Billing code 72126: CT spineMedicare rate & RVUs in Oregon
Reports contrast-enhanced CT imaging of the cervical spine, commonly performed after myelography to evaluate the spinal canal and nerve roots.
Medicare pays $166.95–$182.15 for 72126 in the office in Oregon, from Rest Of Oregon to Portland. 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 72126 covers
This service is a CT examination of the cervical spine performed with contrast. It is commonly used after cervical myelography to assess the spinal canal and nerve roots, including when MRI is unsuitable or more detail is needed for a specific finding. A radiologist interprets the images; the technical service includes the scanner, acquisition, and supporting staff. The examination may be performed in a hospital or an imaging center.
Choose this code when the cervical CT uses contrast only. Use the sibling code for a study performed both before and after contrast, and the noncontrast sibling when no contrast is used. The order and report should support the cervical anatomy examined, the contrast protocol, and the clinical question. Medicare recognizes professional and technical components: report modifier 26 for interpretation, TC for the technical service, or neither for the global service. When multiple diagnostic imaging services are performed, the multiple procedure reduction applies to both 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 72126 pays more and less in Oregon
| Payment locality | Office | Facility |
|---|---|---|
| Portland | $182.15 | Unavailable |
| Rest Of Oregon | $166.95 | Unavailable |
How the 72126 rate is calculated
Each of 72126’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 · 72126
RVUs × geographic indexes × conversion factor
Work1.19
1.19 RVUs× 1.000 GPCI
Practice expense3.76
3.76 RVUs× 1.000 GPCI
Malpractice0.09
0.09 RVUs× 1.000 GPCI
Adjusted RVUs
5.0400
Conversion factor
$33.4009
Medicare rate
$168.34
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 72126
The CMS indicators that decide how 72126 is paid alongside other services.
CMS payment indicators · 72126
CT spine
| 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
72126 without 26 · national office
$168.34
CT spine
72126-26 · Professional component
$56.11
Pays only the interpretation and report.
72126 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 72125Cervical spine CT
- Choose 72125 for a cervical CT without contrast; choose 72126 when contrast is used for the CT examination.
- 72127Cervical spine CT
- 72127 represents cervical CT imaging both before and after contrast; 72126 is for contrast-only imaging.
- 72142Spine MRI
- 72142 is cervical MRI with contrast, not CT. Select according to the imaging modality performed and documented.
72126 billing questions
How does this differ from 72125?
72126 is for a cervical CT performed with contrast. Use 72125 when the examination is performed without contrast.
When should 72127 be used instead?
Use 72127 when the cervical CT includes imaging both before and after contrast. 72126 represents the contrast-only examination.
Can 72126 be reported with cervical myelography?
A cervical CT performed after myelography may be reported with the cervical myelography service when both are performed and documented. The CT code represents the CT examination, not the myelographic service.
Which modifier identifies the radiologist's interpretation?
Modifier 26 identifies the professional interpretation. Modifier TC identifies the technical service; reporting without either modifier represents the global service.
What happens when multiple imaging services are performed?
CMS's diagnostic imaging multiple procedure reduction applies to both the professional and technical components. Apply the rule when billing the applicable component services.
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
Fee sheets
Put 72126 and the rest of your codes on one sheet
Build a fee sheet from your own code list at your locality, put your payer contracts beside Medicare, and see what changed each quarter.
Build my fee sheetOr price your code list free →