CPT 72200 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 | • 11 - Office • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • 26 - Professional component • TC - Technical component |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 72200 |
National average reimbursement for CPT 72200 by major payers:
$42.40
$35.65
$39.95
$46.86
| 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 72200 | ||||||
United | 72200 | $190.53 | 1447303227 - GULF HEALTH HOSPITALS, INC, THOMAS HOSPITAL | 630891904 - (AL) GULF HEALTH HOSPITALS INC | AL | General Acute Care Hospital (282N00000X) |
United | 72200 | $611.79 | 1811006661 - SOUTHEAST HOSPITAL, MERCY HOSPITAL SOUTHEAST | 430654874 - (MO) SOUTHEAST HOSPITAL | MO | General Acute Care Hospital (282N00000X) |
United | 72200 | $117.68 | 1508859661 - MERCY HOSPITAL JEFFERSON, JEFFERSON MEMORIAL HOSPITAL ASSOCIATION | 430687077 - (MO) MERCY HOSPITAL JEFFERSON | MO | General Acute Care Hospital (282N00000X) |
United | 72200 | $207.03 | 1841237807 - CHCA MAINLAND, L.P., MAINLAND MEDICAL CENTER | 621801360 | TX | General Acute Care Hospital (282N00000X) |
United | 72200 | $272.42 | 1144894577 - HMH HOSPITALS CORPORATION | 221487576 - HACKENSACK MERIDIAN HEALTH INC | NJ | General Acute Care Hospital (282N00000X) |
United | 72200 | $50.00 | 1982600920 - EASTERN PLUMAS HEALTH CARE DISTRICT, EASTERN PLUMAS HEALTH CARE | 941741654 | CA | Critical Access Hospital (282NC0060X) |
United | 72200 | $299.67 | 1790297547 - HMH HOSPITALS CORPORATION, JERSEY SHORE UNIVERSITY MEDICAL CENTER | 221487576 - HACKENSACK MERIDIAN HEALTH INC | NJ | General Acute Care Hospital (282N00000X) |
United | 72200 | $108.97 | 1598744856 - VHS SAN ANTONIO PARTNERS LLC, BAPTIST MEDICAL CENTER | 760714523 | TX | General Acute Care Hospital (282N00000X) |
United | 72200 | $194.58 | 1346354677 - FLORIDA HOSPITAL ZEPHYRHILLS INC, ADVENTHEALTH ZEPHYRHILLS | 592108057 - (FL) FLORIDA HOSPITAL ZEPHYRHILLS INC | FL | General Acute Care Hospital (282N00000X) |
United | 72200 | $108.97 | 1396745832 - ARIZONA SPINE AND JOINT HOSPITAL LLC | 364399746 - (AZ) ARIZONA SPINE AND JOINT HOSPITAL LLC | AZ | General Acute Care Hospital (282N00000X) |
United | 72200 | $224.16 | 1972557064 - BILOXI HMA LLC, MERIT HEALTH BILOXI | 592754033 | MS | General Acute Care Hospital (282N00000X) |
United | 72200 | $108.97 | 1427472463 - RESOLUTE HOSPITAL COMPANY, LLC, RESOLUTE HEALTH HOSPITAL | 462942963 - (TX) RESOLUTE HOSPITAL COMPANY LLC | TX | General Acute Care Hospital (282N00000X) |
United | 72200 | $12.09 | 1598702870 - OPEN MRI & IMAGING CENTER OF ELKTON,LLC | 202119977 - (MD) OPEN MRI IMAGING CENTER OF ELKTONLLC | MD | Radiology Clinic/Center (261QR0200X) |
United | 72200 | $250.17 | 1134125016 - VIRTUA, VIRTUA MOUNT HOLLY HOSPITAL | 210634562 - (NJ) VIRTUA-MEMORIAL HOSPITAL BURLINGTON COUNTY INC | NJ | General Acute Care Hospital (282N00000X) |
United | 72200 | $174.35 | 1932160082 - MARION REGIONAL MEDICAL CENTER, INC., MARION REGIONAL MEDICAL CENTER | 640926753 - (AL) MARION REGIONAL MEDICAL CENTER INC | AL | General Acute Care Hospital (282N00000X) |
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 72200 vs. Other Diagnostic Radiology (Diagnostic Imaging) Procedures Codes
The CPT 72200 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 72200 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 |
|---|---|---|
| 72170-CPT | Low | Radiologic Examination, Pelvis; Anteroposterior Only |
| 72196-CPT | Moderate | Magnetic Resonance (Eg, Proton) Imaging, |
| 72197-CPT | Moderate | Magnetic Resonance (Eg, Proton) Imaging, Pelvis; Without Contrast Material(S), Followed By Contrast Material(S) And Further Sequences |
| 72200-CPT | Low | X-Ray Sacroiliac Joints;Under 3 Vws |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 72200. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 72200 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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