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See a sample rate comparisonCPT 72265 is classified under Radiology Procedures, in the Diagnostic Radiology (Diagnostic Imaging) Procedures subgroup.
| 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 | 59 - Distinct Procedural Service 26 - Professional component |
| Complexity Level | Low |
| Medicare Fee Schedule | $110.22 national non-facility rate (2026) · View Medicare rates for 72265 |
| Medicaid Fee Schedule | $88.965 median of the 8 states in the free preview · View Medicaid rates for 72265 |
National average reimbursement for CPT 72265 by major payers:

$138.20
BCBS / Anthem

$141.50
UnitedHealthcare

$133.75
Aetna

$171.18
Cigna
Choose a payer to see a sample of rates for CPT 72265.
Prisma Health-Upstate, Prisma Health Op Surgery Spartanburg
Prisma Health - Upstate
Catholic Health Initiatives Colorado, Centura St Anthony North Hospital
Catholic Health Initiatives Colorado
University Community Hospital, Inc, Adventhealth Tampa
University Community Hospital Inc
Mercy Hospital Jefferson, Jefferson Memorial Hospital Association
Mercy Hospital Jefferson
Maryville Imaging, LLC, Goshen Imaging
Maryville Imaging LLC
Choose your state and specialty to build a report from payer-published rates.
Rate Benchmarking
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonPayer Contract Negotiation
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 72265 vs. Other Diagnostic Radiology (Diagnostic Imaging) Procedures Codes
The table lists codes related to 72265. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| 72131-CPT | Low | Ct Scan Of Lower Spine, Ct (Computed Tomography) Of Spine (Low Back). The Scanner Circles The Body Taking X-Rays And Assembles Them Into A 3-D Image. Dye May Be Injected To Make The Area Easier To See. |
| 72132-CPT | Moderate | Ct Scan Of Lower Spine, Ct (Computed Tomography) Of Spine (Low Back). The Scanner Circles The Body Taking X-Rays And Assembles Them Into A 3-D Image. Dye May Be Injected To Make The Area Easier To See. |
| 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. |
| 72265-CPT | Low | Radiology For Spinal X-Ray, Radiology Supervision And Interpretation Of X-Rays Taken Of The Spinal Cord Using Contrast Dye (Myelogram). Myelography Is An X-Ray Technique That Shows Movement Of A Contrast Agent Around The Spinal Cord In Real-Time. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 72265. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 72265 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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