How much does Medicare pay for CPT 72131?

Medicare allowed an average of $53.06 per service and paid $40.28 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $361.31, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 72131?

Ct scan of lower spine without contrast. It was billed 501,287 times to 493,283 Medicare beneficiaries by 12,819 providers in 2024.

Does 72131 pay differently in an office than a hospital?

Yes. The allowed amount averaged $95.46 in an office setting and $44.91 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 72131 most?

Diagnostic Radiology, with 471,210 services from 11,929 clinicians. Next are Independent Diagnostic Testing Facility (IDTF), Interventional Radiology, Orthopedic Surgery.

CPT 72131

Ct scan of lower spine without contrast

$53.06Medicare-allowed amount per service, averaged across 501,287 services

Providers submitted

$361.31

Asking price, not received

Medicare allowed

$53.06

The fee schedule figure

Medicare paid

$40.28

Balance is patient coinsurance

Providers submitted an average of $361.31 for this code and Medicare allowed $53.06 — 6.8× 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 $40.28 (76%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $95.46
Hospital / facility: $44.91

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. 80,907 services were billed in an office setting and 420,380 in a facility.

Services: 501,287
Beneficiaries: 493,283
Providers billing it: 12,819
Total allowed: $26,598,288

What Medicare pays for CPT 72131

Across 501,287 services billed by 12,819 providers to 493,283 beneficiaries, Medicare allowed an average of $53.06 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 72131

Specialty	Services	Beneficiaries	Avg allowed	Providers
Diagnostic Radiology	471,210	464,071	$51.47	11,929
Independent Diagnostic Testing Facility (IDTF)	12,512	12,016	$107.10	344
Interventional Radiology	10,952	10,883	$49.01	327
Orthopedic Surgery	1,829	1,710	$79.16	59
Neurosurgery	1,645	1,528	$81.36	41
Internal Medicine	481	479	$68.08	19
Nuclear Medicine	443	437	$55.65	21
Neurology	293	291	$43.92	5
Undefined Physician type	262	261	$43.03	4
Emergency Medicine	227	225	$87.35	11
Radiation Oncology	189	185	$57.96	9
Family Practice	187	184	$67.29	8
Vascular Surgery	172	172	$43.90	3
Physician Assistant	150	140	$65.30	7
Physical Medicine and Rehabilitation	125	120	$77.38	8

72131 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
Texas	47,480	$52.59	$39.52	1,005
California	46,911	$61.07	$41.74	1,162
Florida	44,835	$58.57	$43.09	943
New York	28,261	$62.50	$42.19	636
Illinois	20,839	$48.97	$35.46	558
Ohio	20,511	$46.08	$34.11	514
Minnesota	20,327	$52.09	$38.31	551
Pennsylvania	17,282	$48.87	$35.83	479
Missouri	15,210	$46.81	$35.56	332
North Carolina	14,746	$49.96	$37.83	413
Michigan	14,517	$47.27	$34.61	374
Virginia	13,619	$49.79	$36.43	331
Georgia	12,661	$52.38	$39.33	339
Arizona	11,620	$55.32	$41.16	256
New Jersey	11,183	$64.19	$43.65	304
Massachusetts	11,001	$49.35	$34.73	331
Maryland	10,637	$66.40	$47.27	273
Tennessee	10,432	$49.17	$38.06	327
Colorado	9,119	$53.66	$38.11	251
Alabama	8,806	$47.99	$37.08	253
Washington	8,672	$51.17	$35.88	235
Indiana	7,955	$46.45	$35.41	213
Oklahoma	6,968	$48.64	$37.06	187
Kentucky	6,642	$46.60	$35.56	163
Louisiana	6,530	$54.19	$42.03	185
Kansas	6,141	$46.13	$35.90	137
South Carolina	5,674	$51.85	$39.80	195
Connecticut	5,344	$56.18	$40.08	158
Wisconsin	5,334	$45.58	$33.70	206
Arkansas	4,970	$42.85	$33.18	132
Mississippi	4,826	$44.94	$34.50	124
Nebraska	4,331	$46.21	$35.86	105
Nevada	4,259	$54.10	$40.98	121
Utah	3,888	$45.14	$34.36	130
Oregon	3,513	$48.13	$35.06	124
Iowa	3,109	$47.62	$36.60	91
West Virginia	2,942	$45.89	$33.61	91
Rhode Island	2,534	$53.10	$37.98	67
New Hampshire	2,187	$45.22	$32.90	60
District of Columbia	2,065	$58.79	$41.00	43
Delaware	1,846	$56.49	$41.54	34
New Mexico	1,712	$48.24	$35.78	56
Idaho	1,632	$44.93	$33.38	50
North Dakota	1,179	$44.40	$33.04	39
Hawaii	1,098	$49.57	$34.83	44
Montana	1,049	$53.40	$39.45	42
Alaska	1,030	$77.60	$45.97	31
South Dakota	892	$44.36	$32.55	28
Wyoming	843	$52.87	$39.89	26
Maine	796	$46.59	$33.22	34
Vermont	676	$43.51	$31.59	17
Puerto Rico	360	$55.37	$41.12	9
AA	112	$44.41	$33.18	2
ZZ	75	$44.45	$34.21	2
AP	52	$46.90	$31.97	3
XX	30	$46.24	$34.51	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
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.