How much does Medicare pay for CPT 72120?

Medicare allowed an average of $29.91 per service and paid $22.21 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $132.58, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 72120?

X-ray lower and sacral spine, 2-3 views bending views. It was billed 22,451 times to 21,758 Medicare beneficiaries by 665 providers in 2024.

Does 72120 pay differently in an office than a hospital?

Yes. The allowed amount averaged $35.45 in an office setting and $10.47 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 72120 most?

Diagnostic Radiology, with 8,216 services from 361 clinicians. Next are Orthopedic Surgery, Physician Assistant, Neurosurgery.

CPT 72120

X-ray lower and sacral spine, 2-3 views bending views

$29.91Medicare-allowed amount per service, averaged across 22,451 services

Providers submitted

$132.58

Asking price, not received

Medicare allowed

$29.91

The fee schedule figure

Medicare paid

$22.21

Balance is patient coinsurance

Providers submitted an average of $132.58 for this code and Medicare allowed $29.91 — 4.4× 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 $22.21 (74%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $35.45
Hospital / facility: $10.47

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. 17,475 services were billed in an office setting and 4,976 in a facility.

Services: 22,451
Beneficiaries: 21,758
Providers billing it: 665
Total allowed: $671,509

What Medicare pays for CPT 72120

Across 22,451 services billed by 665 providers to 21,758 beneficiaries, Medicare allowed an average of $29.91 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 72120

Specialty	Services	Beneficiaries	Avg allowed	Providers
Diagnostic Radiology	8,216	8,042	$19.74	361
Orthopedic Surgery	8,058	7,708	$40.24	130
Physician Assistant	1,383	1,368	$26.63	36
Neurosurgery	1,164	1,121	$29.29	35
Physical Medicine and Rehabilitation	852	845	$34.16	18
Independent Diagnostic Testing Facility (IDTF)	728	653	$33.14	24
Nurse Practitioner	634	631	$29.47	16
Interventional Radiology	428	424	$16.93	17
Family Practice	288	283	$36.67	5
Pain Management	237	233	$41.18	4
Internal Medicine	91	88	$37.42	3
Radiation Oncology	59	58	$11.50	2
Portable X-Ray Supplier	51	42	$28.49	2
Anesthesiology	49	49	$31.83	2
Interventional Pain Management	47	47	$41.33	1

72120 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
Illinois	3,291	$33.66	$24.38	48
California	2,595	$39.23	$25.40	71
Texas	1,421	$30.05	$23.03	41
Florida	1,269	$33.67	$25.41	47
Maryland	1,267	$36.66	$25.49	21
Ohio	1,197	$21.89	$16.49	37
Missouri	893	$26.88	$21.52	17
Tennessee	736	$26.49	$21.14	21
Pennsylvania	631	$19.81	$15.63	26
North Carolina	626	$32.92	$25.55	22
Virginia	621	$26.68	$19.81	28
Iowa	602	$33.79	$26.46	12
Colorado	531	$25.44	$18.34	14
New York	500	$34.59	$23.60	19
Georgia	496	$34.55	$26.01	10
Minnesota	460	$16.41	$12.69	18
Wisconsin	415	$18.68	$15.01	18
Nebraska	393	$31.05	$25.71	11
Michigan	377	$26.22	$20.13	12
Massachusetts	334	$33.14	$22.48	8
Arkansas	329	$15.72	$12.71	9
Mississippi	325	$25.75	$21.47	10
Louisiana	299	$18.74	$15.72	13
Alabama	296	$26.95	$23.60	10
Indiana	243	$20.66	$16.35	13
South Dakota	227	$20.18	$15.18	12
Oklahoma	214	$27.29	$20.33	11
New Hampshire	196	$17.92	$13.04	8
New Jersey	180	$43.55	$30.03	5
Connecticut	172	$38.41	$26.14	6
Montana	153	$10.47	$7.13	8
Kentucky	146	$23.11	$17.94	6
South Carolina	140	$30.01	$25.29	7
Oregon	133	$21.10	$15.59	7
Arizona	128	$28.04	$22.11	7
Washington	101	$28.01	$19.74	7
Kansas	93	$24.49	$19.41	5
Utah	92	$27.51	$22.12	5
Rhode Island	92	$31.14	$22.03	2
District of Columbia	77	$11.49	$7.57	3
New Mexico	36	$17.58	$13.60	1
West Virginia	29	$10.38	$7.23	2
Alaska	27	$32.75	$21.78	2
North Dakota	26	$10.32	$7.07	2
Nevada	15	$39.77	$27.54	1
Delaware	15	$39.93	$31.73	1
Hawaii	12	$12.17	$8.35	1

Related codes

72125Ct scan of upper spine without contrast$46.99
72100X-ray of lower and sacral spine$23.76
72148Mri scan of lower spinal canal without contrast$116.92
72110X-ray of lower and sacral spine$34.78
72170X-ray of pelvis$13.01
72141Mri scan of upper spinal canal without contrast$108.96
72131Ct scan of lower spine without contrast$53.06
72197Mri scan of pelvis before and after contrast$191.31
72146Mri scan of middle spinal canal without contrast$99.42
72128Ct scan of middle spine without contrast$46.63
72158Mri scan of lower spinal canal before and after contrast$149.73
72192Ct scan of pelvis without contrast$53.35

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.