Cervical spine CT performed after contrast is given, either intravenously or intrathecally, including CT done after a myelogram.
- Medicare
- $168.34
- Work RVU
- 1.19
- Global, days
- Region
- Spine
Documentation requirements
What must appear in the operative or office note to support the claim.
Source · Editorial brief grounded in 3 cited references ↓
- Route of contrast: intrathecal or intravenous
- Reason MRI was not used, when CT myelography is chosen
- Contrast agent, dose, and any reaction
- Signed report describing canal and foraminal findings
- Authorization matching the with-contrast code
Applicable modifiers
Modifiers commonly billed with this code.
Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual
What this code covers
Source · Editorial summary grounded in 3 cited references ↓
72126 is cervical spine CT with contrast. IV contrast in the neck is unusual for spine questions, so in ortho and spine practices this code usually means a CT myelogram: contrast is placed in the thecal sac and the CT follows. CPT treats intrathecal contrast as contrast, so the with-contrast code is correct.
Surgeons order CT myelography when MRI is not possible (pacemaker, some stimulators) or when hardware artifact ruins the MRI. It shows nerve root and cord compression next to bone better than plain CT.
The billing trap is the injection. When the injection is done only so the CT can follow, with no myelogram films read, report the injection with 62284 and the CT as 72126. When one physician performs the injection and also supervises and reads conventional myelogram images, the combined cervical myelography code (62302) replaces 62284 plus 72240, and the CT is still 72126. Contrast supply is reported with a HCPCS code in the office setting. Check that the claim says with contrast, because a without-contrast authorization will not cover it.
RVU & reimbursement
Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.
Source · CMS Physician Fee Schedule, RVU26A · January 2026
Work RVU vs. total RVU
The work RVU (1.19) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (5.04) adds practice overhead and malpractice, and is what drives the Medicare payment below.
| Work RVU | 1.19 |
| Practice expense RVU | 3.76 |
| Malpractice RVU | 0.09 |
| Total RVU | 5.04 |
| Medicare national rate | $168.34 |
| Global period | days |
Payment by site of service
Medicare pays different rates by setting. HOPD typically pays substantially more than ASC for the same procedure.
Source · CMS OPPS Addendum B·ASC HCPCS payment rates·2026
| Setting | Medicare rate (national) |
|---|---|
Office (PFS non-facility) Procedure performed in physician's office | $168.34 |
HOPD (APC 5572) Hospital outpatient department | $356.43 |
Common denial reasons
The recurring reasons claims for CPT 72126 get rejected.
Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓
- Authorization obtained for 72125 instead of 72126
- 62284 billed alongside a combined myelography code
- No explanation why MRI could not answer the question
- Contrast supply missing or billed with the wrong HCPCS units
- Diagnosis does not support advanced imaging
Frequently asked questions
Source · Generated from the editorial pipeline, verified against 3 cited references ↓
01Is CT myelogram of the neck billed as 72126?
02Do I bill 62284 with 72126?
03Is contrast billed separately with 72126?
Sources & references
Editorial content was developed using the following public sources.
Mira Scribe
Mira Scribe notes document why MRI was not an option and the specific compression question the surgeon needs answered, which supports the more expensive study.
See how Mira captures CPT 72126 documentation