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CPT 72255 Fee Schedule

Last Verified: December 2025

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.

Myelography Thoracic Rad S&I
Key FactDetail
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

59 - Distinct Procedural Service

Complexity LevelLow

National average reimbursement for CPT 72255 by major payers:

bcbs

$146.47

uhc

$149.09

aetna

$140.54

cigna

$180.30

Preview provider-level rates for...
For billing codeCPT 72255
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 72255

United
72255$59.881235122029 - BAYCARE HOME CARE, INC.593582520 - (FL) BAYCARE HOME CARE INCFLHome Health Agency (251E00000X)
United
72255$33.271598375651 - E AND A MEDICAL ON THE GO HEALTHCARE OF SOUTH FLORIDA LLC, E AND A HEALTHCARE ON THE GO832289173 - (FL) E AND A MEDICAL ON THE GO HEALTHCARE OF SOUTH FLORIDA LLCFLHome Health Agency (251E00000X)
United
72255$247.211457447120 - STEVEN LUTZKER751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PATXDiagnostic Radiology Physician (2085R0202X)
United
72255$128.111578879151 - BLAKE WATSON751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PATXDiagnostic Radiology Physician (2085R0202X)
United
72255$338.951568416204 - DAVID PHELPS751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PATXDiagnostic Radiology Physician (2085R0202X)
United
72255$75.011780947937 - GURJEET SINGH742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATIONIDNeurology Physician (2084N0400X)
United
72255$87.621366400376 - SUNRISE HOME HEALTH CARE INC.650307774 - (FL) SUNRISE HOME HEALTH CARE INCFLHome Health Agency (251E00000X)
United
72255$59.881134127301 - BAYCARE HOME CARE, INC.593582520 - (FL) BAYCARE HOME CARE INCFLHome Health Agency (251E00000X)
United
72255$240.611073787545 - MICHAEL MIRZOYAN742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATIONTXPulmonary Disease Physician (207RP1001X)
United
72255$162.661033492483 - HEALTH IMAGING PARTNERS, LLC271385885TXPhysiological Laboratory (293D00000X)
United
72255$66.411922457894 - AARON JAFFE742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATIONTXInternal Medicine Physician (207R00000X)
United
72255$247.211194992842 - STEPHEN WEI751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PAFLDiagnostic Radiology Physician (2085R0202X)
United
72255$165.581285874362 - FARHOUD KHOSRAVI742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATIONAKGastroenterology Physician (207RG0100X)
United
72255$165.581104239540 - IV GODZDANKER742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATIONAZEmergency Medicine Physician (207P00000X)
United
72255$116.971851390637 - BAYCARE HOME CARE, INC.593582520 - (FL) BAYCARE HOME CARE INCFLHome Health Agency (251E00000X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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CPT 72255 vs. Other Diagnostic Radiology (Diagnostic Imaging) Procedures Codes

The CPT 72255 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 72255 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.

CodeComplexityDescription
72128-CPTLowCt Thoracic Spine;W/0 Contrast Mat.
72129-CPTModerateCat,Thoracic Spine;W/Contrst Materl,18-2
72146-CPTModerateMri,Spin.Canal,Thor;W/O Cntrst Matl
72255-CPTLowMyelography Thoracic Rad S&I

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 72255. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 72255 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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