CPT code 72149: MRI, contrast only2026 Medicare rate & RVUs

Medicare pays $269.55 for 72149 nationally in the office. Local office rates run $238.36–$365.76.

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

What 72149 covers

This service is an MRI examination of the lumbar spine performed with contrast. A radiologist interprets the images, while imaging staff operate the scanner and acquire the study in a hospital or outpatient imaging center. Clinicians may request contrast-enhanced lumbar imaging when evaluating suspected infection, tumor, inflammatory disease, or a postoperative abnormality.

Report this code when the documented examination uses contrast without also acquiring the corresponding noncontrast study. If the MRI includes both noncontrast and contrast imaging, the combined code 72158 is the relevant choice; a noncontrast-only examination is reported with 72148. Documentation should identify the lumbar anatomy studied, the use of contrast, and the clinical reason for the examination. The service may be billed globally, or its interpretation and technical work may be billed separately with modifiers 26 and TC. When multiple diagnostic imaging services are performed, the CMS multiple procedure reduction applies to both the 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.

Where 72149 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

72149 rates by state

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

How the 72149 rate is calculated

Each of 72149’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.

Payment rules and modifiers for 72149

The CMS indicators that decide how 72149 is paid alongside other services.

What modifiers do to the payment

When to use modifier 26

72149 compared with similar codes

How to choose

72148Lumbar spine MRIWithout contrast

72148 is for lumbar MRI without contrast. Report 72149 when contrast is used and no corresponding noncontrast acquisition is performed.

72158Lumbar MRIWithout and with contrast

72158 applies when the lumbar MRI includes both noncontrast and contrast imaging. 72149 represents contrast imaging only.

72132Spine CTLumbar, with contrast

72132 describes lumbar spine CT with contrast, not MRI. Choose based on the modality documented as performed.

Codes related to 72149

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

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

Open CMS sourceHow we calculate rates