Plain radiographs of the sacroiliac joints taken in fewer than three views, typically to look for arthritis, sacroiliitis, or fracture.
- Medicare
- $33.73
- Work RVU
- 0.17
- Global, days
- Region
- Spine
Documentation requirements
What must appear in the operative or office note to support the claim.
Source · Editorial brief grounded in 3 cited references ↓
- Number and type of views taken
- Clinical reason (SI pain, suspected sacroiliitis, fusion planning)
- Physical exam findings such as SI provocation tests
- Signed interpretation
- Order distinguishing SI views from a pelvis study
Applicable modifiers
Modifiers commonly billed with this code.
Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual
What this code covers
Source · Editorial summary grounded in 3 cited references ↓
72200 covers sacroiliac joint X-rays with one or two views. Three or more views move to 72202. Ortho, spine, and rheumatology practices order SI films for buttock pain, suspected inflammatory sacroiliitis, SI joint degeneration, and before SI fusion or SI joint injections.
The overlap with pelvis films is the main issue. An AP pelvis shows both SI joints, so payers may question billing a pelvis X-ray and an SI joint series on the same day. When both are truly needed, the SI study should involve dedicated SI views (angled or oblique), and the order should say why. If only an AP pelvis was taken, bill the pelvis code only.
Bill one unit for both SI joints. This study is not reported per side and does not take RT, LT, or 50. In the office, bill globally if your physician reads it. If an outside radiologist reads it, split TC and 26.
RVU & reimbursement
Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.
Source · CMS Physician Fee Schedule, RVU26A · January 2026
Work RVU vs. total RVU
The work RVU (0.17) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (1.01) adds practice overhead and malpractice, and is what drives the Medicare payment below.
| Work RVU | 0.17 |
| Practice expense RVU | 0.82 |
| Malpractice RVU | 0.02 |
| Total RVU | 1.01 |
| Medicare national rate | $33.73 |
| 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 | $33.73 |
HOPD (APC 5522) Hospital outpatient department | $106.81 |
Common denial reasons
The recurring reasons claims for CPT 72200 get rejected.
Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓
- Billed with pelvis X-ray for the same images
- Three or more views taken but 72200 billed, or the reverse
- Laterality modifiers added to a bilateral study
- No documented interpretation
- Diagnosis does not support SI imaging
Frequently asked questions
Source · Generated from the editorial pipeline, verified against 3 cited references ↓
01Is 72200 billed per side?
02What is the difference between 72200 and 72202?
03Can I bill an SI joint X-ray and a pelvis X-ray on the same day?
Sources & references
Editorial content was developed using the following public sources.
Mira Scribe
Mira Scribe records the SI provocation tests and pain pattern from the exam, which supports dedicated SI joint films.
See how Mira captures CPT 72200 documentation