Radiographs of the sacrum and coccyx, with at least two views, to evaluate tailbone pain, fracture, or alignment.
- Medicare
- $32.06
- 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 ↓
- Mechanism of injury or pain history
- Views taken (AP and lateral at minimum)
- Exam findings such as coccyx tenderness
- Signed interpretation
- Separate indication when billed with lumbar films
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 ↓
72220 covers X-rays of the sacrum and tailbone, minimum two views. Orthopedic and spine offices order it after a fall onto the buttocks, for persistent coccyx pain (coccydynia), and when a sacral insufficiency fracture is suspected in an older patient.
The common question is how it fits with lumbar and pelvis films. A lumbar series that includes the sacrum does not justify billing 72220 too. 72220 needs dedicated sacrum and coccyx views. If the patient gets lumbar films and dedicated coccyx views the same day, both are billable with distinct documentation, but expect edits and keep the separate views clear in the report.
Sacral insufficiency fractures are often missed on plain films. A negative 72220 followed by MRI or CT is normal, and the MRI order should reference the persistent pain despite negative films. This code is one unit, with no laterality. Dynamic sitting and standing coccyx films are still billed under this code.
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 (0.96) adds practice overhead and malpractice, and is what drives the Medicare payment below.
| Work RVU | 0.17 |
| Practice expense RVU | 0.77 |
| Malpractice RVU | 0.02 |
| Total RVU | 0.96 |
| Medicare national rate | $32.06 |
| 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 | $32.06 |
HOPD (APC 5521) Hospital outpatient department | $88.91 |
Common denial reasons
The recurring reasons claims for CPT 72220 get rejected.
Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓
- Billed with lumbar series when no dedicated views were taken
- Only one view documented
- No interpretation report
- Diagnosis does not match imaging
- Duplicate with pelvis study
Frequently asked questions
Source · Generated from the editorial pipeline, verified against 3 cited references ↓
01Can I bill 72220 with a lumbar spine X-ray?
02How many views is required for 72220?
03Are sitting and standing coccyx films billed separately?
Sources & references
Editorial content was developed using the following public sources.
Mira Scribe
Mira Scribe records the fall mechanism and point tenderness from the exam, which supports dedicated sacrum and coccyx films.
See how Mira captures CPT 72220 documentation