{
    "code": "72100",
    "coding_system": "CPT",
    "canonical_url": "https://localishealth.com/cpt/72100/2021/A",
    "release_specific_url": "https://localishealth.com/cpt/72100/2021/A",
    "description": "A short plain-film study of the lower back, usually a front and a side picture and sometimes a third angle, covering the lumbar vertebrae and often the sacrum where the spine meets the pelvis. It shows alignment, disc space height, arthritic change, and vertebral fractures, but not discs or nerves themselves, which need MRI. A larger lumbar study exists for when oblique or bending views are also required.",
    "answer": {
        "question": "How much did Medicare pay for CPT 72100 in Q1 2021?",
        "text": "Medicare paid $40.48 for CPT 72100 in the office (non-facility) setting and $40.48 in a facility under the Q1 2021 Physician Fee Schedule, effective January 2021. These are the national allowed amounts before the ~2% sequestration cut and before locality (GPCI) adjustment. This is a 4.8% increase from the previous quarter."
    },
    "release": {
        "schedule": "pfs",
        "year": 2021,
        "quarter": "A",
        "label": "Q1 2021",
        "effective": "January 1 – March 31, 2021",
        "revision": 1
    },
    "status": {
        "code": "A",
        "non_facility_payable": true,
        "facility_payable": true
    },
    "national_rates_usd": {
        "office_non_facility": 40.48,
        "facility": 40.48,
        "sequestration_applied": false,
        "gpci": 1
    },
    "rvus": {
        "work": 0.22,
        "practice_expense_non_facility": 0.92,
        "practice_expense_facility": 0.92,
        "malpractice": 0.02
    },
    "formula": "(work_rvu × work_gpci + pe_rvu × pe_gpci + mp_rvu × mp_gpci) × conversion_factor",
    "conversion_factor": 34.8931,
    "source": {
        "label": "Physician relative value file (Q1 2021)",
        "cms_url": "https://www.cms.gov/files/zip/rvu21a-updated-01052021.zip",
        "local_source_url": "https://localishealth.com/sources/physician-fee-schedule/2021/A",
        "file": "PPRRVU21_JAN.csv",
        "row": 12294,
        "sha256": "8e6212d64ca58c6a20c44ea319d2148c49156b1fe63a6b68e64a5b0695b0e674"
    },
    "modified_at": "2026-08-04T03:10:16+00:00"
}