CPT 72040 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | • Radiology Procedures • Diagnostic Radiology (Diagnostic Imaging) Procedures |
| Common Place of Service | • 11 - Office • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • 26 - Professional component • TC - Technical component |
| Complexity Level | Low |
National average reimbursement for CPT 72040 by major payers:

$46.14

$43.14

$48.67

$56.28
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 72040 | ||||||
United | 72040 | $21.85 | 1447489620 - JOHN MORRISON | 131974191 - (NY) BRONXCARE HEALTH SYSTEM | FL | Neurological Surgery Physician (207T00000X) |
United | 72040 | $7.51 | 1013478924 - EDGAR FRANCIS SY | 590624364 - (FL) BARRY UNIVERSITY INC | FL | Foot & Ankle Surgery Podiatrist (213ES0103X) |
United | 72040 | $13.47 | 1235367483 - SEUNG YI | 592929608 - (FL) MUSCULOSKELETAL INSTITUTE INC. FLORIDA ORTHOPAEDIC INSTITUTE | FL | Sports Medicine (Orthopaedic Surgery) Physician (207XX0005X) |
United | 72040 | $22.01 | 1972695195 - MICHAEL MCDERMOTT | 205155995 | CA | Neurological Surgery Physician (207T00000X) |
United | 72040 | $28.87 | 1003864042 - ANTHONY EMELIANCHIK | 593469991 | FL | Foot Surgery Podiatrist (213ES0131X) |
United | 72040 | $36.34 | 1134397714 - ALEXANDER POWERS | 883413605 - (NC) COVENANT SPINE AND NEUROLOGY PLLC | NC | Neurological Surgery Physician (207T00000X) |
United | 72040 | $20.60 | 1477116721 - SALVATORE MELECA | 923372977 - (FL) MELECA FOOT AND ANKLE LLC | FL | Foot & Ankle Surgery Podiatrist (213ES0103X) |
United | 72040 | $14.25 | 1558814053 - JOSE MANUEL SARMIENTO | 650003177 - CLEVELAND CLINIC FLORIDA A NONPROFIT CORPORATION | NY | Neurological Surgery Physician (207T00000X) |
United | 72040 | $15.60 | 1649233958 - ELLEN GERSHBEIN | 650429853 | FL | Podiatrist (213E00000X) |
United | 72040 | $23.62 | 1629445275 - CERTIFIED FOOT & ANKLE SPECIALISTS | 270492585 - (FL) CERTIFIED FOOT ANKLE SPECIALISTS | FL | Foot & Ankle Surgery Podiatrist (213ES0103X) |
United | 72040 | $9.50 | 1790102655 - ROBERT ROTHROCK | 205155995 | FL | Neurological Surgery Physician (207T00000X) |
United | 72040 | $21.63 | 1184757635 - FLORIDA COAST FOOT & ANKLE PA | 208197740 - (FL) FLORIDA COAST FOOT & ANKLE, P.A. | FL | Foot & Ankle Surgery Podiatrist (213ES0103X) |
United | 72040 | $26.03 | 1992723647 - TIMOTHY SYPEREK | 593591435 - (FL) PHYSICIANS GROUP SERVICES, P.A. DBA FAMILY MEDICAL CENTERS | FL | Podiatrist (213E00000X) |
United | 72040 | $25.60 | 1881089985 - POLLYANNA REEVES | 203992889 - (FL) GARNET AND CARBONELL, DPM, LLC | FL | Foot & Ankle Surgery Podiatrist (213ES0103X) |
United | 72040 | $20.60 | 1639838618 - STELLAR FOOT AND ANKLE SPECIALISTS LLC | 873047257 - (FL) STELLAR FOOT AND ANKLE SPECIALISTS LLC | FL | Podiatrist (213E00000X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 72040 vs. Other Diagnostic Radiology (Diagnostic Imaging) Procedures Codes
The CPT 72040 code is part of the Radiology Procedures services used for Diagnostic Radiology (Diagnostic Imaging) Procedures. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 72040 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 72040. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 72040 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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