CPT 72133 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 | Diagnostic Radiology (Diagnostic Imaging) Procedures of the Spine and Pelvis 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 |
| Medicare Fee Schedule | View Medicare rates for 72133 |
National average reimbursement for CPT 72133 by major payers:
$264.80
$332.30
$356.08
$373.94
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
United | 72133 | $237.41 | 1134127301 - BAYCARE HOME CARE, INC. | 593582520 - (FL) BAYCARE HOME CARE INC | FL | Home Health Agency (251E00000X) |
United | 72133 | $99.61 | 1255478004 - CHRISTOPHER RAIO | 113438973 - ST JOSEPH HOSPITAL | NY | Emergency Medicine Physician (207P00000X) |
United | 72133 | $197.86 | 1699727784 - JEREMY PAYNE | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Neurology Physician (2084N0400X) |
United | 72133 | $163.32 | 1891180634 - ERIC PEPIN | 751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PA | TX | Diagnostic Radiology Physician (2085R0202X) |
United | 72133 | $77.55 | 1851390637 - BAYCARE HOME CARE, INC. | 593582520 - (FL) BAYCARE HOME CARE INC | FL | Home Health Agency (251E00000X) |
United | 72133 | $108.00 | 1124152368 - SCOTT LONGFELLOW | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | FL | Anesthesiology Physician (207L00000X) |
United | 72133 | $686.61 | 1992021075 - ADAM PRATER | 751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PA | GA | Diagnostic Radiology Physician (2085R0202X) |
United | 72133 | $523.29 | 1437508140 - UZOMA IGBOAGI | 751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PA | GA | Diagnostic Radiology Physician (2085R0202X) |
United | 72133 | $585.00 | 1437644374 - JAMES DEES | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Anesthesiology Physician (207L00000X) |
United | 72133 | $163.32 | 1023079050 - TIMOTHY LEIHGEBER | 751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PA | TX | Diagnostic Radiology Physician (2085R0202X) |
United | 72133 | $279.33 | 1396010856 - BERTRAND LIANG | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | CO | Neurology Physician (2084N0400X) |
United | 72133 | $686.61 | 1285926659 - JUSTIN SACKS | 751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PA | TX | Vascular & Interventional Radiology Physician (2085R0204X) |
United | 72133 | $96.16 | 1740728088 - SUSAN WALL | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Clinical Social Worker (1041C0700X) |
United | 72133 | $163.32 | 1467985986 - MOHAMMAD IBRAHIM | 751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PA | TX | Diagnostic Radiology Physician (2085R0202X) |
United | 72133 | $523.29 | 1649276072 - KENNETH WHITE | 751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PA | TX | 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 72133 vs. Other Diagnostic Radiology (Diagnostic Imaging) Procedures Codes
The CPT 72133 code is part of the Diagnostic Radiology (Diagnostic Imaging) Procedures of the Spine and Pelvis 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 72133 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 72133. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 72133 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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