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See a sample rate comparisonCPT 72040 Fee Schedule
Medicare rates as of October 2026
CPT 72040 is classified under Radiology Procedures, in the Diagnostic Radiology (Diagnostic Imaging) Procedures subgroup.
X-Ray Of Upper Spine (Neck), X-Ray Showing Two Or Three Views Of The Back Of Neck (Cervical Spine).
| Key Fact | Detail |
|---|---|
| Service Type | Radiology Procedures Diagnostic Radiology (Diagnostic Imaging) Procedures |
| Common Place of Service | 11 - Office 22 - On Campus Outpatient Hospital |
| Common Modifiers | 26 - Professional component TC - Technical component |
| Complexity Level | Low |
| Medicare Fee Schedule | $39.75 national non-facility rate (2026) · View Medicare rates for 72040 |
| Medicaid Fee Schedule | $32.02 median of the 8 states in the free preview · View Medicaid rates for 72040 |
National average reimbursement for CPT 72040 by major payers:
$46.14
BCBS / Anthem
$43.14
UnitedHealthcare
$48.67
Aetna
$54.99
Cigna
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CPT 72040
5 of 25 sample ratesHigher to lower in this preview
Rodrigo Navarro Ramirez
$53.84Published rateAlexander Powers
Covenant Spine And Neurology PLLC
$36.34Published rateWilliam Thompson
$27.06Published ratePhilip Collis
Appalachian Regional Healthcare Inc
$21.60Published rateJorge Valdes
Pines Foot Ankle Surgical Group Inc
$7.05Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 72040 vs. Other Diagnostic Radiology (Diagnostic Imaging) Procedures Codes
The table lists codes related to 72040. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| 72020-CPT | Low | X-Ray Spine,Single View, Specify Level |
| 72040-CPT | Low | X-Ray Of Upper Spine (Neck), X-Ray Showing Two Or Three Views Of The Back Of Neck (Cervical Spine). |
| 72050-CPT | Low | X-Ray Of Upper Spine (Neck), X-Ray Showing Four Or Five Views Of The Back Of Neck (Cervical Spine). |
| 72052-CPT | Low | Radiologic Examination Spine, Radiologic Examination Spine Cervical Completeincludingoblique And Flexion Andor Extension Stu Dies |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 72040. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 72040 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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Frequently Asked Questions
CPT code 72040 identifies a Radiologic Examination of the cervical spine, typically involving 2 or 3 views. Healthcare providers use this code for documenting and seeking reimbursement for these diagnostic imaging services.
A fee schedule for CPT 72040 is a predetermined list of prices that healthcare providers charge for this specific service. These prices are not universal and can vary significantly based on factors like the type of payer (Medicare, Medicaid, or private insurance), the geographic location, and specific contracts a provider has. This helps patients understand potential costs and aids providers in billing. For specific fee schedule information relevant to your location and payer, you can use a lookup tool like Payerprice.
Private insurance rates for CPT 72040 are typically the result of negotiations between healthcare providers and individual insurance companies, leading to a wide range of pricing. In contrast, Medicare rates for CPT 72040 are standardized reimbursement amounts set by the government, adhering to a fixed fee schedule.