$179.76
Use 72148 when the lumbar MRI is performed without contrast only. 72158 requires imaging before and after contrast.
On this page
CMS RVU26D · Effective 2026-10-01
72158 Lumbar MRI Medicare reimbursement rates in Indiana
Reports a lumbar spine MRI acquired before and after contrast, commonly used to evaluate suspected tumor, infection, or postoperative changes. Compare 72158 office and facility rates across CMS payment localities in Indiana.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 72158 in Indiana?
Indiana has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$298.15
1 of 1 localities have a supported rate.
Payment area: Indiana
One mapped payment locality.
Facility setting
No supported rate
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
MRI
About 72158: Lumbar spine MRI before and after contrast
Reports a lumbar spine MRI acquired before and after contrast, commonly used to evaluate suspected tumor, infection, or postoperative changes.
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.
CMS billing rules for 72158
- Professional and technical components
- Diagnostic test with a professional component (modifier 26, interpretation) and a technical component (modifier TC, equipment and staff); billing without a modifier is the global service.
- Multiple procedures
- Diagnostic imaging multiple procedure reduction applies to the technical and professional components.
Where the value comes from
- Work RVU2.23 · 23%
- Practice expense (office) RVU7.14 · 75%
- Malpractice RVU0.16 · 2%
222.2K
Medicare services in 2024 · #364 by national volume
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.
72158 compared with similar codes
Office rates for Indiana, from the same CMS release.
$252.34
Use 72149 when the lumbar MRI is performed with contrast only. 72158 includes both precontrast and postcontrast imaging.
$184.07
72133 describes lumbar spine CT before and after contrast. Choose the MRI code when the service performed is MRI, not CT.
Compare 72158 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Indiana →
Office / nonfacility
$298.15
Facility
Unavailable
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 72158 in Indiana.
PPRRVU2026_Oct_nonQPP.csv
8,036
- Code
- 72158
- Physician work
- 2.23
- Practice expense
- 7.14
- Malpractice
- 0.16
GPCI2026.csv
52
- Locality
- Indiana
- Physician work
- 1.000
- Practice expense
- 0.927
- Malpractice
- 0.486
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 2.23 | × 1.000 | 2.2300 |
| Practice expense | 7.14 | × 0.927 | 6.6188 |
| Malpractice | 0.16 | × 0.486 | 0.0778 |
| Total RVUs | 8.9265 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Indiana$298.15
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 2.23 | 1 |
| Practice expense | 7.14 | 0.927 |
| Malpractice | 0.16 | 0.486 |
(2.23 × 1 + 7.14 × 0.927 + 0.16 × 0.486) × $33.4009 = $298.15
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
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 indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
8,03372157,,Mri chest spine w/o & w/dye,A,,2.23,7.15,,7.15,NA,0.16,9.54,9.54,1,XXX,0.00,0.00,0.00,4,0,0,0,0,9,,33.4009,09,0,88,11.42,11.42,0.18
8,03472157,26,Mri chest spine w/o & w/dye,A,,2.23,0.80,,0.80,,0.13,3.16,3.16,1,XXX,0.00,0.00,0.00,4,0,0,0,0,9,,33.4009,09,0,88,0.00,0.00,0.00
8,03572157,TC,Mri chest spine w/o & w/dye,A,,0.00,6.35,,6.35,NA,0.03,6.38,6.38,1,XXX,0.00,0.00,0.00,4,0,0,0,0,9,,33.4009,02,0,88,10.62,10.62,0.05
8,03672158,,Mri lumbar spine w/o & w/dye,A,,2.23,7.14,,7.14,NA,0.16,9.53,9.53,1,XXX,0.00,0.00,0.00,4,0,0,0,0,9,,33.4009,09,0,88,11.42,11.42,0.18
8,03772158,26,Mri lumbar spine w/o & w/dye,A,,2.23,0.80,,0.80,,0.13,3.16,3.16,1,XXX,0.00,0.00,0.00,4,0,0,0,0,9,,33.4009,09,0,88,0.00,0.00,0.00
8,03872158,TC,Mri lumbar spine w/o & w/dye,A,,0.00,6.34,,6.34,NA,0.03,6.37,6.37,1,XXX,0.00,0.00,0.00,4,0,0,0,0,9,,33.4009,02,0,88,10.62,10.62,0.05
8,03972159,,Mr angio spine w/o&w/dye,R,,1.76,8.21,,8.21,NA,0.13,10.10,10.10,1,XXX,0.00,0.00,0.00,4,0,0,0,0,9,,33.4009,09,0,88,11.23,11.23,0.15
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014
5006102,IL,15,SUBURBAN CHICAGO,1.007,1.027,1.772
5106102,IL,99,REST OF ILLINOIS,1.000,0.913,1.563
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915