Cervical spine CT acquired first without contrast and then repeated after contrast, with both image sets interpreted together.
- Medicare
- $196.06
- Work RVU
- 1.24
- 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 ↓
- Report describing both non-contrast and contrast phases
- Clinical reason contrast was needed (infection, mass, abscess)
- Reason MRI was not used, if applicable
- Contrast agent and dose
- Authorization for the with-and-without 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 ↓
72127 covers a cervical CT done in two passes in one session: a non-contrast scan, then a scan after contrast. It replaces billing 72125 and 72126 together. You never bill both of those for one encounter.
For orthopedic and spine care this is a rare study. It may come up when a soft tissue mass, infection, or abscess near the cervical spine is suspected and MRI is not possible. Most spine surgeons would rather have MRI for those questions, so a payer reviewer will want to know why CT with and without contrast was chosen.
Denials usually come from the authorization. Radiology benefit managers approve a specific code, and a with-and-without study needs its own approval. If the radiologist decides to add contrast after seeing the plain images, the practice has to update the authorization, often within a short window after the service. The report must show both phases were acquired. If only one phase was done, bill the single-phase code.
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 (1.24) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (5.87) adds practice overhead and malpractice, and is what drives the Medicare payment below.
| Work RVU | 1.24 |
| Practice expense RVU | 4.54 |
| Malpractice RVU | 0.09 |
| Total RVU | 5.87 |
| Medicare national rate | $196.06 |
| 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 | $196.06 |
HOPD (APC 5571) Hospital outpatient department | $179.20 |
Common denial reasons
The recurring reasons claims for CPT 72127 get rejected.
Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓
- Authorization covered only one phase
- 72125 and 72126 billed together instead of 72127
- Report shows only one phase performed
- Indication does not explain the need for contrast
- Missing contrast supply line or wrong units
Frequently asked questions
Source · Generated from the editorial pipeline, verified against 3 cited references ↓
01Can I bill 72125 and 72126 together?
02What if the radiologist adds contrast after the authorization was for 72125?
03When is CT cervical spine with and without contrast used?
Sources & references
Editorial content was developed using the following public sources.
Mira Scribe
Mira Scribe records the suspected infection or mass and the contraindication to MRI in plain terms, so the reason for a two-phase CT is on the record.
See how Mira captures CPT 72127 documentation