CPT 72265 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 • 59 - Distinct Procedural Service • 26 - Professional component |
| Complexity Level | Low |
National average reimbursement for CPT 72265 by major payers:

$138.20

$141.50

$133.75

$175.53
| 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 72265 | ||||||
United | 72265 | $173.52 | 1548750417 - UKHS GREAT BEND, LLC, THE UNIVERSITY OF KANSAS HEALTH SYSTEM GREAT BEND CAMPUS | 830516935 | KS | General Acute Care Hospital (282N00000X) |
United | 72265 | $1531.84 | 1265486278 - EAST GEORGIA REGIONAL MEDICAL CENTER, LLC, EAST GEORGIA REGIONAL MEDICAL CENTER LLC | 582190713 - (GA) EAST GEORGIA REGIONAL MEDICAL CENTER LLC | GA | General Acute Care Hospital (282N00000X) |
United | 72265 | $1609.16 | 1689676835 - NATCHITOCHES PARISH HOSPITAL SERVICE DISTRICT, NATCHITOCHES REGIONAL MEDICAL CENTER | 726013916 - (LA) NATCHITOCHES REGIONAL MEDICAL CENTER | LA | General Acute Care Hospital (282N00000X) |
United | 72265 | $1361.64 | 1073601043 - HH HEALTH SYSTEM, RED BAY HOSPITAL | 472323163 - (AL) HH HEALTH SYSTEM | AL | Critical Access Hospital (282NC0060X) |
United | 72265 | $1094.22 | 1629021845 - ST DAVIDS HEALTHCARE PARTNERSHIP LP LLP, NORTH AUSTIN MEDICAL CENTER | 742781812 | TX | General Acute Care Hospital (282N00000X) |
United | 72265 | $1159.19 | 1053321919 - UNIVERSITY COMMUNITY HOSPITAL, INC, ADVENTHEALTH TAMPA | 591113901 - (FL) UNIVERSITY COMMUNITY HOSPITAL INC | FL | General Acute Care Hospital (282N00000X) |
United | 72265 | $162.78 | 1013908912 - INDEPENDENT IMAGING, LLC | 651090586 - (FL) INDEPENDENT IMAGING, L.L.C. | FL | Radiology Clinic/Center (261QR0200X) |
United | 72265 | $1358.83 | 1609275585 - CHCA PEARLAND, L.P., HCA HOUSTON HEALTHCARE PEARLAND | 50631189 | TX | General Acute Care Hospital (282N00000X) |
United | 72265 | $477.92 | 1952311243 - LARKIN COMMUNITY HOSPITAL INC | 650729921 - (FL) LARKIN COMMUNITY HOSPITAL, INC. | FL | General Acute Care Hospital (282N00000X) |
United | 72265 | $715.17 | 1477537363 - VHS OF PHOENIX INC, ABRAZO CENTRAL CAMPUS | 621809851 | AZ | General Acute Care Hospital (282N00000X) |
United | 72265 | $643.65 | 1396317137 - STEWARD HH. INC. | 862669849 | FL | General Acute Care Hospital (282N00000X) |
United | 72265 | $643.65 | 1083286801 - STEWARD CGH, INC. | 650638215 | FL | General Acute Care Hospital (282N00000X) |
United | 72265 | $1159.19 | 1306938071 - ADVENTIST HEALTH SYSTEM-SUNBELT, INC, ADVENTHEALTH ORLANDO | 590724459 - (FL) ADVENTIST HEALTH SYSTEM-SUNBELT INC | FL | General Acute Care Hospital (282N00000X) |
United | 72265 | $1430.35 | 1003925959 - HOSPITAL SERVICE DISTRICT 2 OF THE PARISH OF TANGIPAHOA STATE OF LA., HOOD MEMORIAL HOSPITAL | 720694946 - (LA) HOSPITAL SERVICE DISTRICT 2 OF THE PARISH OF TANGIPAHOA STATE OF LA | LA | Critical Access Hospital (282NC0060X) |
United | 72265 | $716.39 | 1841231461 - MULTICARE HEALTH SYSTEM, MULTICARE GOOD SAMARITAN HOSPITAL | 911352172 - MULTICARE HEALTH SYSTEM | WA | General Acute Care Hospital (282N00000X) |
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 |
Want to see your competitors' rates?
Start your trial today to unlock complete access to provider rates and fee schedules in your area.
Here's what you can do with PayerPrice
Renegotiate your managed care contracts
Benchmark your current rates against market averages to identify opportunities for rate optimization.
Prospect for new business using fee schedules
Access every provider's negotiated rates for every billing code in your market to inform your prospecting strategies.
Integrate real-time payer data into your workflows
Automatically keep fee schedules up-to-date without adding yet another log-in to your insurance systems. Connect via API or SQL.
PayerPrice shows you the exact negotiated rates that insurers publish under federal transparency rules.
We display the raw data directly from insurers' files, giving you the same information they make public. Learn more about Price Transparency.
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.
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.
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 72265) and we'll show you how you compare in 15 minutes or less.
