Imaging · Spine

Radiologic examination of the lumbosacral spine, complete series with bending (flexion/extension) views — minimum of 6 views total.

Verified May 8, 2026 · 5 sources ↓

Medicare: $61.79
Total RVUs: 1.85
Global, days
Region: Spine

Drawn from CMSGenhealthPayerpriceAAPC

Documentation requirements

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

Source · Editorial brief grounded in 5 cited references ↓

State the number of views obtained — must be 6 or more to support 72114 over lower-view codes
Name each view explicitly (AP, lateral, bilateral obliques, flexion, extension) in the radiology report or order
Document clinical indication that requires dynamic bending views, not just a standard lumbar series
Include the interpreting physician's signed attestation with findings and impression for modifier 26 professional-component claims
For IDTF billing, confirm supervising physician board certification and technologist credentials are on file with the MAC

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

26 Professional component 52 Reduced services 76 Repeat, same physician 77 Repeat, another physician RT Right side

What this code covers

Source · Editorial summary grounded in 5 cited references ↓

CPT 72114 covers a complete lumbosacral spine X-ray series that includes at minimum 6 views: standard projections (AP, lateral) plus dynamic bending views in flexion and extension. The bending views are what separate this code from 72110 (complete without bending, minimum 4 views) and 72100 (2-3 views). Use 72114 when the clinical question requires assessment of spinal mobility, instability, or listhesis under load — not simply for a routine lumbar series.

For IDTF billing under Medicare, the supervising physician must be a board-certified radiologist or neurologist; a general radiographer or medical physicist qualifies as the performing personnel. When the interpreting physician bills separately from the technical acquisition, append modifier 26 for the professional component or TC for the technical component. Without a split-billing arrangement, bill globally.

Common ICD-10 pairings include lumbar spondylosis (M47.816), degenerative disc disease (M51.36), and spondylolisthesis (M43.16). Payers including Anthem/BCBS flag 72114 for pre-payment clinical utilization review — have the medical necessity documentation ready before claim submission, not after a denial.

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU	0.29
Practice expense RVU	1.53
Malpractice RVU	0.03
Total RVU	1.85
Medicare national rate	$61.79
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	$61.79
HOPD (APC 5522) Hospital outpatient department	$106.81

Common denial reasons

The recurring reasons claims for CPT 72114 get rejected.

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

Upcoding from 72110 or 72100 when the operative report or requisition doesn't confirm bending views were performed
Missing medical necessity — payer requires justification for bending views beyond routine low back pain screening
Global bill submitted when facility and professional components are split between separate entities, causing duplicate-claim flags
Modifier 26 or TC missing when the interpreting physician and technical facility bill separately
IDTF credential deficiency — supervisor or technologist credentials not matching MAC-required qualifications on file

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 5 cited references ↓

01What is the difference between 72114 and 72110?

72110 is a complete lumbosacral series without bending views, requiring a minimum of 4 views. 72114 requires a minimum of 6 views and must include flexion and/or extension bending views. If bending views were not performed and documented, bill 72110, not 72114.

02When should I append modifier 26 to 72114?

Use modifier 26 when the interpreting physician bills only for the professional component — reading and reporting the images — while a separate entity (hospital, IDTF, imaging center) bills the technical component. Bill globally only when both components are provided by the same entity.

03Does 72114 require prior authorization?

It depends on the payer. Anthem/BCBS applies pre-payment clinical utilization management review to 72114 in some markets. Check the specific plan's radiology management policy before scheduling, especially for non-emergent outpatient requests.

04Can an orthopedic surgeon bill 72114 in the office setting?

Yes. Orthopedic surgery is one of the top billing specialties for 72114 per CMS PUF data. The surgeon must either perform or directly supervise the technical component and provide a written interpretation with findings and impression to bill globally or with modifier 26.

05Can 72114 and 72120 be billed together on the same date?

No. 72120 covers bending views only of the lumbar spine. Since 72114 already includes the complete series with bending views, billing both on the same date represents unbundling. Use 72114 alone when a full series with bending views is performed.

06What ICD-10 codes most commonly support medical necessity for 72114?

Common pairings include M47.816 (lumbar spondylosis without myelopathy or radiculopathy), M43.16 (spondylolisthesis, lumbar), M51.36 (degeneration of lumbar intervertebral disc), and M54.50 (low back pain, unspecified) when dynamic instability evaluation is clinically warranted.

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 specific views performed (AP, lateral, bilateral obliques, flexion, extension), the clinical indication driving the need for dynamic bending views, and the interpreting physician's findings and impression from dictation. That prevents the most common 72114 denial: a claim for a 6-view bending series with documentation that only supports a standard 4-view lumbar study, or a missing rationale for why bending views were clinically necessary.

See how Mira captures CPT 72114 documentation