How much does Medicare pay for CPT 72125?

Medicare allowed an average of $46.99 per service and paid $35.31 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $290.69, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 72125?

Ct scan of upper spine without contrast. It was billed 1,503,184 times to 1,480,100 Medicare beneficiaries by 17,573 providers in 2024.

Does 72125 pay differently in an office than a hospital?

Yes. The allowed amount averaged $98.06 in an office setting and $45.78 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 72125 most?

Diagnostic Radiology, with 1,448,308 services from 16,580 clinicians. Next are Interventional Radiology, Independent Diagnostic Testing Facility (IDTF), Nuclear Medicine.

CPT 72125

Ct scan of upper spine without contrast

$46.99Medicare-allowed amount per service, averaged across 1,503,184 services

Providers submitted

$290.69

Asking price, not received

Medicare allowed

$46.99

The fee schedule figure

Medicare paid

$35.31

Balance is patient coinsurance

Providers submitted an average of $290.69 for this code and Medicare allowed $46.99 — 6.2× 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 $35.31 (75%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $98.06
Hospital / facility: $45.78

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. 34,801 services were billed in an office setting and 1,468,383 in a facility.

Services: 1,503,184
Beneficiaries: 1,480,100
Providers billing it: 17,573
Total allowed: $70,634,616

What Medicare pays for CPT 72125

Across 1,503,184 services billed by 17,573 providers to 1,480,100 beneficiaries, Medicare allowed an average of $46.99 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 72125

Specialty	Services	Beneficiaries	Avg allowed	Providers
Diagnostic Radiology	1,448,308	1,426,173	$46.73	16,580
Interventional Radiology	40,462	39,952	$46.34	589
Independent Diagnostic Testing Facility (IDTF)	5,514	5,264	$110.69	220
Nuclear Medicine	2,107	2,082	$46.42	30
Radiation Oncology	952	946	$46.52	19
Internal Medicine	863	849	$51.52	16
Neurology	662	640	$44.70	6
Neurosurgery	613	570	$80.76	20
Emergency Medicine	503	493	$59.35	15
Vascular Surgery	479	471	$44.77	3
Undefined Physician type	444	439	$46.46	6
Orthopedic Surgery	385	367	$81.99	21
Family Practice	330	321	$51.82	8
General Surgery	324	318	$47.42	3
Pediatric Medicine	238	238	$46.28	5

72125 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	121,206	$50.93	$34.50	1,524
Texas	114,760	$46.36	$34.22	1,219
Florida	103,242	$48.28	$34.64	1,044
New York	81,574	$51.41	$34.34	879
Illinois	68,803	$46.79	$33.34	809
Pennsylvania	67,173	$45.90	$33.03	823
Minnesota	65,022	$46.75	$33.73	736
Massachusetts	56,886	$47.58	$32.80	510
North Carolina	56,049	$45.13	$33.66	632
Ohio	52,947	$45.27	$33.00	664
Michigan	47,856	$45.82	$33.23	521
Virginia	46,017	$45.91	$33.40	493
New Jersey	40,302	$50.28	$34.31	476
Georgia	39,455	$46.25	$33.95	475
Missouri	39,310	$45.14	$33.73	401
Tennessee	34,684	$44.30	$33.07	470
Maryland	33,032	$50.33	$35.44	322
Colorado	31,499	$47.41	$33.29	337
Indiana	27,812	$44.54	$33.20	332
Washington	26,815	$47.15	$32.40	330
South Carolina	25,313	$44.91	$33.83	302
Wisconsin	24,978	$44.35	$32.35	450
Arizona	24,552	$47.11	$34.40	298
Connecticut	23,756	$48.08	$33.73	274
Alabama	22,804	$44.39	$33.50	291
Louisiana	17,829	$46.09	$34.44	270
Oklahoma	17,637	$45.18	$33.82	205
Arkansas	15,574	$43.14	$33.16	154
Kentucky	15,109	$44.87	$33.51	212
Kansas	14,380	$43.89	$33.55	150
Mississippi	13,185	$43.98	$33.11	147
Nebraska	11,831	$43.81	$33.32	126
Iowa	11,648	$44.46	$33.25	160
Nevada	11,072	$46.24	$34.25	150
Oregon	10,777	$45.56	$32.59	206
West Virginia	10,090	$44.69	$32.16	116
New Hampshire	9,606	$45.41	$32.45	108
Rhode Island	9,586	$47.25	$32.61	88
Utah	8,384	$44.33	$33.15	155
Delaware	6,782	$46.70	$34.58	50
Idaho	6,114	$44.01	$32.02	97
New Mexico	5,910	$45.70	$32.73	86
District of Columbia	4,989	$50.54	$34.93	52
Maine	4,547	$45.85	$32.31	70
Hawaii	4,284	$46.56	$32.59	65
Montana	3,581	$45.56	$33.11	58
Alaska	2,822	$61.21	$34.73	48
Vermont	2,555	$44.53	$31.79	24
North Dakota	2,483	$44.51	$32.90	52
South Dakota	2,288	$44.36	$31.76	43
Wyoming	2,245	$45.26	$33.07	33
Puerto Rico	1,118	$46.78	$33.56	21
AA	353	$44.91	$33.37	2
AP	181	$47.33	$32.48	3
ZZ	116	$45.36	$34.72	2
Guam	101	$47.37	$30.49	4

Related codes

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
72156Mri scan of upper spinal canal before and after contrast$142.72

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.