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CMS RVU26D · Effective 2026-10-01

72157 Thoracic MRI Medicare reimbursement rates in Wisconsin

Reports thoracic spine MRI images acquired before and after contrast, commonly used to evaluate spinal cord, nerve, or vertebral abnormalities. Compare 72157 office and facility rates across CMS payment localities in Wisconsin.

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 72157 in Wisconsin?

Wisconsin 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

$304.92

1 of 1 localities have a supported rate.

Payment area: Wisconsin

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.

Find 72157 in your payment locality →

Diagnostic imaging

About 72157: Thoracic spine MRI without and with contrast

Reports thoracic spine MRI images acquired before and after contrast, commonly used to evaluate spinal cord, nerve, or vertebral abnormalities.

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.

CMS billing rules for 72157

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) RVU7.15 · 75%
  • Malpractice RVU0.16 · 2%

111.6K

Medicare services in 2024 · #526 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.

72157 compared with similar codes

Office rates for Wisconsin, from the same CMS release.

72146

Spine MRI

Thoracic, without contrast

$182.24

72146 is for a thoracic MRI performed without contrast only; use 72157 when the study includes both precontrast and postcontrast imaging.

72147

Thoracic MRI

With contrast only

$259.66

72147 describes a thoracic MRI performed with contrast only. Select 72157 when the examination includes both noncontrast and postcontrast phases.

72130

Thoracic spine CT

Without and with contrast

$189.53

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.

72156

Spine MRI

Cervical spine, without and with contrast

$304.28

72156 uses the same without-and-with-contrast MRI approach for the cervical spine; 72157 is for the thoracic spine.

Compare 72157 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

Office and facility base rates · shared scale starting at $0

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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 72157 in Wisconsin.

PPRRVU2026_Oct_nonQPP.csv

8,033

Code
72157
Physician work
2.23
Practice expense
7.15
Malpractice
0.16

GPCI2026.csv

111

Locality
Wisconsin
Physician work
1.000
Practice expense
0.958
Malpractice
0.308
Office / nonfacility calculation for 72157 in Wisconsin
ComponentRVULocality factorAdjusted
Physician work2.23× 1.0002.2300
Practice expense7.15× 0.9586.8497
Malpractice0.16× 0.3080.0493
Total RVUs9.1290
Conversion factor× 33.4009

Office / nonfacility rate, Wisconsin$304.92

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work2.231
Practice expense7.150.958
Malpractice0.160.308

(2.23 × 1 + 7.15 × 0.958 + 0.16 × 0.308) × $33.4009 = $304.92

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.

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 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.

RVUs for 72157PPRRVU2026_Oct_nonQPP.csv, line 8,033 (RVU26D)
Geographic factors for WisconsinGPCI2026.csv, line 111 (RVU26D)