$165.93
72131 is for lumbar CT without contrast; 72132 is for lumbar CT with contrast.
On this page
CMS RVU26D · Effective 2026-10-01
72131 Lumbar CT Medicare reimbursement rates in Vermont
Reports CT imaging of the lumbar spine without contrast, commonly selected to assess vertebral fractures, bony anatomy, or spinal hardware. Compare 72131 office and facility rates across CMS payment localities in Vermont.
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 72131 in Vermont?
Vermont 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
$127.83
1 of 1 localities have a supported rate.
Payment area: Vermont
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.
Diagnostic imaging
About 72131: Lumbar spine CT without contrast
Reports CT imaging of the lumbar spine without contrast, commonly selected to assess vertebral fractures, bony anatomy, or spinal hardware.
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.
CMS billing rules for 72131
- 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 RVU0.98 · 25%
- Practice expense (office) RVU2.84 · 73%
- Malpractice RVU0.07 · 2%
566.3K
Medicare services in 2024 · #211 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.
72131 compared with similar codes
Office rates for Vermont, from the same CMS release.
$193.72
72133 describes lumbar CT performed both without and with contrast. Do not use it for a study performed only without contrast.
$188.67
72148 is lumbar MRI without contrast, not CT. Select between them according to the imaging modality performed.
$39.76
72100 reports lumbar radiographs with two or three views. It is not the cross-sectional CT service represented by 72131.
Compare 72131 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
Vermont →
Office / nonfacility
$127.83
Facility
Unavailable
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
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 72131 in Vermont.
PPRRVU2026_Oct_nonQPP.csv
8,003
- Code
- 72131
- Physician work
- 0.98
- Practice expense
- 2.84
- Malpractice
- 0.07
GPCI2026.csv
105
- Locality
- Vermont
- Physician work
- 1.000
- Practice expense
- 0.990
- Malpractice
- 0.506
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.98 | × 1.000 | 0.9800 |
| Practice expense | 2.84 | × 0.990 | 2.8116 |
| Malpractice | 0.07 | × 0.506 | 0.0354 |
| Total RVUs | 3.8270 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Vermont$127.83
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.98 | 1 |
| Practice expense | 2.84 | 0.99 |
| Malpractice | 0.07 | 0.506 |
(0.98 × 1 + 2.84 × 0.99 + 0.07 × 0.506) × $33.4009 = $127.83
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.
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 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.
8,00072130,,Ct chest spine w/o & w/dye,A,,1.24,4.60,,4.60,NA,0.09,5.93,5.93,1,XXX,0.00,0.00,0.00,4,0,0,0,0,9,,33.4009,09,0,88,5.78,5.78,0.10
8,00172130,26,Ct chest spine w/o & w/dye,A,,1.24,0.44,,0.44,,0.07,1.75,1.75,1,XXX,0.00,0.00,0.00,4,0,0,0,0,9,,33.4009,09,0,88,0.00,0.00,0.00
8,00272130,TC,Ct chest spine w/o & w/dye,A,,0.00,4.16,,4.16,NA,0.02,4.18,4.18,1,XXX,0.00,0.00,0.00,4,0,0,0,0,9,,33.4009,02,0,88,5.34,5.34,0.03
8,00372131,,Ct lumbar spine w/o dye,A,,0.98,2.84,,2.84,NA,0.07,3.89,3.89,1,XXX,0.00,0.00,0.00,4,0,0,0,0,9,,33.4009,09,0,88,3.53,3.53,0.07
8,00472131,26,Ct lumbar spine w/o dye,A,,0.98,0.35,,0.35,,0.06,1.39,1.39,1,XXX,0.00,0.00,0.00,4,0,0,0,0,9,,33.4009,09,0,88,0.00,0.00,0.00
8,00572131,TC,Ct lumbar spine w/o dye,A,,0.00,2.49,,2.49,NA,0.01,2.50,2.50,1,XXX,0.00,0.00,0.00,4,0,0,0,0,9,,33.4009,01,0,88,3.18,3.18,0.01
8,00672132,,Ct lumbar spine w/dye,A,,1.19,3.77,,3.77,NA,0.09,5.05,5.05,1,XXX,0.00,0.00,0.00,4,0,0,0,0,9,,33.4009,09,0,88,11.03,11.03,0.13
10204412,TX,18,HOUSTON,1.008,0.993,1.376
10304412,TX,99,REST OF TEXAS,1.000,0.949,0.903
10403502,UT,09,UTAH,1.000,0.940,0.898
10514512,VT,50,VERMONT,1.000,0.990,0.506
10611302,VA,00,VIRGINIA,1.000,0.983,0.706
10709202,VI,50,VIRGIN ISLANDS,1.000,1.011,0.985
10802402,WA,02,SEATTLE (KING CNTY),1.050,1.227,0.817