CPT code 72157: Thoracic MRI2026 Medicare rate & RVUs in Massachusetts
Reports thoracic spine MRI images acquired before and after contrast, commonly used to evaluate spinal cord, nerve, or vertebral abnormalities.
Medicare pays $331.41–$367.44 for 72157 in the office in Massachusetts, from Rest Of Massachusetts to Metropolitan Boston. 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 72157 covers
This service covers MRI imaging of the thoracic spine, the mid-back portion of the spine, with images obtained before and after contrast administration. A radiologic technologist performs the image acquisition in an imaging center or hospital department; a radiologist interprets the study. Clinical uses can include evaluating suspected spinal cord or nerve abnormalities, tumors, infection, or changes after thoracic spine surgery when both contrast phases are requested and performed.
Report one study when the examination includes both the noncontrast and postcontrast imaging phases. The order and report should support the thoracic region examined, the use of both phases, and the clinical indication. CMS permits separate professional and technical component billing: modifier 26 identifies the interpretation, modifier TC identifies the equipment and staff, and billing without either modifier represents the global service. When multiple diagnostic imaging services are performed, CMS's imaging multiple procedure reduction applies to both the 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 72157 pays more and less in Massachusetts
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Boston | $367.44 | Unavailable |
| Rest Of Massachusetts | $331.41 | Unavailable |
How the 72157 rate is calculated
Each of 72157’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 · 72157
RVUs × geographic indexes × conversion factor
Work2.23
2.23 RVUs× 1.000 GPCI
Practice expense7.15
7.15 RVUs× 1.000 GPCI
Malpractice0.16
0.16 RVUs× 1.000 GPCI
Adjusted RVUs
9.5400
Conversion factor
$33.4009
Medicare rate
$318.64
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 72157
The CMS indicators that decide how 72157 is paid alongside other services.
CMS payment indicators · 72157
Thoracic MRI
| 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
72157 without 26 · national office
$318.64
Thoracic MRI
72157-26 · Professional component
$105.55
Pays only the interpretation and report.
72157 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 72146Spine MRI
- 72146 is for a thoracic MRI performed without contrast only; use 72157 when the study includes both precontrast and postcontrast imaging.
- 72147Thoracic MRI
- 72147 describes a thoracic MRI performed with contrast only. Select 72157 when the examination includes both noncontrast and postcontrast phases.
- 72130Thoracic spine CT
- 72130 is a thoracic spine CT performed without and with contrast. Choose between it and 72157 according to whether the performed study is CT or MRI.
- 72156Spine MRI
- 72156 uses the same without-and-with-contrast MRI approach for the cervical spine; 72157 is for the thoracic spine.
72157 billing questions
When is this code used instead of 72146 or 72147?
Use 72157 when the thoracic MRI includes imaging both before and after contrast. Code 72146 describes a thoracic MRI without contrast, while 72147 describes one with contrast only.
Should the noncontrast and postcontrast phases be reported as two MRI codes?
No. For one thoracic MRI study performed both without and with contrast, report 72157 rather than separately reporting 72146 and 72147.
How are the interpretation and image acquisition billed?
Modifier 26 identifies the professional interpretation, and modifier TC identifies the technical service. Report the global service without either modifier when billing both components together.
Does the multiple imaging reduction affect both components?
Yes. CMS applies the diagnostic imaging multiple procedure reduction to both the professional and technical components.
What should the documentation support?
The order and report should identify the thoracic spine, document that images were obtained before and after contrast, and support the clinical reason for the examination.
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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