CPT 72125 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 | • 23 - Emergency Room • 21 - Inpatient Hospital |
| Common Modifiers | • None • 26 - Professional component • TC - Technical component |
| Complexity Level | Low |
National average reimbursement for CPT 72125 by major payers:
$182.85
$227.57
$256.87
$260.53
| 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 72125 | ||||||
United | 72125 | $207.00 | 1801175401 - KYLE HIRSCHMAN | 42472266 - (MA) RELIANT MEDICAL GROUP, INC. | MO | Diagnostic Radiology Physician (2085R0202X) |
United | 72125 | $307.33 | 1811376254 - DHAVAL PATEL | 272042610 - FROEDTERT & THE MEDICAL COLLEGE OF WISCONSIN COMMUNITY PHYSICIANS INC | TN | Diagnostic Radiology Physician (2085R0202X) |
United | 72125 | $202.19 | 1548435290 - DENIS PRIMAKOV | 232678055 - METHODIST ASSOCIATES IN HEALTHCARE INC | MD | Diagnostic Radiology Physician (2085R0202X) |
United | 72125 | $534.94 | 1508182742 - NAUSHEEN NAVEED | 274803222 - CITY OF HOPE MEDICAL FOUNDATION | CA | Diagnostic Radiology Physician (2085R0202X) |
United | 72125 | $131.44 | 1730107913 - MARY NEWELL | 581537752 - EMORY UNIVERSITY | GA | Diagnostic Radiology Physician (2085R0202X) |
United | 72125 | $225.33 | 1609863240 - ALAN CHAN | 912073120 | WA | Diagnostic Radiology Physician (2085R0202X) |
United | 72125 | $202.91 | 1396749867 - KATHRYN CAMBRON | 760453250 - (TX) BAPTIST PHYSICIAN NETWORK | NE | Diagnostic Radiology Physician (2085R0202X) |
United | 72125 | $192.52 | 1306108386 - STEVEN HOLE | 850422820 | TX | Diagnostic Radiology Physician (2085R0202X) |
United | 72125 | $136.24 | 1205887577 - JAYNISH PATEL | 752131429 - US ONCOLOGY CORPORATE, INC. | TX | Diagnostic Radiology Physician (2085R0202X) |
United | 72125 | $103.36 | 1497963011 - DISHANT SHAH | 823095346 - (IN) COLUMBUS RADIOLOGY PHYSICIANS, LLC | VA | Diagnostic Radiology Physician (2085R0202X) |
United | 72125 | $106.81 | 1316366776 - JAY COLEMAN | 464289822 - (TN) TENNESSEE INTERVENTIONAL AND IMAGING ASSOCIATES, PLLC | TX | Diagnostic Radiology Physician (2085R0202X) |
United | 72125 | $90.19 | 1316955925 - AMY FEDERICO | 132655001 - NEW YORK CITY HEALTH AND HOSPITALS CORPORATION | MN | Diagnostic Radiology Physician (2085R0202X) |
United | 72125 | $166.44 | 1730447186 - SCOTT PARKER | 454551946 - (ID) TETON VALLEY HEALTH CARE INC | ID | Diagnostic Radiology Physician (2085R0202X) |
United | 72125 | $267.17 | 1114176906 - MICHAEL CARUSO | 200236047 | MN | Diagnostic Radiology Physician (2085R0202X) |
United | 72125 | $140.88 | 1851391700 - EMIL SHIH | 562669185 - NUVANCE HEALTH MEDICAL PRACTICE PC | NY | 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 72125 vs. Other Diagnostic Radiology (Diagnostic Imaging) Procedures Codes
The CPT 72125 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 72125 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 |
|---|---|---|
| 72125-CPT | Low | Cat Cerv.Spine;W/O Contrst Material,18-2 |
| 72126-CPT | Moderate | Ct Cervical Spine;W/Contrast Mater. |
| 72127-CPT | Moderate | Computerized Axial Tomography Cervical Spine; Without Contrast Material Followed By Contrast Material(S) And Further Sections |
| 72141-CPT | Moderate | Mri,Spin.Canal,Cerv;W/O Contrst Mat |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 72125. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 72125 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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