CPT code 72131: Lumbar CT, without contrast2026 Medicare rate & RVUs in Puerto Rico

Reports CT imaging of the lumbar spine without contrast, commonly selected to assess vertebral fractures, bony anatomy, or spinal hardware.

CMS RVU26DEffective Oct 1, 2026One payment locality566.3K Medicare services in 2024

In Puerto Rico, Medicare pays $130.94 for 72131 in the office.

$130.94Office (non-facility)
Not available in this settingHospital or facility
+0.8%vs the national office rate ($129.93)

Check a contract rate as a % of Medicare · 72131 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 72131 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Puerto Rico
  2. What 72131 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 72131 covers

This service uses computed tomography to produce cross-sectional images of the lumbar spine without administered contrast. It is commonly used to evaluate suspected vertebral fracture, define bony anatomy, or assess spinal instrumentation. A technologist performs the scan in a hospital or outpatient imaging center, and a radiologist or other qualified physician interprets the images. The clinical order and report should identify the lumbar region and the diagnostic question addressed.

Choose this code when the documented examination is a lumbar spine CT without contrast; use a contrast-specific code when the protocol includes contrast. The global service includes image acquisition and interpretation. Modifier 26 identifies the professional interpretation, while modifier TC identifies the technical service, including equipment and staff. CMS applies the diagnostic imaging multiple procedure reduction to both the technical and professional components when applicable. Documentation should support the body region, contrast protocol, and interpretation.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

How Puerto Rico compares for 72131

Across 109 of 109 payment localities, the office rate for 72131 runs from $115.42 in Arkansas to $174.37 in San Benito County, CA. Puerto Rico pays $130.94. The RVUs are the same everywhere; the geographic indexes change the dollars.

72131 in Puerto Rico vs other payment areas
  1. Puerto Rico · this page$130.94
  2. Los Angeles, CA · California$147.85+$16.91
  3. Washington, DC area · District of Columbia$148.85+$17.91
  4. Miami, FL · Florida$137.39+$6.45
  5. Chicago, IL · Illinois$133.66+$2.72
  6. Manhattan, NY · New York$148.76+$17.82
  7. Alaska · Alaska$151.41+$20.47

Other areas in Puerto Rico first, then benchmark localities. Bars start at $0.

Every other payment area

72131 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$117.06—
ArkansasArkansas$115.42—
ArizonaArizona$126.65—
Bakersfield, CACalifornia$138.74—
Chico, CACalifornia$138.51—
El Centro, CACalifornia$138.52—
Fresno, CACalifornia$138.51—
Hanford, CACalifornia$138.51—

72131 rates by state

Office rate range in each state. Select a state to see its payment localities.

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$115.42

$156.44

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
72131 office rate range by state
State / territoryOffice rate rangeLocalities
AK$151.411
AL$117.061
AR$115.421
AZ$126.651
CA$138.51–$174.3729
CO$135.881
CT$138.381
DC$148.851
DE$128.721
FL$126.93–$137.393
GA$120.13–$132.022
GU$141.941
HI$141.941
IA$120.461
ID$121.111
IL$122.99–$134.524
IN$121.801
KS$119.661
KY$119.201
LA$118.92–$124.652
MA$135.01–$149.422
MD$131.20–$148.853
ME$121.46–$128.212
MI$121.98–$128.212
MN$131.031
MO$116.78–$125.383
MS$116.131
MT$129.921
NC$122.731
ND$128.541
NE$121.171
NH$133.531
NJ$140.19–$147.332
NM$122.531
NV$129.631
NY$124.49–$151.965
OH$121.701
OK$119.261
OR$128.86–$140.382
PA$122.02–$134.862
PR$130.941
RI$133.431
SC$122.371
SD$128.381
TN$120.211
TX$121.23–$135.238
UT$124.001
VA$127.63–$148.852
VI$130.941
VT$127.831
WA$134.82–$152.672
WI$124.331
WV$118.511
WY$129.321

See 72131 in every payment locality

How the 72131 rate is calculated

Each of 72131’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 72131

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.98

0.98 RVUs× 1.000 GPCI

Practice expense2.84

2.84 RVUs× 1.000 GPCI

Malpractice0.07

0.07 RVUs× 1.000 GPCI

Adjusted RVUs

3.8900

Conversion factor

$33.4009

Medicare rate

$129.93

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Puerto Rico inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

8,003

Code
72131
Physician work
0.98
Practice expense
2.84
Malpractice
0.07

GPCI2026.csv

91

Locality
Puerto Rico
Physician work
1.000
Practice expense
1.011
Malpractice
0.985
Office calculation for 72131 in Puerto Rico
ComponentRVULocality factorAdjusted
Physician work0.98× 1.0000.9800
Practice expense2.84× 1.0112.8712
Malpractice0.07× 0.9850.0690
Total RVUs3.9202
Conversion factor× 33.4009

Office rate, Puerto Rico$130.94

Office: (0.98 × 1 + 2.84 × 1.011 + 0.07 × 0.985) × $33.4009 = $130.94

Open 72131 in the RVU calculator

Payment rules and modifiers for 72131

The CMS indicators that decide how 72131 is paid alongside other services.

CMS payment indicators · 72131

Lumbar CT, without contrast

RuleCMS valueWhat it means
Global periodXXXThe global surgery concept doesn’t apply.
Multiple procedures4Diagnostic imaging reduction applies to the technical component (and professional component) of additional services.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical1Diagnostic test with separate professional (26) and technical (TC) components.

What modifiers do to the payment

Modifier 26 · payment effect

With and without the modifier

72131 without 26 · national office

$129.93

Lumbar CT, without contrast

72131-26 · Professional component

$46.43

Pays only the interpretation and report.

When to use modifier 26

How 72131 has changed in Puerto Rico

72131 · Office / nonfacility

$130.94

Effective 2026-10-01

The base rate is $2.87 higher than on 2025-10-01, moving from $128.07 to $130.94 (2.2%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release
  1. January 1, 2026

    RVU26A

    $128.07changed to$130.94

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.00 changed to 0.98
    • Practice expense RVU 2.89 changed to 2.84
    • Malpractice RVU 0.05 changed to 0.07
    • Practice expense GPCI 1.007 changed to 1.011
    • Malpractice GPCI 0.982 changed to 0.985

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $132.79changed to$128.07

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 2.91 changed to 2.89
    • Malpractice RVU 0.06 changed to 0.05

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $130.63changed to$132.79

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $136.32changed to$130.63

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 2.95 changed to 2.91
    • Malpractice RVU 0.05 changed to 0.06
    • Practice expense GPCI 1.008 changed to 1.007
    • Malpractice GPCI 0.984 changed to 0.982
  5. October 1, 2023

    RVU23D

    $135.55changed to$136.32

    • Practice expense GPCI 1.000 changed to 1.008
    • Malpractice GPCI 1.000 changed to 0.984
  6. January 1, 2023

    RVU23A

    $139.56changed to$135.55

    • Conversion factor 34.6062 changed to 33.8872
    • Malpractice RVU 0.06 changed to 0.05
    • Practice expense GPCI 1.008 changed to 1.000
    • Malpractice GPCI 0.986 changed to 1.000

    Held through RVU23B, RVU23C.

  7. January 1, 2022

    RVU22A

    $143.18changed to$139.56

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 3.02 changed to 2.95

    Held through RVU22B, RVU22C, RVU22D.

  8. January 1, 2021

    RVU21A

    $158.28changed to$143.18

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 3.30 changed to 3.02
    • Malpractice GPCI 0.988 changed to 0.986

    Held through RVU21B, RVU21C, RVU21D.

  9. January 1, 2020

    RVU20A

    No ratechanged to$158.28

    Held through RVU20B, RVU20C, RVU20D.

  10. January 1, 2014

    RVU14A

    $154.25changed toNo rate

    Held through RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D, RVU16A, RVU16B, RVU16C, RVU16D, RVU17A, RVU17B, RVU17C, RVU17D, RVU18AR1, RVU18B, RVU18C, RVU18D, RVU19A, RVU19B, RVU19C, RVU19D.

  11. January 1, 2013

    RVU13AR

    Earliest loaded release: $154.25

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$130.94Not available in this settingRVU26D
2026-07-01$130.94Not available in this settingRVU26C
2026-04-01$130.94Not available in this settingRVU26B
2026-01-01$130.94Not available in this settingRVU26A
2025-10-01$128.07Not available in this settingRVU25D
2025-07-01$128.07Not available in this settingRVU25C
2025-04-01$128.07Not available in this settingRVU25B
2025-01-01$128.07Not available in this settingRVU25A
2024-10-01$132.79Not available in this settingRVU24D
2024-07-01$132.79Not available in this settingRVU24C
2024-04-01$132.79Not available in this settingRVU24B
2024-03-09$132.79Not available in this settingRVU24AR
2024-01-01$130.63Not available in this settingRVU24A
2023-10-01$136.32Not available in this settingRVU23D
2023-07-01$135.55Not available in this settingRVU23C
2023-04-01$135.55Not available in this settingRVU23B
2023-01-01$135.55Not available in this settingRVU23A
2022-10-01$139.56Not available in this settingRVU22D
2022-07-01$139.56Not available in this settingRVU22C
2022-04-01$139.56Not available in this settingRVU22B
2022-01-01$139.56Not available in this settingRVU22A
2021-10-01$143.18Not available in this settingRVU21D
2021-07-01$143.18Not available in this settingRVU21C
2021-04-01$143.18Not available in this settingRVU21B
2021-01-01$143.18Not available in this settingRVU21A
2020-10-01$158.28Not available in this settingRVU20D
2020-07-01$158.28Not available in this settingRVU20C
2020-04-01$158.28Not available in this settingRVU20B
2020-01-01$158.28Not available in this settingRVU20A
2019-10-01Additional calculation requiredNot available in this settingRVU19D
2019-07-01Additional calculation requiredNot available in this settingRVU19C
2019-04-01Additional calculation requiredNot available in this settingRVU19B
2019-01-01Additional calculation requiredNot available in this settingRVU19A
2018-10-01Additional calculation requiredNot available in this settingRVU18D
2018-07-01Additional calculation requiredNot available in this settingRVU18C
2018-04-01Additional calculation requiredNot available in this settingRVU18B
2018-01-01Additional calculation requiredNot available in this settingRVU18AR1
2017-10-01Additional calculation requiredNot available in this settingRVU17D
2017-07-01Additional calculation requiredNot available in this settingRVU17C
2017-04-01Additional calculation requiredNot available in this settingRVU17B
2017-01-01Additional calculation requiredNot available in this settingRVU17A
2016-10-01Additional calculation requiredNot available in this settingRVU16D
2016-07-01Additional calculation requiredNot available in this settingRVU16C
2016-04-01Additional calculation requiredNot available in this settingRVU16B
2016-01-01Additional calculation requiredNot available in this settingRVU16A
2015-10-01Additional calculation requiredNot available in this settingRVU15D
2015-07-01Additional calculation requiredNot available in this settingRVU15C
2015-04-01Additional calculation requiredNot available in this settingRVU15B
2015-01-01Additional calculation requiredNot available in this settingRVU15A
2014-10-01Additional calculation requiredNot available in this settingRVU14D
2014-07-01Additional calculation requiredNot available in this settingRVU14C
2014-04-01Additional calculation requiredNot available in this settingRVU14B
2014-01-01Additional calculation requiredNot available in this settingRVU14A
2013-10-01$154.25Not available in this settingRVU13D
2013-07-01$154.25Not available in this settingRVU13C
2013-04-01$154.25Not available in this settingRVU13B
2013-01-01$154.25Not available in this settingRVU13AR

Price 72131 for an earlier date of service

Where the Puerto Rico rate applies

Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.

  • Aceitunas
  • Adjuntas
  • Aguada
  • Aguadilla
  • Aguas Buenas
  • Aguas Claras
  • Aguilita
  • Aibonito

Browse all communities in Puerto Rico

72131 billing questions

When should this code be selected instead of 72132?

Use 72131 for a lumbar spine CT performed without contrast. Code 72132 is for the examination with contrast.

Can 72131 be reported with 72133 for the same examination?

72133 represents a lumbar CT performed without and with contrast. Select the code that matches the examination performed rather than reporting 72131 as an additional phase.

What do modifiers 26 and TC identify?

Modifier 26 identifies the physician's professional interpretation, and modifier TC identifies the technical service, including equipment and staff. Without either modifier, the claim represents the global service.

How does the multiple procedure reduction affect this service?

The diagnostic imaging multiple procedure reduction applies to both the technical and professional components. It can therefore affect the applicable component claims when multiple imaging procedures are performed.

What documentation supports reporting 72131?

The record should identify the lumbar spine as the imaged region, show that the examination was performed without contrast, and include the diagnostic interpretation.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 72131PPRRVU2026_Oct_nonQPP.csv, line 8,003 (RVU26D)
Geographic factors for Puerto RicoGPCI2026.csv, line 91 (RVU26D)

Open CMS sourceHow we calculate rates

Did this answer your question about what 72131 pays in Puerto Rico?

Tell us what you were actually trying to work out. We’ll answer you directly, or build the page that does.

Fee sheets · Coming soon

Put 72131 and the rest of your codes on one sheet

Your codes at your locality, with payer contracts beside Medicare.

Join the waitlist