X-Ray Lumbar Spine price: Medicare anchor and facility lever
Anchor for X-Ray Lumbar Spine - CPT 72100
$39.73
Professional (26) $10.80 plus technical (TC) $28.93.
Hospital OPPS facility anchor, this code billed alone: $106.81 (APC 5522, Level 2 Imaging without Contrast; national unadjusted, before wage-index adjustment).
A two- or three-view lower back X-ray is CPT 72100. The view count decides the code: more views, including bending views, move to other codes in the same family. The anchor is small, which makes the hospital facility line the dominant part of a hospital bill.
CPT code
72100
Radiologic examination, spine, lumbosacral; 2 or 3 views
CPT 72100 is two or three views of the lumbosacral spine. A complete study with bending views uses a different code (72114). Confirm the view count on the order.
The codes this visit can be billed under
| CPT | PFS office or global | PFS facility (professional) | Global period | Hospital single-service APC | Minimum Medicare copay at hospital |
|---|---|---|---|---|---|
| 72100 (this page) | $39.73 | $39.73 | not a surgical global | $106.81 (APC 5522) | $21.37 |
| 72110 | $52.59 | $52.59 | not a surgical global | $106.81 (APC 5522) | $21.37 |
In CY2026 the hospital APC for 72100 is 5522 at $106.81, with a minimum unadjusted copayment of $21.37. The office or imaging-center global anchor is $39.73. Four or more views (72110) carry a global anchor of $52.59 but map to the same hospital APC; CMS Addendum B lists both codes with status indicator Q1.
For a Medicare patient, the hospital line for 72100 carries a minimum unadjusted copayment of $21.37, which on its own is close to half of the office global anchor of $39.73. The radiologist's coinsurance on $10.80 comes on top. In an office, one coinsurance on the global amount covers the study.
The reading fee moves with the view count too: the CY2026 Michigan Locality 01 professional component is $10.80 for 72100 and $13.02 for 72110.
Inside and outside the 72100 anchor
Covered by the anchor
- Image acquisition for two or three views
- Radiologist interpretation and written report (professional component, modifier 26)
- Standard image storage
Billed outside it
- Additional views billed under a different code
- The ordering visit and follow-up visit
- Comparison with prior imaging billed as a separate interpretation in limited circumstances
Why prices vary for CPT 72100
For a plain spine X-ray the radiologist's reading is a modest amount and the technical work is quick. A hospital bills that technical work as an OPPS facility payment that, in CY2026, exceeds the entire global fee schedule amount. An office or imaging center bills one global amount. The same three images can therefore cost very different amounts depending only on the building.
Ask for the global cash price at an office or imaging center and compare it with the hospital outpatient quote for the same 72100 code.
Questions specific to Lumbar spine X-ray
- How many views are ordered, and which code does that make?
- Is the reading included in the price?
- Is the X-ray done in a hospital department or an office?
- If the X-ray is part of an urgent care or ER visit, is it billed separately from the visit?
- If additional views are taken on the day, which code will be billed and will I be told first?
X-Ray Lumbar Spine: billing questions
Why does a hospital charge more for a spine X-ray than the global anchor?
The hospital is paid an OPPS facility amount for the imaging plus the radiologist's fee. In CY2026 the hospital APC for 72100 is larger than the full global fee schedule amount.
Do more views change the price?
They change the code. Four or more views bill as 72110, which has a higher global anchor. In a hospital both codes map to the same APC.
Is a lumbar X-ray at a chiropractor billed the same way?
Billing depends on who takes and reads the images. Ask the office which code and setting apply and whether the reading is included.
How much of a spine X-ray anchor is the reading?
For 72100 the CY2026 Michigan Locality 01 professional component is $10.80 of a $39.73 global anchor. The technical share is larger, and in a hospital it is replaced by the facility payment.