CPT 72100
Global XXX ActiveX-ray exam l-s spine 2/3 vws
CPT 72100 Billing & Documentation Guide
CPT code 72100 (X-ray exam l-s spine 2/3 vws) is classified under Radiology with a global period indicator of XXX. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 0.21, a non-facility practice expense RVU of 0.98, and a malpractice RVU of 0.02, a total non-facility RVU of 1.21 and facility RVU of 1.21. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $41.89, though rates vary from $35.48 to $55.34 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 72100, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 72100 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
No global period (E/M and other non-procedural services)
MUE Limit (Medically Unlikely Edits)
Submitting more than 2 units of 72100 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 72100
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 0.21 | 0.21 |
| Practice Expense RVU | 0.98 | 0.98 |
| Malpractice RVU | 0.02 | 0.02 |
| Total RVU | 1.21 | 1.21 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 72100
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $46.36 | $46.36 | $43.37 - $55.34 | 29 |
| Florida | $41.16 | $41.16 | $39.31 - $42.78 | 3 |
| Georgia | $39.05 | $39.05 | $37.01 - $41.09 | 2 |
| Illinois | $39.94 | $39.94 | $37.94 - $41.86 | 4 |
| Michigan | $38.69 | $38.69 | $37.65 - $39.73 | 2 |
| North Carolina | $37.98 | $37.98 | $37.98 - $37.98 | 1 |
| New York | $44.77 | $44.77 | $38.58 - $47.62 | 5 |
| Ohio | $37.57 | $37.57 | $37.57 - $37.57 | 1 |
| Pennsylvania | $39.85 | $39.85 | $37.69 - $42.01 | 2 |
| Texas | $39.9 | $39.9 | $37.42 - $42.25 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 72100
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 72100 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 36591 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 36592 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 72010 | Column 1 (primary), can be billed with modifier | Yes | Mutually exclusive procedures |
| 72080 | Column 1 (primary), can be billed with modifier | Yes | Mutually exclusive procedures |
| 96523 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 0348T | Column 2 (secondary), bundled into primary | Yes | Misuse of Column Two code with Column One code |
| 72010 | Column 2 (secondary), bundled into primary | Yes | HCPCS/CPT procedure code definition |
| 72081 | Column 2 (secondary), bundled into primary | Yes | HCPCS/CPT procedure code definition |
| 72082 | Column 2 (secondary), bundled into primary | Yes | HCPCS/CPT procedure code definition |
| 72083 | Column 2 (secondary), bundled into primary | Yes | HCPCS/CPT procedure code definition |
Frequently Asked Questions, CPT 72100
What does CPT code 72100 mean? +
CPT code 72100 represents: X-ray exam l-s spine 2/3 vws. It's in the Radiology category with a global period of XXX.
What is the Medicare reimbursement for CPT 72100? +
The 2026 Medicare national average non-facility payment for CPT 72100 is $41.89. Rates range from $35.48 to $55.34 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 72100? +
Radiology codes rely heavily on the professional/technical split: modifier 26 (professional component only) and TC (technical component only). Also common: 50 (bilateral imaging), 76 (repeat by same physician), 77 (repeat by different physician), and LT/RT for laterality.
What bundling edits apply to CPT 72100? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
Get the full PayerReady toolkit
Free access to CPT/ICD-10 lookup, denial appeals, fee comparator, and claim auditing with credentialing enrollment.
Start free →Run this code through our claim audit tool
Check NCCI bundling, MUE limits, and modifier logic before submission.
Try the auditor →Did this page help?
Quick signal so we know what to improve.
If you want a code reference page that doesn't exist yet, email coding@payerready.com.
Tell us what's missing or wrong: coding@payerready.com. We respond within 5 business days.
Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
Powered by 11K CPT · 98K ICD-10 · 860K MPFS rates · 4.5M NCCI edits · 9.5M NPIs. Our data methodology · About our coding team