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 |
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 | $252.17 | 1326061730 - GRANVILLE HEALTH SYSTEM, GRANVILLE HEALTH SYSTEM | 560593547 - (NC) GRANVILLE HEALTH SYSTEM | NC | General Acute Care Hospital (282N00000X) |
United | 72200 | $56.77 | 1700352374 - BON SECOURS DIAGNOSTIC IMAGING, ST. FRANCIS MILLENNIUM | 832087782 - BON SECOURS DIAGNOSTIC IMAGING | SC | Radiology Clinic/Center (261QR0200X) |
United | 72200 | $18.13 | 1841471471 - NEXT GENERATION IMAGING | 208967541 - (TN) NEXT GENERATION IMAGING | TN | Radiology Clinic/Center (261QR0200X) |
United | 72200 | $333.57 | 1760488266 - ST. LUKE'S WARREN HOSPITAL, INC. | 221494454 - (NJ) ST LUKES WARREN HOSPITAL INC | NJ | General Acute Care Hospital (282N00000X) |
United | 72200 | $190.53 | 1134164924 - GULF HEALTH HOSPITALS, INC., NORTH BALDWIN INFIRMARY | 630891904 - (AL) GULF HEALTH HOSPITALS INC | AL | General Acute Care Hospital (282N00000X) |
United | 72200 | $455.19 | 1851686059 - SWEDISH HEALTH SERVICES, SWEDISH/ISSAQUAH | 910433740 - (WA) SWEDISH HEALTH SERVICES | WA | 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 | $252.17 | 1265445506 - WILLIAMSON COUNTY HOSPITAL DISTRICT, WILLIAMSON MEDICAL CENTER | 621501534 | TN | General Acute Care Hospital (282N00000X) |
United | 72200 | $134.50 | 1073576740 - MARICOPA COUNTY SPECIAL HEALTH CARE DISTRICT, VALLEYWISE HEALTH | 860830701 | AZ | General Acute Care Hospital (282N00000X) |
United | 72200 | $245.17 | 1598766495 - OUR LADY OF LOURDES REGIONAL MEDICAL CENTER,INC | 720423635 - OUR LADY OF LOURDES REGIONAL MEDICAL CENTER INC | LA | General Acute Care Hospital (282N00000X) |
United | 72200 | $45.88 | 1952311243 - LARKIN COMMUNITY HOSPITAL INC | 650729921 - (FL) LARKIN COMMUNITY HOSPITAL, INC. | FL | General Acute Care Hospital (282N00000X) |
United | 72200 | $305.76 | 1831220714 - INOVA HEALTH CARE SERVICES, INOVA FAIRFAX HOSPITAL | 540620889 - INOVA HEALTH CARE SERVICES | VA | General Acute Care Hospital (282N00000X) |
United | 72200 | $108.97 | 1700801909 - TENET HOSPITALS LIMITED, THE HOSPITALS OF PROVIDENCE MEMORIAL CAMPUS | 954537720 | TX | 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 | $29.12 | 1265626436 - ADVANTAGE MRI-CAROL STREAM, LLC | 260810327 | IL | Radiology Clinic/Center (261QR0200X) |
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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