CPT 72270 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 |
| Medicare Fee Schedule | View Medicare rates for 72270 |
National average reimbursement for CPT 72270 by major payers:

$194.62

$206.29

$193.92

$254.79
| 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 72270 | ||||||
United | 72270 | $381.58 | 1851387278 - JOHN MOUGIN | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Internal Medicine Physician (207R00000X) |
United | 72270 | $150.66 | 1265438691 - GARY SIMMONS | 751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PA | TX | Diagnostic Radiology Physician (2085R0202X) |
United | 72270 | $172.33 | 1669259297 - EMILY JENSEN | 751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PA | TX | Physician Assistant (363A00000X) |
United | 72270 | $323.01 | 1205897477 - JOHN ANDREWS | 751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PA | TX | Diagnostic Radiology Physician (2085R0202X) |
United | 72270 | $94.56 | 1235629825 - ALYSSA NORMAN | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Psychiatry Physician (2084P0800X) |
United | 72270 | $75.43 | 1154378164 - HASSAN SHAFEEQ | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Internal Medicine Physician (207R00000X) |
United | 72270 | $381.58 | 1508936592 - ALI ALAVI | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | CA | Urology Physician (208800000X) |
United | 72270 | $112.80 | 1619545985 - ANDREA GUM | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Certified Registered Nurse Anesthetist (367500000X) |
United | 72270 | $172.33 | 1497747653 - LUCIANA ROCHETTI | 751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PA | TX | Physician Assistant (363A00000X) |
United | 72270 | $323.01 | 1700812815 - MICHAEL PENNEY | 751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PA | TX | Diagnostic Radiology Physician (2085R0202X) |
United | 72270 | $75.43 | 1619207008 - SHARITA NAGARAJ | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | NY | Surgery Physician (208600000X) |
United | 72270 | $75.43 | 1033564026 - AYSHA AGARWAL | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Critical Care Medicine (Internal Medicine) Physician (207RC0200X) |
United | 72270 | $104.76 | 1609823194 - SACRED HEART HEALTH SYSTEM INC, SACRED HEART HOME CARE | 590634434 - SACRED HEART HEALTH SYSTEM INC | FL | Home Health Agency (251E00000X) |
United | 72270 | $323.01 | 1154302719 - RACHEL BIZOT | 751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PA | TX | Physician Assistant (363A00000X) |
United | 72270 | $75.43 | 1295977718 - CHRISTOPHER MUELLER | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Cardiovascular Disease Physician (207RC0000X) |
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 |
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CPT 72270 vs. Other Diagnostic Radiology (Diagnostic Imaging) Procedures Codes
The CPT 72270 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 72270 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 |
|---|---|---|
| 72125-CPT | Low | Cat Cerv.Spine;W/O Contrst Material,18-2 |
| 72128-CPT | Low | Ct Thoracic Spine;W/0 Contrast Mat. |
| 72131-CPT | Low | Cat Lumbar Spine;W/O Contrst Materl,18-2 |
| 72270-CPT | Low | Myelography Two Or More Regions (Eg Lumbar/Thoracic Cervical/Thoracic Lumbar/Cervical Lumbar/Thoracic/Cervical) Radiological Supervision And Interpretation (Rvsd 1/1/04) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 72270. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 72270 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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