CPT code 72149: MRI, contrast only2026 Medicare rate & RVUs in Texas
Reports lumbar spine MRI acquired with contrast when evaluation requires contrast-enhanced imaging, such as assessment of suspected infection, tumor, or postoperative abnormality.
Medicare pays $250.59–$281.23 for 72149 in the office in Texas, from Beaumont, TX to Austin, TX. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
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 in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 payment localities
$250.59 to $281.23
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin, TX | $281.23 | Unavailable |
| Beaumont, TX | $250.59 | Unavailable |
| Brazoria, TX | $267.26 | Unavailable |
| Dallas, TX | $268.67 | Unavailable |
| Fort Worth, TX | $266.65 | Unavailable |
| Galveston, TX | $267.87 | Unavailable |
| Houston, TX | $270.07 | Unavailable |
| Rest of Texas | $258.58 | Unavailable |
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.
How the rate is built · 72149
RVUs × geographic indexes × conversion factor
Work1.74
1.74 RVUs× 1.000 GPCI
Practice expense6.21
6.21 RVUs× 1.000 GPCI
Malpractice0.12
0.12 RVUs× 1.000 GPCI
Adjusted RVUs
8.0700
Conversion factor
$33.4009
Medicare rate
$269.55
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 72149
The CMS indicators that decide how 72149 is paid alongside other services.
CMS payment indicators · 72149
MRI, contrast only
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| Multiple procedures | 4 | Diagnostic imaging reduction applies to the technical component (and professional component) of additional services. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 1 | Diagnostic test with separate professional (26) and technical (TC) components. |
What modifiers do to the payment
Modifier 26 · payment effect
With and without the modifier
72149 without 26 · national office
$269.55
MRI, contrast only
72149-26 · Professional component
$82.17
Pays only the interpretation and report.
72149 compared with similar codes
Compare codes · National
4 codes, side by side
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.
72149 billing questions
When should 72149 be reported instead of 72158?
Use 72149 for a lumbar MRI performed with contrast only. Use 72158 when the examination includes both noncontrast and contrast imaging.
How does 72149 differ from 72148?
72149 represents lumbar MRI with contrast, while 72148 represents the noncontrast examination. Select the code that matches the imaging actually performed.
Can the professional and technical portions be billed separately?
Yes. Modifier 26 identifies the interpretation, and modifier TC identifies the technical service. Billing without either modifier represents the global service.
Does the multiple procedure reduction affect both components?
Yes. CMS applies the diagnostic imaging multiple procedure reduction to both the professional and technical components.
What documentation supports reporting 72149?
The record should identify the lumbar MRI, confirm that contrast was used without a noncontrast acquisition, and document the clinical reason for the examination.
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
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