X-ray exam thorac spine 2vws

CPT code 72070 is used for a standard X-ray examination of the thoracic spine (mid-back) taken from two different angles. This is one of the most common imaging studies to evaluate mid-back pain, spinal alignment, or injury.

Showing rates for

National Average

Base Medicare rate

$32.02

This calculator gives a typical-case estimate using standard Medicare modifier rules. Actual payment depends on payer policies, documentation, code-specific CMS status indicators, and locality. Verify before billing.

RVU breakdown

Work RVU

0.2

PE RVU (NF)

0.77

MP RVU

0.02

Total RVU

0.99

Conversion factor: 32.3465 · Source: CMS MPFS RVU25A · Confidence: High

NCCI bundling edits

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Billing tips

Verify exactly two views were obtained and documented - billing 72070 requires documentation of two distinct radiographic views (typically AP and lateral). If three or more views are taken, use 72072 instead.
Impact: Using incorrect code based on view count can result in underpayment of approximately $11-15 or denials for incorrect coding
Document medical necessity with specific ICD-10 codes - link to appropriate diagnosis such as M54.6 (thoracic pain), S22.0 (thoracic vertebral fracture), or M41.0 (scoliosis) to establish medical necessity
Impact: Lack of appropriate diagnosis code correlation is responsible for 35-40% of 72070 denials, delaying the full $32.02 payment
Append modifier 26 when billing only professional interpretation in facility settings - hospital-based radiologists should bill with modifier 26 as the hospital bills the TC component
Impact: Incorrect component billing results in claim rejection or overpayment recovery; proper modifier use ensures correct payment split
Do not bill 72070 with 72080 on same date without modifier - thoracic and cervicothoracic spine studies may be bundled by some payers
Impact: Bundling edits can reduce total payment by $30-40; use modifier 59 only when anatomically distinct and medically necessary
Obtain Advance Beneficiary Notice (ABN) for routine screening or maintenance imaging - Medicare does not cover thoracic X-rays without specific signs/symptoms
Impact: Without ABN, provider absorbs the $32.02 cost when Medicare denies for lack of medical necessity
Bill on date of interpretation, not date of service - for professional component billing, use the date the radiologist signs the final report

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Frequently asked questions

What is the Medicare reimbursement rate for CPT 72070 in 2025?

The 2025 Medicare national average payment for CPT 72070 is $32.02 for both facility and non-facility settings. This is based on 0.99 total RVUs (0.2 work RVU, 0.77 PE RVU, 0.02 MP RVU) multiplied by the 2025 conversion factor of 32.3465.

How many views are required to bill CPT code 72070?

CPT 72070 requires exactly two radiographic views of the thoracic spine. If only one view is obtained, use CPT 72069 instead. If three or more views are taken, report CPT 72072. The radiology report must clearly document both views performed.

What is the difference between CPT 72070 and 72072?

CPT 72070 is for thoracic spine X-ray with 2 views, while CPT 72072 is for 3 views. The number of distinct radiographic projections (AP, lateral, oblique, etc.) documented in the radiology report determines which code to use. 72072 typically reimburses approximately $12-18 more than 72070.

Can I bill 72070 with modifier 26 for professional interpretation only?

Yes, modifier 26 is appropriate when billing only the professional component (physician interpretation and report) without the technical component. This is common in hospital settings where the facility bills the technical component separately. The modifier 26 payment is typically 40-50% of the total $32.02 global fee.

What diagnosis codes support medical necessity for 72070?

Common supporting ICD-10 codes include M54.6 (thoracic pain), S22.0xxA (fracture of thoracic vertebra), M41.04-M41.06 (thoracic scoliosis), M47.814-M47.816 (thoracic spondylosis), and M48.04-M48.06 (spinal stenosis of thoracic region). The diagnosis must reflect specific signs, symptoms, or documented clinical findings rather than screening.

How often can CPT 72070 be billed for the same patient?

Medicare and most payers do not have specific frequency limits for 72070, but medical necessity must be documented for each service. Repeat imaging within 30-90 days typically requires documentation of new injury, significant symptom change, post-treatment evaluation, or progression of condition. Routine follow-up without clinical indication will be denied.

What are the RVUs for CPT code 72070 in 2025?

The 2025 RVUs for CPT 72070 are: 0.2 work RVU, 0.77 practice expense RVU (both facility and non-facility), 0.02 malpractice RVU, for a total of 0.99 RVUs. These values are from the CMS Medicare Physician Fee Schedule RVU25A released December 23, 2024.