Billing code 72146: Spine MRIMedicare rate & RVUs

Medicare pays $190.39 for 72146 nationally in the office. Local office rates run $169.17–$255.54.

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

What 72146 covers

This service is an MRI examination of the thoracic, or mid-back, spine performed without contrast material. It may be used to evaluate symptoms or findings such as thoracic radiculopathy, spinal cord compression, or suspected disc, bone, or soft-tissue abnormality. Imaging centers and hospital radiology departments typically provide the technical service, while a radiologist interprets the images and issues a report.

Select this code when the documented study covers the thoracic spine and is performed without contrast; use the corresponding contrast or without-and-with-contrast code when that protocol is performed. The order and report should support the body region and contrast protocol. CMS recognizes professional and technical components: modifier 26 identifies interpretation, modifier TC identifies equipment and staff, and billing without either modifier represents the global service. When multiple diagnostic imaging procedures are performed, the multiple procedure reduction applies to both 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 72146 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

72146 rates by state

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

How the 72146 rate is calculated

Each of 72146’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 72146

The CMS indicators that decide how 72146 is paid alongside other services.

What modifiers do to the payment

When to use modifier 26

72146 compared with similar codes

How to choose

72147Thoracic MRI

Use 72146 for a thoracic MRI without contrast; use 72147 when contrast is administered.

72157Thoracic MRI

Use 72157 when the thoracic MRI includes imaging both before and after contrast, rather than a noncontrast-only examination.

72128Spine CT

72128 describes CT imaging of the thoracic spine without contrast. Choose between CT and MRI based on the examination actually performed.

Codes related to 72146

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