How much does Medicare pay for CPT 72202?

Medicare allowed an average of $25.60 per service and paid $19.00 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $106.84, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 72202?

X-ray of joint between lower spine and hip bone, 3 or more views. It was billed 12,431 times to 11,728 Medicare beneficiaries by 575 providers in 2024.

Does 72202 pay differently in an office than a hospital?

Yes. The allowed amount averaged $30.45 in an office setting and $10.37 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 72202 most?

Diagnostic Radiology, with 9,038 services from 452 clinicians. Next are Rheumatology, Independent Diagnostic Testing Facility (IDTF), Pain Management.

CPT 72202

X-ray of joint between lower spine and hip bone, 3 or more views

$25.60Medicare-allowed amount per service, averaged across 12,431 services

Providers submitted

$106.84

Asking price, not received

Medicare allowed

$25.60

The fee schedule figure

Medicare paid

$19.00

Balance is patient coinsurance

Providers submitted an average of $106.84 for this code and Medicare allowed $25.60 — 4.2× 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 $19.00 (74%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $30.45
Hospital / facility: $10.37

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. 9,429 services were billed in an office setting and 3,002 in a facility.

Services: 12,431
Beneficiaries: 11,728
Providers billing it: 575
Total allowed: $318,234

What Medicare pays for CPT 72202

Across 12,431 services billed by 575 providers to 11,728 beneficiaries, Medicare allowed an average of $25.60 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 72202

Specialty	Services	Beneficiaries	Avg allowed	Providers
Diagnostic Radiology	9,038	8,625	$23.37	452
Rheumatology	1,198	1,091	$31.87	38
Independent Diagnostic Testing Facility (IDTF)	943	888	$32.74	42
Pain Management	318	286	$37.49	2
Neurosurgery	162	114	$33.95	5
Orthopedic Surgery	133	104	$36.19	4
Physical Medicine and Rehabilitation	119	119	$26.14	4
Portable X-Ray Supplier	105	90	$30.20	4
Family Practice	100	99	$28.04	6
Interventional Radiology	95	95	$13.11	6
Emergency Medicine	55	55	$32.88	2
Internal Medicine	49	48	$27.42	2
Radiation Oncology	33	31	$11.01	2
Physician Assistant	32	32	$25.22	2
Vascular Surgery	15	15	$10.37	1

72202 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
Florida	1,662	$31.21	$24.64	56
California	921	$34.75	$23.02	44
New York	836	$29.29	$19.83	36
Texas	753	$25.30	$20.00	38
Illinois	744	$24.93	$18.96	30
Ohio	699	$20.32	$16.26	26
Michigan	509	$16.12	$11.93	25
North Carolina	499	$25.56	$20.05	26
Arizona	456	$31.88	$24.35	18
Maryland	429	$28.23	$19.69	21
Missouri	412	$18.89	$14.58	24
Delaware	371	$30.95	$23.74	7
Pennsylvania	342	$21.51	$15.94	18
Virginia	327	$20.42	$14.81	15
New Jersey	290	$41.18	$28.39	19
Georgia	273	$26.02	$20.39	12
Massachusetts	268	$16.58	$10.99	11
Washington	245	$26.99	$17.83	14
Tennessee	240	$18.05	$15.09	11
Wisconsin	198	$21.06	$15.83	12
West Virginia	189	$12.16	$8.82	9
Minnesota	164	$30.52	$21.29	12
New Hampshire	157	$20.91	$15.21	8
South Carolina	134	$18.87	$15.12	8
Oklahoma	122	$14.45	$11.62	6
Oregon	121	$24.90	$17.17	7
Idaho	120	$13.42	$10.08	5
Alabama	93	$24.30	$20.82	5
Louisiana	93	$20.71	$18.04	5
Kentucky	93	$16.23	$12.14	5
Kansas	83	$17.65	$13.63	6
Indiana	83	$17.47	$14.42	5
Iowa	76	$18.29	$14.31	5
Colorado	71	$29.04	$21.22	4
Arkansas	68	$19.75	$18.83	4
New Mexico	48	$23.86	$18.97	2
Vermont	44	$10.30	$7.04	3
Maine	40	$23.79	$19.36	2
South Dakota	33	$10.31	$7.43	2
North Dakota	32	$18.12	$12.60	2
Alaska	20	$14.33	$6.67	1
Connecticut	14	$41.67	$26.32	1
Montana	13	$38.44	$30.54	1
Rhode Island	12	$11.29	$7.65	1
Hawaii	12	$38.37	$29.55	1
Utah	11	$10.11	$8.34	1
Nevada	11	$10.25	$8.34	1

Related codes

72220X-ray of sacrum and tailbone$17.21
72200X-ray of joint between lower spine and hip bone$22.03
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.