CPT 72202 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 72202 |
National average reimbursement for CPT 72202 by major payers:
$47.19
$42.12
$47.89
$55.18
| 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 72202 | ||||||
United | 72202 | $16.20 | 1053480095 - MICHAEL RAY | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Emergency Medicine Physician (207P00000X) |
United | 72202 | $38.61 | 1801888433 - HARSH SINGH | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | FL | Neurology Physician (2084N0400X) |
United | 72202 | $58.63 | 1366739005 - JOSEPH YETTO | 751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PA | TX | Diagnostic Radiology Physician (2085R0202X) |
United | 72202 | $16.20 | 1285678748 - ANDREW ATIEMO | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Interventional Cardiology Physician (207RI0011X) |
United | 72202 | $24.37 | 1477554673 - JAMES CABELL | 751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PA | TX | Diagnostic Radiology Physician (2085R0202X) |
United | 72202 | $28.27 | 1073502985 - CHU CHEN | 42484572 - MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC. | MA | Pediatrics Physician (208000000X) |
United | 72202 | $58.63 | 1013297985 - EUGENIA PAYNE | 751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PA | TX | Diagnostic Radiology Physician (2085R0202X) |
United | 72202 | $57.59 | 1285810598 - SHIREEN JINDANI | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Internal Medicine Physician (207R00000X) |
United | 72202 | $57.59 | 1528054921 - NEERAJ VIJ | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Hospitalist Physician (208M00000X) |
United | 72202 | $57.59 | 1356345383 - EUGENE CHARLEBOIS | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | ME | Emergency Medicine Physician (207P00000X) |
United | 72202 | $57.59 | 1528383429 - REBECCA BURTON | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | WA | Internal Medicine Physician (207R00000X) |
United | 72202 | $83.01 | 1144908096 - NHI BUI | 751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PA | TX | Physician Assistant (363A00000X) |
United | 72202 | $11.90 | 1346650942 - JACK SHORT | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Critical Care Medicine (Internal Medicine) Physician (207RC0200X) |
United | 72202 | $57.59 | 1740324235 - DEBORAH MERRILL | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | OR | Anesthesiology Physician (207L00000X) |
United | 72202 | $16.20 | 1639154537 - MICHELE IDERA | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | CA | Certified Registered Nurse Anesthetist (367500000X) |
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 72202 vs. Other Diagnostic Radiology (Diagnostic Imaging) Procedures Codes
The CPT 72202 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 72202 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 |
|---|---|---|
| 72190-CPT | Low | X-Ray Pelvis;Complete Minimum Of 3 Views |
| 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 |
| 72202-CPT | Low | X-Ray Sacroiliac Joints;3or More Views |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 72202. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 72202 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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