Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonHealthcare 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 |
| Medicaid Fee Schedule | View Medicaid rates for 72270 |
National average reimbursement for CPT 72270 by major payers:

$194.62

$206.29

$193.92

$250.99
Choose a payer to see a sample of rates for CPT 72270.
Northern Arizona Healthcare Corporation
Radiology Associates Of North Texas, PA
Northern Arizona Healthcare Corporation
Northern Arizona Healthcare Corporation
Hroa 401k Plan
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 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 | Ct Scan Of Upper Spine, A Ct Scanner Circles The Body Taking X-Rays Of The Upper (Cervical) Spine And Assembles Them Into A 3-D Image. Dye (Contrast) May Be Used To Make The Area Easier To See. |
| 72128-CPT | Low | Ct Scan Of The Spine, A Ct (Computed Tomography) Scan Circles The Body Taking X-Rays Of The Middle Back (Thoracic Spine) And Assembles Them Into A 3-D Image. Dye May Be Injected Highlight An Area. |
| 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. |
| 72270-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 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.
Bring your top codes (like CPT 72270) and we'll show you how you compare in 15 minutes or less.