CPT 72200
Global XXX ActiveX-ray exam si joints
CPT 72200 Billing & Documentation Guide
CPT code 72200 (X-ray exam si joints) is classified under Radiology with a global period indicator of XXX. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 0.17, a non-facility practice expense RVU of 0.82, and a malpractice RVU of 0.02, a total non-facility RVU of 1.01 and facility RVU of 1.01. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $34.95, though rates vary from $29.55 to $46.16 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 72200, 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 72200 with related codes; this code has 5 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 72200 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 72200
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 0.17 | 0.17 |
| Practice Expense RVU | 0.82 | 0.82 |
| Malpractice RVU | 0.02 | 0.02 |
| Total RVU | 1.01 | 1.01 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 72200
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 | $38.65 | $38.65 | $36.15 - $46.16 | 29 |
| Florida | $34.46 | $34.46 | $32.87 - $35.88 | 3 |
| Georgia | $32.62 | $32.62 | $30.91 - $34.32 | 2 |
| Illinois | $33.44 | $33.44 | $31.73 - $35.03 | 4 |
| Michigan | $32.34 | $32.34 | $31.44 - $33.23 | 2 |
| North Carolina | $31.66 | $31.66 | $31.66 - $31.66 | 1 |
| New York | $37.41 | $37.41 | $32.17 - $39.85 | 5 |
| Ohio | $31.36 | $31.36 | $31.36 - $31.36 | 1 |
| Pennsylvania | $33.27 | $33.27 | $31.45 - $35.09 | 2 |
| Texas | $33.29 | $33.29 | $31.22 - $35.26 | 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 72200
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 72200 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 |
| 96523 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 72202 | Column 2 (secondary), bundled into primary | Yes | HCPCS/CPT procedure code definition |
| 73542 | Column 2 (secondary), bundled into primary | Yes | Standards of medical/surgical practice |
Frequently Asked Questions, CPT 72200
What does CPT code 72200 mean? +
CPT code 72200 represents: X-ray exam si joints. It's in the Radiology category with a global period of XXX.
What is the Medicare reimbursement for CPT 72200? +
The 2026 Medicare national average non-facility payment for CPT 72200 is $34.95. Rates range from $29.55 to $46.16 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 72200? +
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 72200? +
This code has 5 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on June 2, 2026.
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