What is a CPT code and why is it important for understanding medical costs?

A CPT (Current Procedural Terminology) code is a five-digit numerical code used by medical professionals to describe medical, surgical, and diagnostic services. It's crucial for understanding medical costs because it standardizes the identification of services, allowing payers (like insurance companies) and providers to communicate clearly about what services were rendered. Knowing the CPT code for a specific procedure or service is often the first step in estimating its cost.

How can I find out the cost of a specific medical procedure or service?

To find out the cost of a specific medical procedure or service, you typically need its CPT code. Once you have the CPT code, you can use a tool designed for fee schedule lookups. For accurate, location-specific pricing based on various payers, you can use Payerprice's fee schedule lookup tool. This allows you to search with the CPT code and your specific location to get an estimate of costs relevant to your situation.

What is Payerprice and how can it help me?

Payerprice is a service that provides a fee schedule lookup tool, allowing users to search for the cost of medical procedures. By using a CPT code and specifying a location, Payerprice helps individuals and healthcare professionals understand the potential costs of services, facilitating more informed healthcare decisions and financial planning.

How is Payerprice different from resources like CMS for finding medical costs?

While resources like CMS (Centers for Medicare & Medicaid Services) provide information primarily related to Medicare and Medicaid fee schedules, Payerprice offers a broader fee schedule lookup tool. Payerprice is designed for users to search with a CPT code and specific location, providing a more direct and often more comprehensive view of various payer's fee schedules beyond just government programs, making it suitable for a wider range of specific situations and insurance types.

Can I find out costs for a specific location using Payerprice?

Yes, Payerprice's fee schedule lookup tool is specifically designed to allow users to search with a CPT code and a specific location. This feature helps provide more accurate and relevant cost estimates tailored to where the medical service will be performed, as prices can vary significantly by geographic area.

CPT 72131 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 Lower Spine, Ct (Computed Tomography) Of Spine (Low Back). The Scanner Circles The Body Taking X-Rays And Assembles Them Into A 3-D Image. Dye May Be Injected 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 11 - Office
Common Modifiers	None 26 - Professional component TC - Technical component
Complexity Level	Low
Medicare Fee Schedule	View Medicare rates for 72131
Medicaid Fee Schedule	View Medicaid rates for 72131

National average reimbursement for CPT 72131 by major payers:

$171.99

$225.76

$256.18

$256.41

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CPT 72131

5 of 25 sample ratesHigher to lower in this preview

Jonathan Fields
FLDiagnostic Radiology PhysicianNPI 1437131919Tax ID 25-1857035
$356.60Published rate
Heidi Roloson
Slocum Dickson Medical Group PLLC
NYSurgical Physician AssistantNPI 1093949711Tax ID 20-0362623
$181.11Published rate
Gamaliel Rodriguez-Herrera
FLDiagnostic Radiology PhysicianNPI 1396727491Tax ID 34-1855775
$153.61Published rate
Christopher Glynn
Dubois Regional Medical Center
AZAnesthesiology PhysicianNPI 1407812035Tax ID 25-1490707
$72.04Published rate
Aaron Falchook
South Broward Hospital District
FLRadiation Oncology PhysicianNPI 1760773717Tax ID 59-6014973
$42.25Published rate

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Summit Women's CareDenver, Colorado

September 2, 2026

Contracting Manager
UnitedHealthcare
Commercial PPO

Re: Request for fee schedule renegotiation

We request a formal review of our Commercial PPO fee schedule. The comparison below summarizes our current rate alongside published rates for comparable Denver-area practices.

Market evidence · CPT 59485

Current rate: $152.40
Market median: $147.00
Market position: 61st percentile

The comparison includes 1,284 published rates from 96 provider groups, scoped to OB/GYN providers in a professional, office-based setting.

We would welcome a discussion of our fee schedule and the supporting July 2026 market analysis. Please let us know a suitable time to review the comparison together.

Sincerely,
Summit Women's Care

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CPT 72131 vs. Other Diagnostic Radiology (Diagnostic Imaging) Procedures Codes

The CPT 72131 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 72131 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
72131-CPT	Low	Ct Scan Of Lower Spine, Ct (Computed Tomography) Of Spine (Low Back). The Scanner Circles The Body Taking X-Rays And Assembles Them Into A 3-D Image. Dye May Be Injected To Make The Area Easier To See.
72132-CPT	Moderate	Ct Scan Of Lower Spine, Ct (Computed Tomography) Of Spine (Low Back). The Scanner Circles The Body Taking X-Rays And Assembles Them Into A 3-D Image. Dye May Be Injected To Make The Area Easier To See.
72133-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.
72148-CPT	Moderate	Mri Inner Spine (Canal), An Mri (Magnetic Resonance Imaging) Of The Interior Of The Lower 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 72131. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 72131 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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CPT 72131 Fee Schedule

Jonathan Fields

Heidi Roloson

Gamaliel Rodriguez-Herrera

Christopher Glynn

Aaron Falchook