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CPT code 72158: Lumbar MRI, without and with contrast2026 Medicare rate & RVUs in Puerto Rico

Reports a lumbar spine MRI acquired before and after contrast, commonly used to evaluate suspected tumor, infection, or postoperative changes.

CMS RVU26DEffective Oct 1, 2026One payment locality222.2K Medicare services in 2024

In Puerto Rico, Medicare pays $320.85 for 72158 in the office.

$320.85Office (non-facility)
Not available in this settingHospital or facility
+0.8%vs the national office rate ($318.31)

Check a contract rate as a % of Medicare · 72158 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 72158 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Puerto Rico
  2. What 72158 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 72158 covers

This service covers MRI images of the lumbar spine acquired before and after intravenous contrast, plus a physician’s interpretation. MRI technologists typically perform the scan in a hospital or freestanding imaging center, and a radiologist reviews the images and issues a report. Examples include evaluation of suspected spinal infection or tumor and assessment of postoperative findings, such as distinguishing recurrent disc material from scar tissue.

Report 72158 when both precontrast and postcontrast imaging are performed; a study performed only without contrast or only with contrast uses the corresponding single-protocol code. Documentation should support the clinical indication, both imaging phases, contrast administration, and the interpretation. The global service is billed without a component modifier; modifier 26 identifies the professional interpretation, while TC identifies the technical service. CMS diagnostic-imaging multiple-procedure reduction applies to both the professional and technical components when applicable multiple imaging services are reported.

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 72158

Across 109 of 109 payment localities, the office rate for 72158 runs from $282.09 in Arkansas to $429.43 in San Benito County, CA. Puerto Rico pays $320.85. The RVUs are the same everywhere; the geographic indexes change the dollars.

72158 in Puerto Rico vs other payment areas
  1. Puerto Rico · this page$320.85
  2. Los Angeles, CA · California$363.21+$42.36
  3. Washington, DC area · District of Columbia$365.39+$44.54
  4. Miami, FL · Florida$336.26+$15.41
  5. Chicago, IL · Illinois$326.95+$6.10
  6. Manhattan, NY · New York$364.84+$43.99
  7. Alaska · Alaska$368.65+$47.80

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

Every other payment area

72158 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$286.18—
ArkansasArkansas$282.09—
ArizonaArizona$310.15—
Bakersfield, CACalifornia$340.53—
Chico, CACalifornia$339.99—
El Centro, CACalifornia$340.02—
Fresno, CACalifornia$339.99—
Hanford, CACalifornia$339.99—

72158 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.

$282.09

$384.71

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

View every state and territory as a table
72158 office rate range by state
State / territoryOffice rate rangeLocalities
AK$368.651
AL$286.181
AR$282.091
AZ$310.151
CA$339.99–$429.4329
CO$333.301
CT$339.291
DC$365.391
DE$315.281
FL$310.51–$336.263
GA$293.58–$323.422
GU$348.731
HI$348.731
IA$294.821
ID$296.421
IL$300.57–$329.404
IN$298.151
KS$292.771
KY$291.381
LA$290.66–$304.972
MA$331.06–$367.042
MD$321.48–$365.393
ME$297.21–$314.192
MI$298.25–$313.632
MN$321.461
MO$285.26–$306.873
MS$283.771
MT$318.301
NC$300.401
ND$315.141
NE$296.621
NH$327.421
NJ$343.75–$361.522
NM$299.591
NV$317.661
NY$304.80–$372.735
OH$297.611
OK$291.601
OR$315.77–$344.612
PA$298.46–$330.462
PR$320.851
RI$327.021
SC$299.381
SD$314.761
TN$294.131
TX$296.47–$331.688
UT$303.461
VA$312.69–$365.392
VI$320.851
VT$313.291
WA$330.64–$375.192
WI$304.601
WV$289.371
WY$316.921

See 72158 in every payment locality

How the 72158 rate is calculated

Each of 72158’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 · 72158

RVUs × geographic indexes × conversion factor

Office or facility?

Work2.23

2.23 RVUs× 1.000 GPCI

Practice expense7.14

7.14 RVUs× 1.000 GPCI

Malpractice0.16

0.16 RVUs× 1.000 GPCI

Adjusted RVUs

9.5300

Conversion factor

$33.4009

Medicare rate

$318.31

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

8,036

Code
72158
Physician work
2.23
Practice expense
7.14
Malpractice
0.16

GPCI2026.csv

91

Locality
Puerto Rico
Physician work
1.000
Practice expense
1.011
Malpractice
0.985
Office calculation for 72158 in Puerto Rico
ComponentRVULocality factorAdjusted
Physician work2.23× 1.0002.2300
Practice expense7.14× 1.0117.2185
Malpractice0.16× 0.9850.1576
Total RVUs9.6061
Conversion factor× 33.4009

Office rate, Puerto Rico$320.85

Office: (2.23 × 1 + 7.14 × 1.011 + 0.16 × 0.985) × $33.4009 = $320.85

Open 72158 in the RVU calculator

Payment rules and modifiers for 72158

The CMS indicators that decide how 72158 is paid alongside other services.

CMS payment indicators · 72158

Lumbar MRI, without and with 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

72158 without 26 · national office

$318.31

Lumbar MRI, without and with contrast

72158-26 · Professional component

$105.55

Pays only the interpretation and report.

When to use modifier 26

Codes related to 72158

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

Codes related to 72158
CodeHow it relatesOffice range, Puerto Rico
Same family
72148Lumbar spine MRI, without contrastLumbar MRI performed without contrast only.$193.21
72149MRI, contrast onlyLumbar MRI performed with contrast only.$271.77
72156Spine MRI, cervical spine, without and with contrastSame contrast protocol for the cervical spine.$320.52
72157Thoracic MRI, without and with contrastSame contrast protocol for the thoracic spine.$321.19
Used instead
72133Lumbar CT, without and with contrastCT of the lumbar spine before and after contrast, rather than MRI.$198.36

How 72158 has changed in Puerto Rico

72158 · Office / nonfacility

$320.85

Effective 2026-10-01

The base rate is $4.89 higher than on 2025-10-01, moving from $315.96 to $320.85 (1.5%).

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

    $315.96changed to$320.85

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 2.29 changed to 2.23
    • Practice expense RVU 7.27 changed to 7.14
    • 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

    $329.52changed to$315.96

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 7.41 changed to 7.27
    • Malpractice RVU 0.15 changed to 0.16

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $324.14changed to$329.52

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $340.49changed to$324.14

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 7.54 changed to 7.41
    • Malpractice RVU 0.16 changed to 0.15
    • Practice expense GPCI 1.008 changed to 1.007
    • Malpractice GPCI 0.984 changed to 0.982

  5. October 1, 2023

    RVU23D

    $338.53changed to$340.49

    • Practice expense GPCI 1.000 changed to 1.008
    • Malpractice GPCI 1.000 changed to 0.984

  6. January 1, 2023

    RVU23A

    $349.49changed to$338.53

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 7.62 changed to 7.54
    • Malpractice RVU 0.13 changed to 0.16
    • 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

    $367.51changed to$349.49

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 8.05 changed to 7.62

    Held through RVU22B, RVU22C, RVU22D.

  8. January 1, 2021

    RVU21A

    $375.03changed to$367.51

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 7.91 changed to 8.05
    • Malpractice GPCI 0.988 changed to 0.986

    Held through RVU21B, RVU21C, RVU21D.

  9. January 1, 2020

    RVU20A

    $380.39changed to$375.03

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 8.06 changed to 7.91
    • Malpractice RVU 0.15 changed to 0.13
    • Practice expense GPCI 1.007 changed to 1.008
    • Malpractice GPCI 0.990 changed to 0.988

    Held through RVU20B, RVU20C, RVU20D.

  10. January 1, 2019

    RVU19A

    $389.04changed to$380.39

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 8.31 changed to 8.06

    Held through RVU19B, RVU19C, RVU19D.

  11. January 1, 2018

    RVU18AR1

    $339.09changed to$389.04

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 8.25 changed to 8.31
    • Practice expense GPCI 0.856 changed to 1.007
    • Malpractice GPCI 0.642 changed to 0.990

    Held through RVU18B, RVU18C, RVU18D.

  12. January 1, 2017

    RVU17A

    $290.80changed to$339.09

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 8.21 changed to 8.25
    • Practice expense GPCI 0.705 changed to 0.856
    • Malpractice GPCI 0.293 changed to 0.642

    Held through RVU17B, RVU17C, RVU17D.

  13. January 1, 2016

    RVU16A

    $290.69changed to$290.80

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 8.16 changed to 8.21
    • Malpractice RVU 0.16 changed to 0.15

    Held through RVU16B, RVU16C, RVU16D.

  14. July 1, 2015

    RVU15C

    $289.24changed to$290.69

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  15. January 1, 2015

    RVU15A

    $297.27changed to$289.24

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 8.62 changed to 8.16
    • Practice expense GPCI 0.692 changed to 0.705
    • Malpractice GPCI 0.271 changed to 0.293

    Held through RVU15B.

  16. January 1, 2014

    RVU14A

    $403.07changed to$297.27

    • Conversion factor 34.0230 changed to 35.8228
    • Work RVU 2.36 changed to 2.29
    • Practice expense RVU 13.93 changed to 8.62
    • Malpractice RVU 0.17 changed to 0.16
    • Practice expense GPCI 0.678 changed to 0.692
    • Malpractice GPCI 0.249 changed to 0.271

    Held through RVU14B, RVU14C, RVU14D.

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: $403.07

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$320.85Not available in this settingRVU26D
2026-07-01$320.85Not available in this settingRVU26C
2026-04-01$320.85Not available in this settingRVU26B
2026-01-01$320.85Not available in this settingRVU26A
2025-10-01$315.96Not available in this settingRVU25D
2025-07-01$315.96Not available in this settingRVU25C
2025-04-01$315.96Not available in this settingRVU25B
2025-01-01$315.96Not available in this settingRVU25A
2024-10-01$329.52Not available in this settingRVU24D
2024-07-01$329.52Not available in this settingRVU24C
2024-04-01$329.52Not available in this settingRVU24B
2024-03-09$329.52Not available in this settingRVU24AR
2024-01-01$324.14Not available in this settingRVU24A
2023-10-01$340.49Not available in this settingRVU23D
2023-07-01$338.53Not available in this settingRVU23C
2023-04-01$338.53Not available in this settingRVU23B
2023-01-01$338.53Not available in this settingRVU23A
2022-10-01$349.49Not available in this settingRVU22D
2022-07-01$349.49Not available in this settingRVU22C
2022-04-01$349.49Not available in this settingRVU22B
2022-01-01$349.49Not available in this settingRVU22A
2021-10-01$367.51Not available in this settingRVU21D
2021-07-01$367.51Not available in this settingRVU21C
2021-04-01$367.51Not available in this settingRVU21B
2021-01-01$367.51Not available in this settingRVU21A
2020-10-01$375.03Not available in this settingRVU20D
2020-07-01$375.03Not available in this settingRVU20C
2020-04-01$375.03Not available in this settingRVU20B
2020-01-01$375.03Not available in this settingRVU20A
2019-10-01$380.39Not available in this settingRVU19D
2019-07-01$380.39Not available in this settingRVU19C
2019-04-01$380.39Not available in this settingRVU19B
2019-01-01$380.39Not available in this settingRVU19A
2018-10-01$389.04Not available in this settingRVU18D
2018-07-01$389.04Not available in this settingRVU18C
2018-04-01$389.04Not available in this settingRVU18B
2018-01-01$389.04Not available in this settingRVU18AR1
2017-10-01$339.09Not available in this settingRVU17D
2017-07-01$339.09Not available in this settingRVU17C
2017-04-01$339.09Not available in this settingRVU17B
2017-01-01$339.09Not available in this settingRVU17A
2016-10-01$290.80Not available in this settingRVU16D
2016-07-01$290.80Not available in this settingRVU16C
2016-04-01$290.80Not available in this settingRVU16B
2016-01-01$290.80Not available in this settingRVU16A
2015-10-01$290.69Not available in this settingRVU15D
2015-07-01$290.69Not available in this settingRVU15C
2015-04-01$289.24Not available in this settingRVU15B
2015-01-01$289.24Not available in this settingRVU15A
2014-10-01$297.27Not available in this settingRVU14D
2014-07-01$297.27Not available in this settingRVU14C
2014-04-01$297.27Not available in this settingRVU14B
2014-01-01$297.27Not available in this settingRVU14A
2013-10-01$403.07Not available in this settingRVU13D
2013-07-01$403.07Not available in this settingRVU13C
2013-04-01$403.07Not available in this settingRVU13B
2013-01-01$403.07Not available in this settingRVU13AR

Price 72158 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

72158 billing questions

When should 72158 be selected instead of 72148 or 72149?

Use 72158 when lumbar images are obtained both before and after contrast. Use 72148 for imaging without contrast only, or 72149 for imaging with contrast only.

Does the record need to show both imaging phases?

Yes. The record should support that precontrast and postcontrast imaging were performed, along with the clinical indication and the interpreting physician’s report.

How are modifiers 26 and TC used?

Modifier 26 reports the physician’s interpretation, and TC reports the equipment-and-staff technical service. Bill without a component modifier when reporting the global service.

Can multiple-procedure reduction affect this code?

Yes. CMS diagnostic-imaging multiple-procedure reduction applies to both the technical and professional components when the applicable multiple-imaging circumstances are present.

How many units are reported for the examination?

Report one unit for the completed lumbar MRI examination, not separate units for the precontrast and postcontrast phases.

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 72158PPRRVU2026_Oct_nonQPP.csv, line 8,036 (RVU26D)
Geographic factors for Puerto RicoGPCI2026.csv, line 91 (RVU26D)

Open CMS sourceHow we calculate rates

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