How much does Medicare pay for CPT 72200?

Medicare allowed an average of $22.03 per service and paid $16.83 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $100.18, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 72200?

X-ray of joint between lower spine and hip bone, 1-2 views. It was billed 5,336 times to 4,739 Medicare beneficiaries by 146 providers in 2024.

Does 72200 pay differently in an office than a hospital?

Yes. The allowed amount averaged $26.88 in an office setting and $7.98 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 72200 most?

Diagnostic Radiology, with 2,086 services from 83 clinicians. Next are Rheumatology, Portable X-Ray Supplier, Physical Medicine and Rehabilitation.

CPT 72200

X-ray of joint between lower spine and hip bone, 1-2 views

$22.03Medicare-allowed amount per service, averaged across 5,336 services

Providers submitted

$100.18

Asking price, not received

Medicare allowed

$22.03

The fee schedule figure

Medicare paid

$16.83

Balance is patient coinsurance

Providers submitted an average of $100.18 for this code and Medicare allowed $22.03 — 4.5× 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 $16.83 (76%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $26.88
Hospital / facility: $7.98

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. 3,968 services were billed in an office setting and 1,368 in a facility.

Services: 5,336
Beneficiaries: 4,739
Providers billing it: 146
Total allowed: $117,552

What Medicare pays for CPT 72200

Across 5,336 services billed by 146 providers to 4,739 beneficiaries, Medicare allowed an average of $22.03 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 72200

Specialty	Services	Beneficiaries	Avg allowed	Providers
Diagnostic Radiology	2,086	2,023	$15.79	83
Rheumatology	667	615	$30.08	23
Portable X-Ray Supplier	432	314	$22.79	4
Physical Medicine and Rehabilitation	357	266	$9.82	8
Orthopedic Surgery	340	315	$33.57	2
Pain Management	316	200	$29.28	3
Physician Assistant	281	277	$28.70	1
Nurse Practitioner	280	278	$28.81	3
Independent Diagnostic Testing Facility (IDTF)	166	166	$23.88	7
Anesthesiology	157	115	$19.42	4
Interventional Pain Management	138	62	$27.09	1
Internal Medicine	45	45	$31.01	3
Neurosurgery	22	16	$32.39	1
Interventional Radiology	21	21	$32.08	1
General Practice	15	15	$29.68	1

72200 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	1,202	$22.05	$15.32	26
Florida	1,038	$28.68	$21.21	10
Missouri	504	$18.31	$15.80	9
Texas	470	$26.82	$21.32	16
Pennsylvania	385	$8.94	$6.77	8
New York	225	$22.88	$15.44	7
Arizona	186	$30.79	$22.89	8
Ohio	185	$9.20	$7.26	9
Illinois	122	$26.83	$20.35	6
Arkansas	111	$9.77	$9.02	3
Georgia	111	$13.54	$11.32	4
New Jersey	97	$26.36	$19.37	4
Tennessee	71	$16.96	$13.23	3
North Carolina	67	$23.25	$18.22	4
Louisiana	56	$15.54	$11.82	3
Alabama	50	$23.77	$20.40	2
Oklahoma	49	$23.81	$20.37	3
Virginia	47	$31.40	$24.35	3
Kansas	45	$30.07	$25.46	1
Washington	45	$8.31	$5.28	2
South Carolina	44	$30.49	$24.82	2
Minnesota	42	$7.81	$5.34	2
Maryland	40	$17.40	$11.97	1
Massachusetts	38	$23.55	$15.89	3
Michigan	25	$27.91	$20.73	2
North Dakota	22	$32.39	$22.52	1
Alaska	21	$10.66	$4.15	1
Utah	16	$30.87	$25.53	1
Connecticut	11	$8.39	$6.25	1
West Virginia	11	$30.71	$19.86	1

Related codes

72220X-ray of sacrum and tailbone$17.21
72202X-ray of joint between lower spine and hip bone$25.60
72295Review by radiologist of disc of lower spine image$57.56

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.