Billing code 72130: Thoracic spine CTMedicare rate & RVUs

Medicare pays $198.07 for 72130 nationally in the office. Local office rates run $174.95–$269.14.

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

What 72130 covers

This examination uses CT to image the thoracic spine in two phases: one before contrast and another after contrast administration. A radiologic technologist acquires the images, and a radiologist interprets them, typically in a hospital outpatient department or imaging center. The protocol may be used to assess a suspected thoracic spinal lesion when both precontrast and postcontrast findings are needed.

Select this code only when the record supports both phases of the thoracic spine examination. The imaging record and radiology report should identify the region examined and show that images were obtained before and after contrast. Do not report separate noncontrast and contrast-only thoracic spine CT codes for the same combined examination. Medicare distinguishes the radiologist’s interpretation, billed with modifier 26, from the equipment and staff portion, billed with modifier TC; billing without either modifier represents the global service. The diagnostic imaging multiple procedure reduction applies to both the professional and technical components when its criteria are met.

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 72130 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

72130 rates by state

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

How the 72130 rate is calculated

Each of 72130’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 72130

The CMS indicators that decide how 72130 is paid alongside other services.

What modifiers do to the payment

When to use modifier 26

72130 compared with similar codes

How to choose

72128Spine CT

Choose 72128 when the thoracic spine CT has no postcontrast phase. Choose 72130 when both precontrast and postcontrast images are obtained.

72129Spine CT

Choose 72129 for thoracic spine CT performed with contrast without a precontrast phase. A combined precontrast and postcontrast examination is 72130.

72133Lumbar CT

Both codes describe CT before and after contrast. Use 72130 for the thoracic spine and 72133 for the lumbar spine.

72157Thoracic MRI

Both codes involve thoracic spine imaging before and after contrast. Code 72130 is CT; 72157 is MRI.

Codes related to 72130

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