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See a sample rate comparisonCPT 72158 Fee Schedule
Medicare rates as of October 2026
CPT 72158 is classified under Radiology Procedures, in the Diagnostic Radiology (Diagnostic Imaging) Procedures subgroup.
Mri Lumbar Spine W O W Dye, Magnetic Resonance Eg Proton Imaging Spinal Canal And Contents Without Contrast Material Followed By Contrast Material S And Further Sequences Lumbar
| Key Fact | Detail |
|---|---|
| Service Type | Radiology Procedures Diagnostic Radiology (Diagnostic Imaging) Procedures |
| Common Place of Service | 11 - Office 22 - On Campus Outpatient Hospital |
| Common Modifiers | 26 - Professional component TC - Technical component |
| Complexity Level | Moderate |
| Medicare Fee Schedule | $318.31 national non-facility rate (2026) · View Medicare rates for 72158 |
| Medicaid Fee Schedule | $261.53 median of the 8 states in the free preview · View Medicaid rates for 72158 |
National average reimbursement for CPT 72158 by major payers:
$413.96
BCBS / Anthem
$611.54
UnitedHealthcare
$614.43
Aetna
$664.71
Cigna
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CPT 72158
5 of 25 sample ratesHigher to lower in this preview
Robert Williams
$2,084.06Published rateByron Christie
$719.47Published rateGautam Dehadrai
$447.23Published rateJohn Morelli
$316.89Published rateCarol O'Dell
$140.75Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 72158 vs. Other Diagnostic Radiology (Diagnostic Imaging) Procedures Codes
The table lists codes related to 72158. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| 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. |
| 72149-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. |
| 72157-CPT | Moderate | Mri Chest Spine W O W Dye, Magnetic Resonance Eg Proton Imaging Spinal Canal And Contents Without Contrast Material Followed By Contrast Material S And Further Sequences Thoracic |
| 72158-CPT | Moderate | Mri Lumbar Spine W O W Dye, 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 72158. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 72158 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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