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CPT code 72146: Spine MRI, thoracic, without contrast2026 Medicare rate & RVUs in Washington, DC area

Reports MRI evaluation of the thoracic spine without contrast, commonly used to assess mid-back pain, neurologic symptoms, or suspected spinal disease.

CMS RVU26DEffective Oct 1, 2026One payment locality252.3K Medicare services in 2024

In Washington, DC area, Medicare pays $218.09 for 72146 in the office.

$218.09Office (non-facility)
Not available in this settingHospital or facility
+14.5%vs the national office rate ($190.39)

Check a contract rate as a % of Medicare · 72146 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 72146 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Washington, DC area
  2. What 72146 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 72146 covers

This service is an MRI examination of the thoracic, or mid-back, spine performed without contrast material. It may be used to evaluate symptoms or findings such as thoracic radiculopathy, spinal cord compression, or suspected disc, bone, or soft-tissue abnormality. Imaging centers and hospital radiology departments typically provide the technical service, while a radiologist interprets the images and issues a report.

Select this code when the documented study covers the thoracic spine and is performed without contrast; use the corresponding contrast or without-and-with-contrast code when that protocol is performed. The order and report should support the body region and contrast protocol. CMS recognizes professional and technical components: modifier 26 identifies interpretation, modifier TC identifies equipment and staff, and billing without either modifier represents the global service. When multiple diagnostic imaging procedures are performed, the multiple procedure reduction applies to both professional and technical components.

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 Washington, DC area compares for 72146

Across 109 of 109 payment localities, the office rate for 72146 runs from $169.17 in Arkansas to $255.54 in San Benito County, CA. Washington, DC area pays $218.09. The RVUs are the same everywhere; the geographic indexes change the dollars.

72146 in Washington, DC area vs other payment areas
  1. Washington, DC area · this page$218.09
  2. Los Angeles, CA · California$216.66−$1.43
  3. Miami, FL · Florida$201.19−$16.90
  4. Chicago, IL · Illinois$195.74−$22.35
  5. Manhattan, NY · New York$217.93−$0.16
  6. Alaska · Alaska$221.97+$3.88
  7. Alabama · Alabama$171.57−$46.52

Other areas in District of Columbia first, then benchmark localities. Bars start at $0.

Every other payment area

72146 in every other Medicare payment locality
Payment localityOfficeFacility
ArkansasArkansas$169.17—
ArizonaArizona$185.60—
Bakersfield, CACalifornia$203.33—
Chico, CACalifornia$202.99—
El Centro, CACalifornia$203.01—
Fresno, CACalifornia$202.99—
Hanford, CACalifornia$202.99—
Madera, CACalifornia$202.99—

72146 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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.

$169.17

$229.27

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

View every state and territory as a table
72146 office rate range by state
State / territoryOffice rate rangeLocalities
AK$221.971
AL$171.571
AR$169.171
AZ$185.601
CA$202.99–$255.5429
CO$199.121
CT$202.751
DC$218.091
DE$188.621
FL$185.95–$201.193
GA$176.02–$193.422
GU$208.011
HI$208.011
IA$176.561
ID$177.511
IL$180.18–$197.054
IN$178.531
KS$175.391
KY$174.681
LA$174.27–$182.642
MA$197.84–$218.952
MD$192.26–$218.093
ME$178.01–$187.902
MI$178.73–$187.812
MN$192.061
MO$171.12–$183.723
MS$170.201
MT$190.381
NC$179.871
ND$188.401
NE$177.611
NH$195.661
NJ$205.42–$215.872
NM$179.521
NV$189.971
NY$182.45–$222.595
OH$178.321
OK$174.771
OR$188.84–$205.722
PA$178.81–$197.592
PR$191.861
RI$195.521
SC$179.321
SD$188.171
TN$176.191
TX$177.64–$198.168
UT$181.711
VA$187.04–$218.092
VI$191.861
VT$187.351
WA$197.58–$223.722
WI$182.241
WV$173.621
WY$189.521

See 72146 in every payment locality

How the 72146 rate is calculated

Each of 72146’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 · 72146

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.44

1.44 RVUs× 1.000 GPCI

Practice expense4.16

4.16 RVUs× 1.000 GPCI

Malpractice0.10

0.10 RVUs× 1.000 GPCI

Adjusted RVUs

5.7000

Conversion factor

$33.4009

Medicare rate

$190.39

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

The exact Washington, DC area inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

8,018

Code
72146
Physician work
1.44
Practice expense
4.16
Malpractice
0.10

GPCI2026.csv

39

Locality
Washington, DC area
Physician work
1.054
Practice expense
1.178
Malpractice
1.113
Office calculation for 72146 in Washington, DC area
ComponentRVULocality factorAdjusted
Physician work1.44× 1.0541.5178
Practice expense4.16× 1.1784.9005
Malpractice0.10× 1.1130.1113
Total RVUs6.5295
Conversion factor× 33.4009

Office rate, Washington, DC area$218.09

Office: (1.44 × 1.054 + 4.16 × 1.178 + 0.1 × 1.113) × $33.4009 = $218.09

Open 72146 in the RVU calculator

Payment rules and modifiers for 72146

The CMS indicators that decide how 72146 is paid alongside other services.

CMS payment indicators · 72146

Spine MRI, thoracic, 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

72146 without 26 · national office

$190.39

Spine MRI, thoracic, without contrast

72146-26 · Professional component

$68.14

Pays only the interpretation and report.

When to use modifier 26

Codes related to 72146

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 72146
CodeHow it relatesOffice range, Washington, DC area
Same family
72147Thoracic MRI, with contrast onlyThoracic spine MRI performed with contrast.$312.02
72157Thoracic MRI, without and with contrastThoracic spine MRI performed before and after contrast.$365.78
Used instead
72128Spine CT, thoracic, no contrastCT of the thoracic spine without contrast is a different imaging method.$149.24

How 72146 has changed in Washington, DC area

72146 · Office / nonfacility

$218.09

Effective 2026-10-01

The base rate is $0.61 higher than on 2025-10-01, moving from $217.48 to $218.09 (0.3%).

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

    $217.48changed to$218.09

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.48 changed to 1.44
    • Practice expense RVU 4.24 changed to 4.16
    • Malpractice RVU 0.09 changed to 0.10
    • Work GPCI 1.057 changed to 1.054
    • Practice expense GPCI 1.192 changed to 1.178
    • Malpractice GPCI 1.168 changed to 1.113

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $226.18changed to$217.48

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 4.29 changed to 4.24
    • Malpractice RVU 0.10 changed to 0.09

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $222.49changed to$226.18

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $236.50changed to$222.49

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 4.36 changed to 4.29
    • Work GPCI 1.056 changed to 1.057
    • Practice expense GPCI 1.214 changed to 1.192
    • Malpractice GPCI 1.231 changed to 1.168

  5. January 1, 2023

    RVU23A

    $246.66changed to$236.50

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 4.40 changed to 4.36
    • Work GPCI 1.054 changed to 1.056
    • Practice expense GPCI 1.236 changed to 1.214
    • Malpractice GPCI 1.294 changed to 1.231

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $257.27changed to$246.66

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 4.63 changed to 4.40
    • Malpractice RVU 0.07 changed to 0.10

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $260.23changed to$257.27

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 4.54 changed to 4.63
    • Malpractice RVU 0.09 changed to 0.07
    • Work GPCI 1.049 changed to 1.054
    • Practice expense GPCI 1.221 changed to 1.236
    • Malpractice GPCI 1.277 changed to 1.294

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $262.22changed to$260.23

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 4.65 changed to 4.54
    • Malpractice RVU 0.10 changed to 0.09
    • Work GPCI 1.045 changed to 1.049
    • Practice expense GPCI 1.205 changed to 1.221
    • Malpractice GPCI 1.261 changed to 1.277

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $268.44changed to$262.22

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 4.80 changed to 4.65

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $266.51changed to$268.44

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 4.77 changed to 4.80
    • Work GPCI 1.048 changed to 1.045
    • Malpractice GPCI 1.271 changed to 1.261

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $263.92changed to$266.51

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 4.72 changed to 4.77
    • Work GPCI 1.051 changed to 1.048
    • Malpractice GPCI 1.280 changed to 1.271

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $262.65changed to$263.92

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 4.69 changed to 4.72
    • Malpractice RVU 0.08 changed to 0.10

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $261.34changed to$262.65

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $287.34changed to$261.34

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 5.28 changed to 4.69
    • Malpractice RVU 0.10 changed to 0.08
    • Work GPCI 1.050 changed to 1.051
    • Practice expense GPCI 1.202 changed to 1.205
    • Malpractice GPCI 1.205 changed to 1.280

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $456.29changed to$287.34

    • Conversion factor 34.0230 changed to 35.8228
    • Work RVU 1.60 changed to 1.48
    • Practice expense RVU 9.69 changed to 5.28
    • Malpractice RVU 0.11 changed to 0.10
    • Work GPCI 1.049 changed to 1.050
    • Practice expense GPCI 1.198 changed to 1.202
    • Malpractice GPCI 1.130 changed to 1.205

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $456.29

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$218.09Not available in this settingRVU26D
2026-07-01$218.09Not available in this settingRVU26C
2026-04-01$218.09Not available in this settingRVU26B
2026-01-01$218.09Not available in this settingRVU26A
2025-10-01$217.48Not available in this settingRVU25D
2025-07-01$217.48Not available in this settingRVU25C
2025-04-01$217.48Not available in this settingRVU25B
2025-01-01$217.48Not available in this settingRVU25A
2024-10-01$226.18Not available in this settingRVU24D
2024-07-01$226.18Not available in this settingRVU24C
2024-04-01$226.18Not available in this settingRVU24B
2024-03-09$226.18Not available in this settingRVU24AR
2024-01-01$222.49Not available in this settingRVU24A
2023-10-01$236.50Not available in this settingRVU23D
2023-07-01$236.50Not available in this settingRVU23C
2023-04-01$236.50Not available in this settingRVU23B
2023-01-01$236.50Not available in this settingRVU23A
2022-10-01$246.66Not available in this settingRVU22D
2022-07-01$246.66Not available in this settingRVU22C
2022-04-01$246.66Not available in this settingRVU22B
2022-01-01$246.66Not available in this settingRVU22A
2021-10-01$257.27Not available in this settingRVU21D
2021-07-01$257.27Not available in this settingRVU21C
2021-04-01$257.27Not available in this settingRVU21B
2021-01-01$257.27Not available in this settingRVU21A
2020-10-01$260.23Not available in this settingRVU20D
2020-07-01$260.23Not available in this settingRVU20C
2020-04-01$260.23Not available in this settingRVU20B
2020-01-01$260.23Not available in this settingRVU20A
2019-10-01$262.22Not available in this settingRVU19D
2019-07-01$262.22Not available in this settingRVU19C
2019-04-01$262.22Not available in this settingRVU19B
2019-01-01$262.22Not available in this settingRVU19A
2018-10-01$268.44Not available in this settingRVU18D
2018-07-01$268.44Not available in this settingRVU18C
2018-04-01$268.44Not available in this settingRVU18B
2018-01-01$268.44Not available in this settingRVU18AR1
2017-10-01$266.51Not available in this settingRVU17D
2017-07-01$266.51Not available in this settingRVU17C
2017-04-01$266.51Not available in this settingRVU17B
2017-01-01$266.51Not available in this settingRVU17A
2016-10-01$263.92Not available in this settingRVU16D
2016-07-01$263.92Not available in this settingRVU16C
2016-04-01$263.92Not available in this settingRVU16B
2016-01-01$263.92Not available in this settingRVU16A
2015-10-01$262.65Not available in this settingRVU15D
2015-07-01$262.65Not available in this settingRVU15C
2015-04-01$261.34Not available in this settingRVU15B
2015-01-01$261.34Not available in this settingRVU15A
2014-10-01$287.34Not available in this settingRVU14D
2014-07-01$287.34Not available in this settingRVU14C
2014-04-01$287.34Not available in this settingRVU14B
2014-01-01$287.34Not available in this settingRVU14A
2013-10-01$456.29Not available in this settingRVU13D
2013-07-01$456.29Not available in this settingRVU13C
2013-04-01$456.29Not available in this settingRVU13B
2013-01-01$456.29Not available in this settingRVU13AR

Price 72146 for an earlier date of service

Where the Washington, DC area rate applies

Washington, DC area is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in District of Columbia. Some span more than one payment area; confirm with the service ZIP.

  • Washington

Browse all communities in District of Columbia

72146 billing questions

How does this differ from 72147?

This code is for a thoracic spine MRI performed without contrast. Code 72147 describes a thoracic spine MRI performed with contrast.

When should 72157 be reported instead?

Use 72157 when the thoracic MRI is performed both before and after contrast administration. The documented examination protocol determines the code.

Can the interpretation and imaging facility bill separately?

Yes. Modifier 26 identifies the professional interpretation, and modifier TC identifies the technical service. Without either modifier, the claim represents the global service.

How does the multiple procedure reduction affect this service?

When multiple diagnostic imaging procedures are performed, the CMS multiple procedure reduction applies to the professional and technical components.

What documentation supports this code?

The order and imaging report should identify the thoracic spine as the examined region and show that the MRI was performed without contrast.

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 72146PPRRVU2026_Oct_nonQPP.csv, line 8,018 (RVU26D)
Geographic factors for Washington, DC areaGPCI2026.csv, line 39 (RVU26D)

Open CMS sourceHow we calculate rates

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