CPT 72130 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 | • 21 - Inpatient Hospital • 11 - Office |
| Common Modifiers | • None • 26 - Professional component • TC - Technical component |
| Complexity Level | Moderate |
National average reimbursement for CPT 72130 by major payers:
$270.19
$333.45
$341.19
$387.31
| 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 72130 | ||||||
United | 72130 | $108.00 | 1689023228 - HAMISH PATEL | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | FL | Internal Medicine Physician (207R00000X) |
United | 72130 | $585.59 | 1992117089 - ADNAN ZUBAIR | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | GA | Orthopaedic Surgery Physician (207X00000X) |
United | 72130 | $585.59 | 1194757427 - ROBERT TIBALLI | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | MI | Hospitalist Physician (208M00000X) |
United | 72130 | $239.03 | 1720087513 - BAYCARE HOME CARE, INC. | 593582520 - (FL) BAYCARE HOME CARE INC | FL | Home Health Agency (251E00000X) |
United | 72130 | $108.00 | 1639341951 - VINCENT KRESHA | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Anesthesiology Physician (207L00000X) |
United | 72130 | $55.22 | 1346650942 - JACK SHORT | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Critical Care Medicine (Internal Medicine) Physician (207RC0200X) |
United | 72130 | $1184.59 | 1316278229 - HEALTH IMAGING PARTNERS | 271385885 | TX | Radiology Clinic/Center (261QR0200X) |
United | 72130 | $585.59 | 1477993103 - MAGDY HANNA | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | MI | Cardiovascular Disease Physician (207RC0000X) |
United | 72130 | $108.00 | 1497997977 - AMANBIR DHADE | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | CO | Anesthesiology Physician (207L00000X) |
United | 72130 | $693.59 | 1972584779 - CHARLES COFFMAN | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Emergency Medicine Physician (207P00000X) |
United | 72130 | $143.86 | 1548645021 - JELISA VICK | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Acute Care Nurse Practitioner (363LA2100X) |
United | 72130 | $108.00 | 1477009702 - MELISSA KOLNIK | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Certified Registered Nurse Anesthetist (367500000X) |
United | 72130 | $693.59 | 1720036411 - ALICIA HODGE | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | WA | Internal Medicine Physician (207R00000X) |
United | 72130 | $55.22 | 1205013919 - PATRICK MARTIN | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | LA | Critical Care Medicine (Internal Medicine) Physician (207RC0200X) |
United | 72130 | $199.08 | 1851735856 - TIFFANY YNOSENCIO | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | TX | Critical Care Medicine (Internal Medicine) Physician (207RC0200X) |
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 |
Want to see your competitors' rates?
Start your trial today to unlock complete access to provider rates and fee schedules in your area.
Here's what you can do with PayerPrice
Renegotiate your managed care contracts
Benchmark your current rates against market averages to identify opportunities for rate optimization.
Prospect for new business using fee schedules
Access every provider's negotiated rates for every billing code in your market to inform your prospecting strategies.
Integrate real-time payer data into your workflows
Automatically keep fee schedules up-to-date without adding yet another log-in to your insurance systems. Connect via API or SQL.
PayerPrice shows you the exact negotiated rates that insurers publish under federal transparency rules.
We display the raw data directly from insurers' files, giving you the same information they make public. Learn more about Price Transparency.
CPT 72130 vs. Other Diagnostic Radiology (Diagnostic Imaging) Procedures Codes
The CPT 72130 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 72130 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 |
|---|---|---|
| 72128-CPT | Low | Ct Thoracic Spine;W/0 Contrast Mat. |
| 72129-CPT | Moderate | Cat,Thoracic Spine;W/Contrst Materl,18-2 |
| 72130-CPT | Moderate | Computerized Axial Tomography Thoracic Spine; Without Contrast Material Followed By Contrast Material(S) And Further Sections |
| 72146-CPT | Moderate | Mri,Spin.Canal,Thor;W/O Cntrst Matl |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 72130. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 72130 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.
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 72130) and we'll show you how you compare in 15 minutes or less.