Billing code 72131: Lumbar CTMedicare rate & RVUs in Georgia
Reports CT imaging of the lumbar spine without contrast, commonly selected to assess vertebral fractures, bony anatomy, or spinal hardware.
Medicare pays $120.13–$132.02 for 72131 in the office in Georgia, from Rest Of Georgia to Atlanta. 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.
On this page 9 sections
What 72131 covers
This service uses computed tomography to produce cross-sectional images of the lumbar spine without administered contrast. It is commonly used to evaluate suspected vertebral fracture, define bony anatomy, or assess spinal instrumentation. A technologist performs the scan in a hospital or outpatient imaging center, and a radiologist or other qualified physician interprets the images. The clinical order and report should identify the lumbar region and the diagnostic question addressed.
Choose this code when the documented examination is a lumbar spine CT without contrast; use a contrast-specific code when the protocol includes contrast. The global service includes image acquisition and interpretation. Modifier 26 identifies the professional interpretation, while modifier TC identifies the technical service, including equipment and staff. CMS applies the diagnostic imaging multiple procedure reduction to both the technical and professional components when applicable. Documentation should support the body region, contrast protocol, and interpretation.
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 72131 pays more and less in Georgia
| Payment locality | Office | Facility |
|---|---|---|
| Atlanta | $132.02 | Unavailable |
| Rest Of Georgia | $120.13 | Unavailable |
How the 72131 rate is calculated
Each of 72131’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 · 72131
RVUs × geographic indexes × conversion factor
Work0.98
0.98 RVUs× 1.000 GPCI
Practice expense2.84
2.84 RVUs× 1.000 GPCI
Malpractice0.07
0.07 RVUs× 1.000 GPCI
Adjusted RVUs
3.8900
Conversion factor
$33.4009
Medicare rate
$129.93
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 72131
The CMS indicators that decide how 72131 is paid alongside other services.
CMS payment indicators · 72131
Lumbar CT
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| Multiple procedures | 4 | Diagnostic imaging reduction applies to the technical component (and professional component) of additional services. |
| 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
72131 without 26 · national office
$129.93
Lumbar CT
72131-26 · Professional component
$46.43
Pays only the interpretation and report.
72131 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 72132Spine CT
- 72131 is for lumbar CT without contrast; 72132 is for lumbar CT with contrast.
- 72133Lumbar CT
- 72133 describes lumbar CT performed both without and with contrast. Do not use it for a study performed only without contrast.
- 72148Lumbar spine MRI
- 72148 is lumbar MRI without contrast, not CT. Select between them according to the imaging modality performed.
- 72100Lumbar spine X-ray
- 72100 reports lumbar radiographs with two or three views. It is not the cross-sectional CT service represented by 72131.
72131 billing questions
When should this code be selected instead of 72132?
Use 72131 for a lumbar spine CT performed without contrast. Code 72132 is for the examination with contrast.
Can 72131 be reported with 72133 for the same examination?
72133 represents a lumbar CT performed without and with contrast. Select the code that matches the examination performed rather than reporting 72131 as an additional phase.
What do modifiers 26 and TC identify?
Modifier 26 identifies the physician's professional interpretation, and modifier TC identifies the technical service, including equipment and staff. Without either modifier, the claim represents the global service.
How does the multiple procedure reduction affect this service?
The diagnostic imaging multiple procedure reduction applies to both the technical and professional components. It can therefore affect the applicable component claims when multiple imaging procedures are performed.
What documentation supports reporting 72131?
The record should identify the lumbar spine as the imaged region, show that the examination was performed without contrast, and include the diagnostic interpretation.
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
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