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Billing code 72158: Lumbar MRIMedicare rate & RVUs

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

CMS RVU26DEffective Oct 1, 2026109 payment localities222.2K Medicare services in 2024

Medicare pays $318.31 for 72158 nationally in the office. Local office rates run $282.09–$429.43.

Medicare rate · 72158

Lumbar MRI

Swap in your local Medicare rate.

Work RVUs
2.23
Total RVUs
9.53
Global days
XXX

National rate · 2026

$318.31

Office setting, before claim adjustments.

See every locality for 72158 → · Billed by an NP, PA or therapist? →

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

On this page 10 sections
  1. Medicare rate
  2. What 72158 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. 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.

Where 72158 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 payment localities

$282.09 to $429.43

$282.09$355.76$429.43
One dot per payment locality, office / nonfacility. Hover a dot to see the locality; select it to open that rate.

109 of 109 payment localities

72158 office and facility rates by payment locality
Payment localityOfficeFacility
Alabama$286.18Unavailable
Alaska*$368.65Unavailable
Arizona$310.15Unavailable
Arkansas$282.09Unavailable
Atlanta$323.42Unavailable
Austin$331.68Unavailable
Bakersfield$340.53Unavailable
Baltimore/Surr. Cntys$338.18Unavailable
Beaumont$296.47Unavailable
Brazoria$315.58Unavailable

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

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

Swap in your local Medicare rate.

Work 2.23Practice expense 7.14Malpractice 0.16

9.5300 adjusted RVUs×$33.4009 conversion factor=$318.31

All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.

Payment rules and modifiers for 72158

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

CMS payment indicators · 72158

Lumbar MRI

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

72158-26 · Professional component

$105.55

Pays only the interpretation and report.

When to use modifier 26

72158 compared with similar codes

Compare codes

72158 vs 72148 vs 72149 vs 72133: national Medicare rates

Swap in your local Medicare rate.

  • 72158
    Lumbar MRI · 2.23 wRVU
    $318.31
  • 72148
    Lumbar spine MRI · 1.44 wRVU
    $191.72−$126.59
  • 72149
    MRI · 1.74 wRVU
    $269.55−$48.76
  • 72133
    Lumbar CT · 1.24 wRVU
    $196.73−$121.58

How to choose

72148Lumbar spine MRI
Use 72148 when the lumbar MRI is performed without contrast only. 72158 requires imaging before and after contrast.
72149MRI
Use 72149 when the lumbar MRI is performed with contrast only. 72158 includes both precontrast and postcontrast imaging.
72133Lumbar CT
72133 describes lumbar spine CT before and after contrast. Choose the MRI code when the service performed is MRI, not CT.

Codes related to 72158

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

Codes related to 72158
CodeHow it relatesNational office range
Same family
72148Lumbar spine MRILumbar MRI performed without contrast only.$170.32–$257.47
72149MRILumbar MRI performed with contrast only.$238.36–$365.76
72156Spine MRISame contrast protocol for the cervical spine.$281.81–$428.95
72157Thoracic MRISame contrast protocol for the thoracic spine.$282.38–$429.92
Used instead
72133Lumbar CTCT of the lumbar spine before and after contrast, rather than MRI.$173.80–$267.21

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)

Open CMS sourceHow we calculate rates

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