CPT 72081 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 | Moderate |
National average reimbursement for CPT 72081 by major payers:
$51.02
$47.04
$51.61
$69.90
| 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 72081 | ||||||
United | 72081 | $42.34 | 1295477974 - HEALTH IMAGING PARTNERS, LLC | 271385885 | TX | Physiological Laboratory (293D00000X) |
United | 72081 | $45.84 | 1740728088 - SUSAN WALL | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Clinical Social Worker (1041C0700X) |
United | 72081 | $42.59 | 1801888433 - HARSH SINGH | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | WI | Neurology Physician (2084N0400X) |
United | 72081 | $13.71 | 1942763156 - HANNAH FOX | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Emergency Medicine Physician (207P00000X) |
United | 72081 | $35.88 | 1164428249 - DOUGLAS WRIGHT | 751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PA | TX | Diagnostic Radiology Physician (2085R0202X) |
United | 72081 | $42.59 | 1730611625 - DANIEL BRYAN | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | CA | Pain Medicine (Anesthesiology) Physician (207LP2900X) |
United | 72081 | $42.34 | 1942081153 - HEALTH IMAGING PARTNERS LLC | 271385885 | TX | Physiological Laboratory (293D00000X) |
United | 72081 | $42.59 | 1275920928 - JUNLI GALLAGHER | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Speech-Language Pathologist (235Z00000X) |
United | 72081 | $65.40 | 1528350139 - BRANDON ABBOTT | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | NY | Hospitalist Physician (208M00000X) |
United | 72081 | $65.40 | 1386930667 - RIZWAN JAFRI | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Gastroenterology Physician (207RG0100X) |
United | 72081 | $22.80 | 1336551803 - KRISTI ANDREASSEN GUY | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Physical Therapist (225100000X) |
United | 72081 | $28.51 | 1346650942 - JACK SHORT | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Critical Care Medicine (Internal Medicine) Physician (207RC0200X) |
United | 72081 | $42.22 | 1437139474 - MARIAN DIAMOND | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Family Nurse Practitioner (363LF0000X) |
United | 72081 | $22.80 | 1083097976 - DAVID CHMIELECKI | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | CO | Internal Medicine Physician (207R00000X) |
United | 72081 | $98.36 | 1326394859 - DANIELLA PINHO | 751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PA | TX | Diagnostic Radiology Physician (2085R0202X) |
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 72081 vs. Other Diagnostic Radiology (Diagnostic Imaging) Procedures Codes
The CPT 72081 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 72081 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.
| Code | Complexity | Description |
|---|---|---|
| 72081 | Low | Radiologic Examination, Spine, Entire Thoracic And Lumbar, Including Skull, Cervical And Sacral Spine If Performed (Eg, Scoliosis Evaluation); One View |
| 72082 | Low | Radiologic Examination, Spine, Entire Thoracic And Lumbar, Including Skull, Cervical And Sacral Spine If Performed (Eg, Scoliosis Evaluation); 2 Or 3 Views |
| 72083 | Low | Radiologic Examination, Spine, Entire Thoracic And Lumbar, Including Skull, Cervical And Sacral Spine If Performed (Eg, Scoliosis Evaluation); 4 Or 5 Views |
| 72084 | Low | Radiologic Examination, Spine, Entire Thoracic And Lumbar, Including Skull, Cervical And Sacral Spine If Performed (Eg, Scoliosis Evaluation); Minimum Of 6 Views |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 72081. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 72081 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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