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CPT 72265 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 Lumbosacral 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

59 - Distinct Procedural Service

26 - Professional component

Complexity LevelLow

National average reimbursement for CPT 72265 by major payers:

bcbs

$138.20

uhc

$141.50

aetna

$133.75

cigna

$175.53

Preview provider-level rates for...
For billing codeCPT 72265
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 72265

United
72265$173.521548750417 - UKHS GREAT BEND, LLC, THE UNIVERSITY OF KANSAS HEALTH SYSTEM GREAT BEND CAMPUS830516935KSGeneral Acute Care Hospital (282N00000X)
United
72265$1531.841265486278 - EAST GEORGIA REGIONAL MEDICAL CENTER, LLC, EAST GEORGIA REGIONAL MEDICAL CENTER LLC582190713 - (GA) EAST GEORGIA REGIONAL MEDICAL CENTER LLCGAGeneral Acute Care Hospital (282N00000X)
United
72265$1609.161689676835 - NATCHITOCHES PARISH HOSPITAL SERVICE DISTRICT, NATCHITOCHES REGIONAL MEDICAL CENTER726013916 - (LA) NATCHITOCHES REGIONAL MEDICAL CENTERLAGeneral Acute Care Hospital (282N00000X)
United
72265$1361.641073601043 - HH HEALTH SYSTEM, RED BAY HOSPITAL472323163 - (AL) HH HEALTH SYSTEMALCritical Access Hospital (282NC0060X)
United
72265$1094.221629021845 - ST DAVIDS HEALTHCARE PARTNERSHIP LP LLP, NORTH AUSTIN MEDICAL CENTER742781812TXGeneral Acute Care Hospital (282N00000X)
United
72265$1159.191053321919 - UNIVERSITY COMMUNITY HOSPITAL, INC, ADVENTHEALTH TAMPA591113901 - (FL) UNIVERSITY COMMUNITY HOSPITAL INCFLGeneral Acute Care Hospital (282N00000X)
United
72265$162.781013908912 - INDEPENDENT IMAGING, LLC651090586 - (FL) INDEPENDENT IMAGING, L.L.C.FLRadiology Clinic/Center (261QR0200X)
United
72265$1358.831609275585 - CHCA PEARLAND, L.P., HCA HOUSTON HEALTHCARE PEARLAND50631189TXGeneral Acute Care Hospital (282N00000X)
United
72265$477.921952311243 - LARKIN COMMUNITY HOSPITAL INC650729921 - (FL) LARKIN COMMUNITY HOSPITAL, INC.FLGeneral Acute Care Hospital (282N00000X)
United
72265$715.171477537363 - VHS OF PHOENIX INC, ABRAZO CENTRAL CAMPUS621809851AZGeneral Acute Care Hospital (282N00000X)
United
72265$643.651396317137 - STEWARD HH. INC.862669849FLGeneral Acute Care Hospital (282N00000X)
United
72265$643.651083286801 - STEWARD CGH, INC.650638215FLGeneral Acute Care Hospital (282N00000X)
United
72265$1159.191306938071 - ADVENTIST HEALTH SYSTEM-SUNBELT, INC, ADVENTHEALTH ORLANDO590724459 - (FL) ADVENTIST HEALTH SYSTEM-SUNBELT INCFLGeneral Acute Care Hospital (282N00000X)
United
72265$1430.351003925959 - HOSPITAL SERVICE DISTRICT 2 OF THE PARISH OF TANGIPAHOA STATE OF LA., HOOD MEMORIAL HOSPITAL720694946 - (LA) HOSPITAL SERVICE DISTRICT 2 OF THE PARISH OF TANGIPAHOA STATE OF LALACritical Access Hospital (282NC0060X)
United
72265$716.391841231461 - MULTICARE HEALTH SYSTEM, MULTICARE GOOD SAMARITAN HOSPITAL911352172 - MULTICARE HEALTH SYSTEMWAGeneral Acute Care Hospital (282N00000X)
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 72265 vs. Other Diagnostic Radiology (Diagnostic Imaging) Procedures Codes

The CPT 72265 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 72265 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
72131-CPTLowCat Lumbar Spine;W/O Contrst Materl,18-2
72132-CPTModerateCt Lumbar Spine;W/Contrast Material
72149-CPTModerateMri,Spinal Canal/Contents,Lumbar;W/Cntrs
72265-CPTLowMyelography Lumbosacral 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 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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