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See a sample rate comparisonCPT 72100 Fee Schedule
Medicare rates as of October 2026
CPT 72100 is classified under Radiology Procedures, in the Diagnostic Radiology (Diagnostic Imaging) Procedures subgroup.
X-Ray Spine,Lumbosacral;Anteroposterior/
| 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 | $40.42 national non-facility rate (2026) · View Medicare rates for 72100 |
| Medicaid Fee Schedule | $32.42 median of the 8 states in the free preview · View Medicaid rates for 72100 |
National average reimbursement for CPT 72100 by major payers:
$48.28
BCBS / Anthem
$43.98
UnitedHealthcare
$49.70
Aetna
$56.02
Cigna
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CPT 72100
5 of 25 sample ratesHigher to lower in this preview
Charleston Radiologists PA
Charleston Radiologists, P.A.
$82.92Published rateRaja Rajeswari Divi
Healthtexas Provider Network
$48.20Published rateChristopher Raio
St Joseph Hospital
$36.62Published rateMartinsville Surgical Associates PC
Martinsville Surgical Associates
$20.10Published rateHovah Healthcare P.A
$8.68Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 72100 vs. Other Diagnostic Radiology (Diagnostic Imaging) Procedures Codes
The table lists codes related to 72100. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| 72100-CPT | Low | X-Ray Spine,Lumbosacral;Anteroposterior/ |
| 72110-CPT | Low | X-Ray Spine,Lumbosacral;Cmplt,Obliq |
| 72114-CPT | Low | X Ray Exam L S Spine Bending, Radiologic Examination Spine Lumbosacral Complete Including Bending Views Minimum Of 6 Views |
| 72120-CPT | Low | Radiologic Exam Spine Lumbosacral; Bending Views Only 2 Or 3, Radiologic Examination Spine Lumbosacral; Bending Views Only 2 Or 3 |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 72100. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 72100 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 stands for Current Procedural Terminology. CPT codes are standardized numerical codes used by healthcare providers to describe medical, surgical, and diagnostic services to health insurance companies. They are crucial for billing and ensure a consistent understanding of services provided across the healthcare system.
Finding the exact cost of a medical procedure can be complex due to variations based on location, provider, and insurance plan. For precise, localized pricing information based on CPT codes, you can use specialized tools. Payerprice offers a fee schedule lookup tool that allows users to search with a specific CPT code and geographic location to get an estimated cost. It's also advisable to contact your insurance provider directly for details regarding your specific benefits and out-of-pocket costs.
CPT codes are proprietary and maintained by the American Medical Association (AMA). While you can find general information about CPT codes online, a comprehensive and official lookup usually requires access to AMA's CPT codebooks or licensed software. For practical purposes, if you are trying to understand the cost associated with a specific CPT code for a procedure, tools like Payerprice can help you look up fee schedules using CPT codes and your specific location, rather than just the code definition itself.
Healthcare prices vary significantly due to a multitude of factors, including geographic location, the specific healthcare facility (e.g., hospital vs. independent clinic), provider negotiated rates with different insurance companies, the complexity of the service, and whether the service is in-network or out-of-network. Transparency initiatives are aiming to make these prices more predictable, but direct negotiation between providers and payers, along with local market dynamics, still play a huge role. For specific price estimations based on your location and CPT code, Payerprice can provide valuable insights.
Understanding medical bills can be challenging. Many resources can help, starting with your insurance company's Explanation of Benefits (EOB), which details what your plan covered and what you owe. Your healthcare provider's billing department can also clarify charges. For proactive research on procedure costs before or after a service, especially when armed with CPT codes, resources like Payerprice offer fee schedule lookup tools based on CPT code and specific location, allowing you to compare costs and understand potential out-of-pocket expenses.