Imaging · Spine

Radiologic examination of the lumbar spine (lumbosacral) with a minimum of four views, including oblique and/or bending views.

Verified May 8, 2026 · 6 sources ↓

Medicare: $53.44
Total RVUs: 1.6
Global, days
Region: Spine

Drawn from CMSAAPCMdclarity

Documentation requirements

What must appear in the operative or office note to support the claim.

Source · Editorial brief grounded in 6 cited references ↓

Radiology report must explicitly state the number of views obtained (minimum four to support 72110).
Document the specific projections taken (e.g., AP, lateral, right oblique, left oblique, flexion, extension).
Medical necessity must be documented in the ordering provider's notes — include the clinical indication (e.g., low back pain with radiculopathy, suspected fracture, scoliosis surveillance).
If billing modifier 26, the interpreting physician's signed report with findings, impression, and date must be in the record.
If a same-day E&M is billed, document that the visit was significant and separately identifiable from the imaging order/interpretation.

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

26 Professional component 52 Reduced services 59 Distinct service 76 Repeat, same physician 77 Repeat, another physician XS Separate structure

What this code covers

Source · Editorial summary grounded in 6 cited references ↓

72110 covers a lumbar spine X-ray series of four or more views. The minimum view count is what separates this code from 72100 (two or three views, AP and lateral only). The four-view threshold typically includes AP, lateral, and bilateral oblique projections; bending views may also count toward the minimum. If the study consists exclusively of bending views and reaches the four-view minimum, 72120 is the correct code instead.

The global period is XXX, meaning no pre- or post-procedure E&M work is bundled. However, a separately identifiable E&M on the same date must meet the threshold for medical necessity and be supported by distinct documentation — the read and interpretation of the X-ray alone does not justify a same-day E&M charge. Billing splits between professional and technical components are routine: modifier 26 for the interpretation/report when the equipment is hospital- or facility-owned, and TC for the technical component when billed separately.

72100 bundles into 72110 under NCCI edits. Don't bill both for the same lumbar spine encounter. If clinical circumstances genuinely required separate, distinct services (rare), modifier 59 or XS may apply, but document the specific medical rationale — audit teams scrutinize same-day same-region imaging stacks closely.

RVU & reimbursement

Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU	0.25
Practice expense RVU	1.32
Malpractice RVU	0.03
Total RVU	1.6
Medicare national rate	$53.44
Global period	days

Payment by site of service

Medicare pays different rates by setting. HOPD typically pays substantially more than ASC for the same procedure.

Source · CMS OPPS Addendum B·ASC HCPCS payment rates·2026

Setting	Medicare rate (national)
Office (PFS non-facility) Procedure performed in physician's office	$53.44
HOPD (APC 5522) Hospital outpatient department	$106.81

Common denial reasons

The recurring reasons claims for CPT 72110 get rejected.

Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓

Insufficient views documented — radiology report says 'two views' or does not specify view count, triggering downcoding to 72100.
Missing or unsigned radiology interpretation report when billing the professional component (modifier 26).
Medical necessity not established — order lacks a supporting diagnosis or clinical indication tied to an ICD-10 code accepted by the payer.
NCCI bundle conflict — 72100 billed on the same date without a valid modifier, resulting in edit denial.
Incorrect modifier usage — TC and 26 billed by the same provider in a global billing situation, or modifiers omitted in a split-billing environment.

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 6 cited references ↓

01What is the difference between 72100 and 72110?

72100 covers two to three views of the lumbar spine (typically AP and lateral). 72110 requires a minimum of four views and generally includes oblique projections. Bill the code that matches the number of views actually documented in the radiology report — never assume four views were taken without confirmation.

02When should I use 72120 instead of 72110?

Use 72120 when all four or more views obtained are bending views only. If the series mixes oblique and bending views (or includes AP/lateral alongside bending views), 72110 is correct.

03Can I bill 72110 and 72100 together on the same date?

Generally no. NCCI edits bundle 72100 into 72110. Billing both for the same lumbar spine study on the same date will produce an edit. Modifier 59 or XS may override the edit only if there is a documented, distinct clinical reason for a separate service — this scenario is rare and scrutinized.

04How do modifiers 26 and TC apply to 72110?

Append modifier 26 when the physician performs only the interpretation and written report, and the imaging equipment belongs to a facility or hospital. Append TC when billing only for the technical component (equipment, technologist, supplies). Bill globally (no modifier) only when the same provider owns the equipment and performs the interpretation.

05Can a same-day E&M be billed with 72110?

Yes, but the E&M must be significant and separately identifiable from the imaging encounter. The ordering or interpreting of an X-ray alone does not support a separate E&M charge. Document the distinct clinical decision-making that drove the visit, and apply modifier 25 to the E&M code.

06Does 72110 have a global period?

The global period is XXX, meaning standard surgical global package rules do not apply. There is no bundled pre- or post-procedure period. However, per NCCI Chapter IX guidance, do not report a separate E&M solely for supervision or interpretation of the imaging procedure itself.

Sources & references

Editorial content was developed using the following public sources. Last verified May 8, 2026.

Mira AI Scribe

Mira's AI scribe captures the exact number of lumbar spine views obtained and the projection names from the dictated radiology report, stamping them directly into the procedure record. That prevents the most common 72110 denial: a claim for four-plus views when the report only documents two or omits view count entirely, which forces a downcode to 72100 or triggers a medical necessity rejection.

See how Mira captures CPT 72110 documentation