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See a sample rate comparisonCPT 72126 Fee Schedule
Last Verified: September 2026
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.
Ct Scan Of Upper Spine, A Ct Scanner Circles The Body Taking X-Rays Of The Upper (Cervical) Spine And Assembles Them Into A 3-D Image. Dye (Contrast) May Be Used To Make The Area Easier To See.
| Key Fact | Detail |
|---|---|
| Service Type | Radiology Procedures Diagnostic Radiology (Diagnostic Imaging) Procedures |
| Common Place of Service | 23 - Emergency Room 22 - On Campus Outpatient Hospital |
| Common Modifiers | None 26 - Professional component GC - Service performed by resident under supervision |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 72126 |
| Medicaid Fee Schedule | View Medicaid rates for 72126 |
National average reimbursement for CPT 72126 by major payers:
$236.19
$278.88
$310.80
$315.21
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CPT 72126
5 of 25 sample ratesHigher to lower in this preview
Health Imaging Partners LLC
$993.58Published rateAndrea Gum
Northern Arizona Healthcare Corporation
$567.59Published rateRobert Reuter
Radiology Associates Of North Texas, PA
$424.05Published rateRadiology Associates Of Tarrant County PA
Radiology Associates Of North Texas, PA
$157.00Published rateNeeja Dave
Northern Arizona Healthcare Corporation
$53.08Published rate
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See a sample payer proposalCPT 72126 vs. Other Diagnostic Radiology (Diagnostic Imaging) Procedures Codes
The CPT 72126 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 72126 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 | Ct Scan Of Upper Spine, A Ct Scanner Circles The Body Taking X-Rays Of The Upper (Cervical) Spine And Assembles Them Into A 3-D Image. Dye (Contrast) May Be Used To Make The Area Easier To See. |
| 72126-CPT | Moderate | Ct Scan Of Upper Spine, A Ct Scanner Circles The Body Taking X-Rays Of The Upper (Cervical) Spine And Assembles Them Into A 3-D Image. Dye (Contrast) May Be Used To Make The Area Easier To See. |
| 72127-CPT | Moderate | Ct Scan Of The Back, A Ct (Computed Tomography) Scan Of The Upper Middle Or Lower Back. The Scanner Circles The Body Taking X-Rays And Assembles Them Into A 3-D Image. After One Set Of Images A Second Set Is Taken With Contrast Dye To Highlight Areas. |
| 72141-CPT | Moderate | Mri Inner Spine (Canal), An Mri (Magnetic Resonance Imaging) Of The Interior Of The Upper Spine (Spinal Canal). A Contrast Agent May Be Given To Enhance The Images. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 72126. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 72126 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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