CPT 72100 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 72100 by major payers:

$48.28

$43.98

$49.70

$57.40
| 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 72100 | ||||||
United | 72100 | $39.22 | 1124651047 - LISA JONES | 383328191 - (MI) PREMIER MEDICINE PC | MI | Primary Care Nurse Practitioner (363LP2300X) |
United | 72100 | $39.72 | 1427084805 - GEORGE NAHHAS | 450969972 - (MI) EHK ENDOVASCULAR PLLC | MI | Cardiovascular Disease Physician (207RC0000X) |
United | 72100 | $63.59 | 1306251343 - NICHOLAS WILLIUS | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | KY | Anesthesiology Physician (207L00000X) |
United | 72100 | $24.96 | 1972934941 - MIREILLE TOUMA | 383297618 - (MI) PROFESSIONAL MEDICAL GROUP MD PC | MI | Primary Care Nurse Practitioner (363LP2300X) |
United | 72100 | $25.70 | 1811000177 - CHARLESTON RADIOLOGISTS PA | 570634747 - CHARLESTON RADIOLOGISTS, P.A. | SC | Diagnostic Radiology Physician (2085R0202X) |
United | 72100 | $28.79 | 1235186149 - MARK FRIKKER | 822768899 - BEAUMONT MEDICAL GROUP - HOSPITAL-BASED SERVICES | MI | Surgery Physician (208600000X) |
United | 72100 | $14.13 | 1366437493 - GEORGE KARTALIAN, JR. | 541383504 - TOWN CENTER ORTHOPAEDIC ASSOCIATES, P.C. | VA | Orthopaedic Surgery Physician (207X00000X) |
United | 72100 | $28.04 | 1740384908 - PLAZA OB-GYN ASSOCIATES, PLAZA OB-GYN ASSOCIATES, LLC | 741951870 - (TX) PLAZA OBGYN ASSOCIATES PLLC | TX | Obstetrics & Gynecology Physician (207V00000X) |
United | 72100 | $13.26 | 1386721033 - JOHN BUTTARI | 541383504 - TOWN CENTER ORTHOPAEDIC ASSOCIATES, P.C. | VA | Physical Therapist (225100000X) |
United | 72100 | $240.08 | 1922396241 - SHAREEF SYED | 943281667 | MI | Surgery Physician (208600000X) |
United | 72100 | $16.51 | 1063908093 - FARHA SYED | 760010407 | TX | Family Medicine Physician (207Q00000X) |
United | 72100 | $40.20 | 1336582063 - VANNA ROCCHI | 311610834 - (VA) CHILDRENS SURGICAL SPECIALTY GROUP INC | VA | Pediatric Orthopaedic Surgery Physician (207XP3100X) |
United | 72100 | $7.51 | 1164414900 - JEAN FOUCAULD | 651036209 - (FL) CARDIOLOGY PARTNERS | FL | Cardiovascular Disease Physician (207RC0000X) |
United | 72100 | $70.73 | 1073502985 - CHU CHEN | 42484572 - MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC. | MA | Pediatrics Physician (208000000X) |
United | 72100 | $38.58 | 1417904806 - WEI GEN LI | 43228556 - JORDAN PHYSICIAN ASSOCIATES INC | MA | Internal Medicine Physician (207R00000X) |
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 72100 vs. Other Diagnostic Radiology (Diagnostic Imaging) Procedures Codes
The CPT 72100 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 72100 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 72100. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 72100 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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