$17.24	24
Illinois	430	$18.65	$14.15	23
Missouri	419	$14.18	$11.24	16
Mississippi	416	$23.71	$20.24	10
Michigan	396	$23.66	$18.18	19
Tennessee	369	$22.39	$18.30	20
Indiana	337	$26.84	$23.04	16
Minnesota	327	$17.81	$13.03	16
Arkansas	326	$13.84	$11.47	7
South Dakota	317	$15.54	$11.44	10
Wisconsin	309	$18.17	$13.78	16
Georgia	286	$25.49	$21.37	13
Washington	282	$22.28	$15.89	14
Louisiana	270	$25.14	$19.87	7
Massachusetts	258	$17.24	$12.57	9
Alabama	247	$24.87	$21.84	11
Nebraska	231	$16.42	$13.35	12
New Jersey	164	$23.48	$16.35	7
Kansas	162	$14.19	$12.02	7
Arizona	156	$26.62	$20.49	8
Oregon	153	$10.26	$7.35	7
Oklahoma	141	$21.64	$17.51	5
Delaware	138	$34.09	$24.60	3
New Hampshire	124	$15.21	$10.79	7
Colorado	113	$10.60	$7.69	7
Montana	102	$12.79	$9.20	6
Kentucky	100	$19.62	$15.46	7
Vermont	84	$9.73	$7.54	5
Maine	83	$9.75	$7.49	4
Iowa	77	$12.28	$10.33	5
North Dakota	61	$16.50	$12.25	3
Utah	49	$19.23	$15.32	3
Hawaii	45	$14.49	$10.22	2
Nevada	37	$33.92	$25.65	2
District of Columbia	32	$21.00	$13.76	1
West Virginia	29	$9.41	$7.35	2
Connecticut	16	$34.86	$22.41	1
Wyoming	14	$10.32	$7.27	1
Rhode Island	13	$32.42	$27.60	1
Idaho	12	$9.46	$7.20	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
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.