CPT 72114Radiology

X-ray exam l-s spine bending

CPT code 72114 covers X-ray imaging of the lower spine (lumbosacral area) taken while the patient bends forward and backward. These specialized images help doctors assess spine flexibility and detect abnormal movement between vertebrae.

Showing rates for

National Average

Base Medicare rate

$59.52

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

0.3

PE RVU (NF)

1.51

MP RVU

0.03

Total RVU

1.84

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

NCCI bundling edits

Loading bundling edits…

Billing tips

Always verify that both flexion AND extension views were actually obtained before billing 72114 instead of a standard lumbosacral X-ray (72100 or 72110)
Impact: Prevents downcoding to routine spine X-rays which reimburse approximately $20-30 less; protects the full $59.52 reimbursement
Document the specific clinical indication for functional imaging (suspected instability, spondylolisthesis evaluation, fusion assessment) separate from routine diagnostic imaging
Impact: Reduces denial rate by 40-60% when medical necessity is clearly established; particularly important when billing same day as routine spine films
Bill global code 72114 when your facility owns equipment and provides interpretation; split with modifier 26/TC only when components are truly separate
Impact: Maximizes reimbursement at $59.52 for global versus approximately $23.81 (26) or $35.71 (TC) when split unnecessarily
Check for LCD/NCD coverage requirements in your MAC jurisdiction, as some require documentation of conservative treatment failure before approving flexion-extension studies
Impact: Prevents front-end denials requiring appeals; some MACs have 30-50% denial rates for studies without documented conservative care
When performed same day as 72100 or 72110, append modifier 59 to 72114 only if both studies have distinct medical indications documented in separate orders
Impact: Preserves reimbursement for both procedures (combined $100+) versus bundled denial resulting in payment for only one code
Ensure radiology report specifically describes measurements of vertebral translation and angular motion between flexion and extension views

Live Field Datano reports yet

Real billers contribute denial patterns and appeal strategies for this code. Once 5+ reports come in, you’ll see live aggregated data here — the only place this exists, free.

Working with CPT 72114?

Get the free Revenue Protection Toolkit — the denial triggers, modifier pitfalls, and bundling conflicts that quietly cost you reimbursement. Instant download.

Help build the field knowledge

MedPayIQ gets smarter as billers contribute. If you've had this code denied, share what happened so others learn from it. Anonymous, no patient info.

Related actions

Frequently asked questions

What is the Medicare reimbursement rate for CPT 72114 in 2025?

The 2025 Medicare national average reimbursement for CPT 72114 is $59.52 for both facility and non-facility settings. This rate is based on 1.84 total RVUs multiplied by the 2025 conversion factor of 32.3465. Actual payment may vary by geographic locality based on GPCI adjustments.

Can CPT 72114 be billed with a regular lumbosacral spine X-ray on the same day?

Yes, but only when both studies have distinct medical indications documented in separate physician orders. Append modifier 59 to CPT 72114 to indicate it is a distinct procedural service. The medical record must clearly support why both routine views and functional flexion-extension views were medically necessary for different clinical questions.

What is the difference between CPT 72114 and 72100?

CPT 72100 is a routine 2-3 view lumbosacral spine X-ray in standard positions, while CPT 72114 specifically requires flexion (bending forward) and extension (bending backward) views to assess spinal stability and dynamic motion. Code 72114 is used when evaluating suspected instability or abnormal vertebral movement, not for routine diagnostic imaging.

How many views are required to bill CPT 72114?

CPT 72114 requires a minimum of four views: anteroposterior neutral, lateral neutral, lateral flexion, and lateral extension. The flexion and extension views are essential to the code definition. If fewer views are obtained or flexion/extension positions are not documented, the study should be coded as 72100 or 72110 instead.

What diagnosis codes support medical necessity for CPT 72114?

Common supporting diagnoses include spondylolisthesis (M43.16, M43.17), spinal instability (M53.2X7), post-laminectomy syndrome (M96.1), lumbar disc disorders with radiculopathy (M51.16, M51.17), and post-surgical spine evaluation (Z98.1). Documentation must explain why functional imaging is necessary beyond routine X-rays for the specific diagnosis.

Should I use modifier 26 or TC when billing CPT 72114?

Use modifier 26 when billing only the professional component (radiologist interpretation) if your physician reads films taken at another facility. Use modifier TC when billing only the technical component (equipment and technologist) if interpretation is provided separately. Bill the global code without modifiers when your facility provides both components.

What are the RVU values for CPT code 72114 in 2025?

The 2025 RVU values for CPT 72114 are: Work RVU 0.3, Practice Expense RVU 1.51 (both facility and non-facility), and Malpractice RVU 0.03, totaling 1.84 RVUs. These values are identical for facility and non-facility settings, which is why the Medicare reimbursement rate is $59.52 in both settings.