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See a sample rate comparisonCPT 72265 Fee Schedule
Last Verified: September 2026
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.
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.
| 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 |
| Medicare Fee Schedule | View Medicare rates for 72265 |
| Medicaid Fee Schedule | View Medicaid rates for 72265 |
National average reimbursement for CPT 72265 by major payers:
$138.20
$141.50
$133.75
$171.18
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CPT 72265
5 of 25 sample ratesHigher to lower in this preview
Prisma Health-Upstate, Prisma Health Op Surgery Spartanburg
Prisma Health - Upstate
$3,606.10Published rateCatholic Health Initiatives Colorado, Centura St Anthony North Hospital
Catholic Health Initiatives Colorado
$1,609.16Published rateUniversity Community Hospital, Inc, Adventhealth Tampa
University Community Hospital Inc
$1,159.19Published rateMercy Hospital Jefferson, Jefferson Memorial Hospital Association
Mercy Hospital Jefferson
$714.85Published rateMaryville Imaging, LLC, Goshen Imaging
Maryville Imaging LLC
$72.69Published rate
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See a sample payer proposalCPT 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.
| 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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