CPT 72190

Across 27,536 services billed by 952 providers to 22,660 beneficiaries, Medicare allowed an average of $26.00 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.

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.

• 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

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.

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