CPT 76125 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 • TC - Technical component • 26 - Professional component |
| Complexity Level | Low |
National average reimbursement for CPT 76125 by major payers:
$57.64
$53.26
$43.86
$66.79
| 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 76125 | ||||||
United | 76125 | $72.00 | 1487830907 - LEITH SAWALHA | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Internal Medicine Physician (207R00000X) |
United | 76125 | $72.00 | 1104875186 - WILLIAM UTZ | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | MN | Urology Physician (208800000X) |
United | 76125 | $118.81 | 1396011771 - JUSTIN BECKER | 751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PA | TX | Diagnostic Radiology Physician (2085R0202X) |
United | 76125 | $81.81 | 1396754719 - RIC BRADFORD | 751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PA | TX | Diagnostic Radiology Physician (2085R0202X) |
United | 76125 | $106.58 | 1225688344 - HEALTH IMAGING PARTNERS, LLC | 271385885 | TX | Physiological Laboratory (293D00000X) |
United | 76125 | $70.76 | 1043282361 - DAVID WATTS | 751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PA | TX | Diagnostic Radiology Physician (2085R0202X) |
United | 76125 | $37.00 | 1063808392 - WILLIAM SMITH | 751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PA | TX | Diagnostic Radiology Physician (2085R0202X) |
United | 76125 | $37.00 | 1396189106 - ADAM JASTER | 751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PA | TX | Diagnostic Radiology Physician (2085R0202X) |
United | 76125 | $81.81 | 1487110474 - JONATHAN DICKSON | 751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PA | TX | Physician Assistant (363A00000X) |
United | 76125 | $49.81 | 1154378164 - HASSAN SHAFEEQ | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Internal Medicine Physician (207R00000X) |
United | 76125 | $49.81 | 1962062455 - JUAN VARGAS | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Hospitalist Physician (208M00000X) |
United | 76125 | $72.00 | 1154435857 - CANDACE SCHUIERER | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | FL | Surgical Physician Assistant (363AS0400X) |
United | 76125 | $49.81 | 1710994884 - BERKELY MCMURRAY | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Acute Care Nurse Practitioner (363LA2100X) |
United | 76125 | $48.31 | 1023094406 - ALEXANDER FLOWER | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | WI | Critical Care Medicine (Internal Medicine) Physician (207RC0200X) |
United | 76125 | $118.81 | 1457327082 - WILLIAM ZIMMER | 751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PA | NM | 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 76125 vs. Other Diagnostic Radiology (Diagnostic Imaging) Procedures Codes
The CPT 76125 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 76125 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 |
|---|---|---|
| 76080-CPT | Low | Rad Exam Fistula Sinus Tract Study Rad S |
| 76098-CPT | Low | X-Ray Breast Surgical Specimen |
| 76100-CPT | Low | X-Ray,Single Plane Body Section, Not W/U |
| 76125-CPT | Low | Cineradiography/Videoradiography To Complement Routine Examination (List Separately In Addition To Code For Primary Procedure) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 76125. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 76125 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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