Billing code 72130: Thoracic spine CTMedicare rate & RVUs in Guam
Report this thoracic spine CT when the examination includes images obtained before contrast and additional images obtained after contrast administration.
Medicare pays $217.85 for 72130 in the office in Guam (Hawaii, Guam). 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 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.
72130 in Hawaii, Guam
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam | $217.85 | Unavailable |
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.
How the rate is built · 72130
RVUs × geographic indexes × conversion factor
Work1.24
1.24 RVUs× 1.000 GPCI
Practice expense4.60
4.60 RVUs× 1.000 GPCI
Malpractice0.09
0.09 RVUs× 1.000 GPCI
Adjusted RVUs
5.9300
Conversion factor
$33.4009
Medicare rate
$198.07
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 72130
The CMS indicators that decide how 72130 is paid alongside other services.
CMS payment indicators · 72130
Thoracic spine 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
72130 without 26 · national office
$198.07
Thoracic spine CT
72130-26 · Professional component
$58.45
Pays only the interpretation and report.
72130 compared with similar codes
Compare codes · National
5 codes, side by side
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.
72130 billing questions
When is 72130 selected instead of 72128 or 72129?
Use 72130 when the thoracic spine CT includes both precontrast and postcontrast imaging. Code 72128 describes a noncontrast study; 72129 describes a contrast study without a precontrast phase.
Should 72128 and 72129 be billed together for one combined examination?
No. Report 72130 for a single thoracic spine examination that includes both phases, rather than splitting it into the noncontrast and contrast-only codes.
How is a radiologist’s interpretation of 72130 billed?
The radiologist bills 72130 with modifier 26 for the professional interpretation. The report should document the thoracic region and findings from the examination.
When is modifier TC used with 72130?
Modifier TC identifies the equipment and staff portion when that portion is billed separately. Billing 72130 without 26 or TC represents the global service.
Can Medicare reduce payment when 72130 is performed with other diagnostic imaging?
Yes. The diagnostic imaging multiple procedure reduction applies to the professional and technical components when its criteria are met.
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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