How much does Medicare pay for CPT 72220?

Medicare allowed an average of $17.21 per service and paid $12.88 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $58.83, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 72220?

X-ray of sacrum and tailbone, minimum of 2 views. It was billed 40,204 times to 32,896 Medicare beneficiaries by 1,068 providers in 2024.

Does 72220 pay differently in an office than a hospital?

Yes. The allowed amount averaged $20.30 in an office setting and $8.52 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 72220 most?

Portable X-Ray Supplier, with 21,038 services from 147 clinicians. Next are Diagnostic Radiology, Independent Diagnostic Testing Facility (IDTF), Orthopedic Surgery.

CPT 72220

X-ray of sacrum and tailbone, minimum of 2 views

$17.21Medicare-allowed amount per service, averaged across 40,204 services

Providers submitted

$58.83

Asking price, not received

Medicare allowed

$17.21

The fee schedule figure

Medicare paid

$12.88

Balance is patient coinsurance

Providers submitted an average of $58.83 for this code and Medicare allowed $17.21 — 3.4× 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 $12.88 (75%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $20.30
Hospital / facility: $8.52

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. 29,647 services were billed in an office setting and 10,557 in a facility.

Services: 40,204
Beneficiaries: 32,896
Providers billing it: 1,068
Total allowed: $691,911

What Medicare pays for CPT 72220

Across 40,204 services billed by 1,068 providers to 32,896 beneficiaries, Medicare allowed an average of $17.21 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.

Who bills 72220

Specialty	Services	Beneficiaries	Avg allowed	Providers
Portable X-Ray Supplier	21,038	14,418	$17.74	147
Diagnostic Radiology	16,798	16,234	$15.35	805
Independent Diagnostic Testing Facility (IDTF)	788	783	$29.81	45
Orthopedic Surgery	374	343	$25.29	11
Interventional Radiology	313	290	$16.85	19
Family Practice	231	212	$24.09	13
Internal Medicine	126	126	$25.13	4
Physician Assistant	86	79	$24.78	4
Pain Management	84	84	$29.73	3
Emergency Medicine	82	81	$21.45	5
General Practice	70	64	$31.04	2
Nuclear Medicine	58	58	$13.92	2
Interventional Pain Management	56	29	$25.95	1
Anesthesiology	22	22	$30.86	1
Urology	16	15	$30.72	1

72220 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
Maryland	6,616	$15.79	$11.99	27
New York	3,910	$19.01	$12.79	69
California	3,773	$24.07	$15.15	143
Florida	3,487	$20.51	$15.70	86
Texas	2,774	$20.32	$15.69	95
Illinois	2,344	$15.50	$11.32	68
Ohio	1,958	$12.35	$9.48	52
Washington	1,224	$10.98	$7.93	21
Pennsylvania	1,157	$15.67	$12.10	33
Tennessee	1,151	$14.31	$11.96	18
Missouri	961	$11.79	$9.40	31
New Jersey	806	$18.17	$12.62	15
Michigan	805	$15.96	$12.06	33
Massachusetts	792	$16.70	$11.69	37
Arizona	785	$26.46	$19.65	35
North Carolina	719	$17.10	$13.70	15
Louisiana	653	$15.55	$13.10	15
Virginia	634	$14.05	$10.22	30
Arkansas	618	$12.22	$10.21	12
Oklahoma	556	$15.34	$12.70	19
Nevada	385	$21.68	$16.70	7
Georgia	362	$15.42	$11.76	18
Kansas	356	$12.98	$10.19	17
Minnesota	348	$11.83	$8.89	14
Indiana	291	$13.46	$10.94	14
Colorado	278	$20.86	$14.84	13
Hawaii	257	$13.79	$9.26	4
Alabama	240	$15.42	$12.66	12
Iowa	217	$11.34	$8.93	12
Kentucky	203	$13.07	$10.12	13
Idaho	187	$11.06	$8.78	9
South Carolina	174	$13.29	$10.56	12
Mississippi	160	$18.52	$16.06	7
Delaware	144	$20.70	$15.41	7
Wisconsin	114	$12.45	$9.51	6
West Virginia	104	$7.95	$5.56	8
Nebraska	99	$7.85	$6.20	8
New Hampshire	84	$8.10	$5.69	5
Rhode Island	77	$16.56	$11.81	3
Oregon	74	$11.21	$8.30	5
Connecticut	69	$12.99	$9.59	3
Vermont	59	$8.01	$5.55	4
North Dakota	53	$12.94	$9.43	4
New Mexico	45	$14.29	$10.36	3
Alaska	40	$15.39	$9.62	2
Utah	39	$30.42	$24.49	2
Montana	11	$8.21	$3.55	1
XX	11	$8.48	$5.31	1

Related codes

72202X-ray of joint between lower spine and hip bone$25.60
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.