CPT 72157 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 | • 22 - On Campus Outpatient Hospital • 11 - Office |
| Common Modifiers | • None • 26 - Professional component • TC - Technical component |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 72157 |
National average reimbursement for CPT 72157 by major payers:

$418.89

$606.84

$616.22

$683.80
| 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 72157 | ||||||
United | 72157 | $279.29 | 1164930616 - KAELA BACON | 593238640 - H LEE MOFFITT CANCER CTR & RES INST LIFE TIME CANCER SCRN CTR INC | FL | Physician Assistant (363A00000X) |
United | 72157 | $328.58 | 1770960031 - KEVIN OLSEN | 593238640 - H LEE MOFFITT CANCER CTR & RES INST LIFE TIME CANCER SCRN CTR INC | FL | Anesthesiology Physician (207L00000X) |
United | 72157 | $328.57 | 1174577159 - JOHN TOURTELOT | 593238640 - H LEE MOFFITT CANCER CTR & RES INST LIFE TIME CANCER SCRN CTR INC | FL | Endocrinology, Diabetes & Metabolism Physician (207RE0101X) |
United | 72157 | $137.42 | 1407840614 - MARIA GESUALDO | 200362623 - SLOCUM DICKSON MEDICAL GROUP PLLC | NY | Critical Care Medicine (Internal Medicine) Physician (207RC0200X) |
United | 72157 | $503.92 | 1891784807 - RAMESH CHERUKURI | 200362623 - SLOCUM DICKSON MEDICAL GROUP PLLC | NY | Anesthesiology Physician (207L00000X) |
United | 72157 | $328.58 | 1356912604 - JOSEPH THOMPSON | 593238640 - H LEE MOFFITT CANCER CTR & RES INST LIFE TIME CANCER SCRN CTR INC | FL | Internal Medicine Physician (207R00000X) |
United | 72157 | $158.22 | 1881787877 - DAHUI QIN | 593238640 - H LEE MOFFITT CANCER CTR & RES INST LIFE TIME CANCER SCRN CTR INC | FL | Anatomic Pathology & Clinical Pathology Physician (207ZP0102X) |
United | 72157 | $293.29 | 1982653457 - KWAKU AMANKWAH | 200362623 - SLOCUM DICKSON MEDICAL GROUP PLLC | NY | Obstetrics & Gynecology Physician (207V00000X) |
United | 72157 | $128.88 | 1841577509 - ANNA COLLINS | 200362623 - SLOCUM DICKSON MEDICAL GROUP PLLC | NY | Family Nurse Practitioner (363LF0000X) |
United | 72157 | $134.50 | 1104217769 - VENKAT LATCHANA | 593238640 - H LEE MOFFITT CANCER CTR & RES INST LIFE TIME CANCER SCRN CTR INC | FL | Adult Health Nurse Practitioner (363LA2200X) |
United | 72157 | $328.57 | 1669640348 - KENNETH GAGE | 593238640 - H LEE MOFFITT CANCER CTR & RES INST LIFE TIME CANCER SCRN CTR INC | FL | Diagnostic Radiology Physician (2085R0202X) |
United | 72157 | $293.29 | 1013177450 - MICHAEL MCNULTY | 200362623 - SLOCUM DICKSON MEDICAL GROUP PLLC | NY | Pain Medicine Physician (208VP0000X) |
United | 72157 | $137.42 | 1699242115 - JEREMY SKIECHS | 200362623 - SLOCUM DICKSON MEDICAL GROUP PLLC | NY | Physician Assistant (363A00000X) |
United | 72157 | $134.50 | 1790497642 - JENNY JORDAN | 593238640 - H LEE MOFFITT CANCER CTR & RES INST LIFE TIME CANCER SCRN CTR INC | FL | Internal Medicine Physician (207R00000X) |
United | 72157 | $328.58 | 1417024746 - MICHAEL JAGLAL | 593238640 - H LEE MOFFITT CANCER CTR & RES INST LIFE TIME CANCER SCRN CTR INC | FL | Internal Medicine Physician (207R00000X) |
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 72157 vs. Other Diagnostic Radiology (Diagnostic Imaging) Procedures Codes
The CPT 72157 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 72157 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 |
|---|---|---|
| 72146-CPT | Moderate | Mri,Spin.Canal,Thor;W/O Cntrst Matl |
| 72147-CPT | Moderate | Mri,Spinal Canal/Contents,Thorac;W/Cntrs |
| 72157-CPT | Moderate | Magnetic Resonance (Eg, Proton) Imaging, Spinal Canal And Contents, Without Contrast Material, Followed By Contrast Material(S) And Further Sequences; Thoracic |
| 72158-CPT | Moderate | Magnetic Resonance (Eg, Proton) Imaging, Spinal Canal And Contents, Without Contrast Material, Followed By Contrast Material(S) And Further Sequences; Lumbar |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 72157. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 72157 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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