CPT 72285 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 24 - Ambulatory Surgical Center |
| Common Modifiers | TC - Technical component 59 - Distinct Procedural Service None |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 72285 |
National average reimbursement for CPT 72285 by major payers:
$164.56
$185.21
$161.88
$223.38
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
United | 72285 | $67.80 | 1255478004 - CHRISTOPHER RAIO | 111888924 - GOOD SAMARITAN HOSPTIAL MEDICAL CENTER | NY | Emergency Medicine Physician (207P00000X) |
United | 72285 | $124.51 | 1922457894 - AARON JAFFE | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | FL | Internal Medicine Physician (207R00000X) |
United | 72285 | $297.60 | 1528090032 - NAEEM CHAVLA | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | WA | Urology Physician (208800000X) |
United | 72285 | $203.41 | 1780998237 - NEEJA DAVE | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Internal Medicine Physician (207R00000X) |
United | 72285 | $51.54 | 1518386325 - JEREMY HALL | 751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PA | TX | Diagnostic Radiology Physician (2085R0202X) |
United | 72285 | $297.60 | 1083097976 - DAVID CHMIELECKI | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | CO | Internal Medicine Physician (207R00000X) |
United | 72285 | $94.19 | 1134325012 - ADAM BOETTCHER | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Surgery Physician (208600000X) |
United | 72285 | $133.85 | 1366400376 - SUNRISE HOME HEALTH CARE INC. | 650307774 - (FL) SUNRISE HOME HEALTH CARE INC | FL | Home Health Agency (251E00000X) |
United | 72285 | $297.60 | 1649471947 - EVAN SCHMITZ | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | FL | Pulmonary Disease Physician (207RP1001X) |
United | 72285 | $94.19 | 1477009702 - MELISSA KOLNIK | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Certified Registered Nurse Anesthetist (367500000X) |
United | 72285 | $203.41 | 1053671677 - GREGORY SCHWEITZ | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Emergency Medicine Physician (207P00000X) |
United | 72285 | $297.60 | 1326265893 - OMAR WANI | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Cardiovascular Disease Physician (207RC0000X) |
United | 72285 | $122.26 | 1992424923 - JEFFREY ROTH | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Nurse Practitioner (363L00000X) |
United | 72285 | $203.41 | 1588192363 - NICOLE CHIEKA | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Gerontology Nurse Practitioner (363LG0600X) |
United | 72285 | $289.61 | 1811164452 - AUZHAND ZONOZY | 751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PA | TX | Diagnostic Radiology Physician (2085R0202X) |
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 72285 vs. Other Diagnostic Radiology (Diagnostic Imaging) Procedures Codes
The CPT 72285 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 72285 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 |
|---|---|---|
| 72126-CPT | Moderate | 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. |
| 72127-CPT | Moderate | Ct Scan Of The Back, A Ct (Computed Tomography) Scan Of The Upper Middle Or Lower Back. The Scanner Circles The Body Taking X-Rays And Assembles Them Into A 3-D Image. After One Set Of Images A Second Set Is Taken With Contrast Dye To Highlight Areas. |
| 72156-CPT | Moderate | Mri Neck Spine W O W Dye, Magnetic Resonance Eg Proton Imaging Spinal Canal And Contents Without Contrast Material Followed By Contrast Material S And Further Sequences Cervical |
| 72285-CPT | Low | X-Ray Of Spinal Disc, An Exam Of One Or More Spinal Discs Using X-Ray And A Contrast Agent (Discography). A Spinal Disc Is The Soft Cushion Between Each Bone Of The Spine (Vertebra). |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 72285. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 72285 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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