CPT code 72255: Myelography, thoracic spine2026 Medicare rate & RVUs in California
Report thoracic spine myelography imaging when intrathecal contrast is used to assess the thoracic spinal canal, cord, or nerve roots.
Medicare pays $110.74–$138.59 for 72255 in the office in California, from Chico, CA to San Benito County, CA. 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 72255 covers
This service covers radiologic imaging and interpretation of the thoracic spinal canal after contrast is introduced into the cerebrospinal fluid. A radiologist commonly supervises or performs the imaging and interprets the resulting views, often using fluoroscopy. The study may help evaluate suspected thoracic canal narrowing, cord compression, or another lesion, including when MRI is limited or cannot be performed.
Report 72255 when the myelographic examination is confined to the thoracic region; use the multiple-region code when two or more spinal regions are examined. The record should identify the thoracic region imaged and support the medical reason for the study, with an interpretation and report. CMS recognizes professional and technical components: modifier 26 identifies the interpretation, modifier TC identifies the equipment and staff, and reporting without either modifier represents the global service.
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 72255 pays more and less in California
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
29 payment localities
$110.74 to $138.59
29 of 29 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield, CA | $110.95 | Unavailable |
| Chico, CA | $110.74 | Unavailable |
| El Centro, CA | $110.75 | Unavailable |
| Fresno, CA | $110.74 | Unavailable |
| Hanford, CA | $110.74 | Unavailable |
| Los Angeles, CA | $118.02 | Unavailable |
| Madera, CA | $110.74 | Unavailable |
| Marin County, CA | $135.67 | Unavailable |
| Merced, CA | $110.74 | Unavailable |
| Modesto, CA | $110.74 | Unavailable |
| Napa, CA | $128.15 | Unavailable |
| Oxnard, CA | $117.48 | Unavailable |
| Redding, CA | $110.74 | Unavailable |
| Rest of California | $110.74 | Unavailable |
| Riverside, CA | $111.41 | Unavailable |
| Sacramento, CA | $116.17 | Unavailable |
| Salinas, CA | $115.73 | Unavailable |
| San Benito County, CA | $138.59 | Unavailable |
| San Diego, CA | $118.39 | Unavailable |
| San Francisco, CA | $135.60 | Unavailable |
| San Luis Obispo, CA | $113.86 | Unavailable |
| Santa Clara County, CA | $138.31 | Unavailable |
| Santa Cruz, CA | $119.49 | Unavailable |
| Santa Maria, CA | $116.14 | Unavailable |
| Santa Rosa, CA | $120.70 | Unavailable |
| Stockton, CA | $110.74 | Unavailable |
| Vallejo, CA | $128.05 | Unavailable |
| Visalia, CA | $110.74 | Unavailable |
| Yuba City, CA | $110.74 | Unavailable |
How the 72255 rate is calculated
Each of 72255’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 · 72255
RVUs × geographic indexes × conversion factor
Work0.89
0.89 RVUs× 1.000 GPCI
Practice expense2.17
2.17 RVUs× 1.000 GPCI
Malpractice0.06
0.06 RVUs× 1.000 GPCI
Adjusted RVUs
3.1200
Conversion factor
$33.4009
Medicare rate
$104.21
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 72255
The CMS indicators that decide how 72255 is paid alongside other services.
CMS payment indicators · 72255
Myelography, thoracic spine
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| 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
72255 without 26 · national office
$104.21
Myelography, thoracic spine
72255-26 · Professional component
$42.09
Pays only the interpretation and report.
72255 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 72240MyelographyCervical spine
- 72240 covers cervical spine myelographic imaging. Choose 72255 when the examined region is thoracic.
- 72265MyelographyLumbar or lumbosacral region
- 72265 covers lumbosacral myelographic imaging. Choose 72255 for the thoracic region.
- 72270MyelographyTwo or more spine regions
- 72270 is for a myelographic examination involving two or more spinal regions; 72255 is for the thoracic region alone.
72255 billing questions
When should 72255 be chosen instead of 72270?
Use 72255 for a thoracic-only myelographic examination. Use 72270 when the examination covers two or more spinal regions.
Can the contrast injection be reported separately?
The spinal contrast injection for myelography may be separately reported with 62284 when performed and supported by the record. 72255 represents the thoracic imaging and interpretation service.
When should modifier 26 or TC be used?
Use modifier 26 for the professional interpretation and report, or TC for the technical service, including equipment and staff. Without either modifier, 72255 represents the global service.
What documentation supports 72255?
Document the thoracic region examined, the clinical reason for myelography, and the imaging findings in the interpretation. The record should make clear whether the service was professional, technical, or global.
How does 72255 differ from 72265?
72255 is for myelographic imaging of the thoracic spine; 72265 is for the lumbosacral region. Select based on the spinal region examined.
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
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