Lumbar spine CT done with contrast, including CT performed after contrast is placed into the spinal canal for a myelogram.
- Medicare
- $168.67
- 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 ↓
- Contrast route, agent, and volume
- Reason MRI was contraindicated or nondiagnostic
- Prior surgery levels and hardware
- Signed report with level-by-level findings
- Authorization for 72132
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 ↓
72132 is lumbar spine CT with contrast. In orthopedic and spine practice it nearly always means lumbar CT myelography. Surgeons order it when a patient cannot have MRI, when an old fusion or stimulator makes MRI useless, or when they want root compression shown against bone detail before revision surgery.
The injection is billed separately. If the injection is done only so a CT can follow, 62284 goes with 72132. If the same physician does a full lumbar myelogram with interpreted fluoroscopic images, 62304 applies, and the CT is still billed as 72132. Many practices get this wrong by billing 72265 along with the combined code, which is a duplicate.
In the office, the contrast agent is billed with its HCPCS supply code. Payers want the note to say why MRI was not used. The authorization must be for the contrast code, not 72131.
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 (5.05) adds practice overhead and malpractice, and is what drives the Medicare payment below.
| Work RVU | 1.19 |
| Practice expense RVU | 3.77 |
| Malpractice RVU | 0.09 |
| Total RVU | 5.05 |
| Medicare national rate | $168.67 |
| 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 | $168.67 |
HOPD (APC 5572) Hospital outpatient department | $356.43 |
Common denial reasons
The recurring reasons claims for CPT 72132 get rejected.
Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓
- Authorization obtained for 72131
- Radiological myelography code billed along with the combined code
- No reason documented for skipping MRI
- Contrast supply missing or wrong
- 62284 billed along with 62304
Frequently asked questions
Source · Generated from the editorial pipeline, verified against 3 cited references ↓
01What CPT codes are used for a lumbar CT myelogram?
02Can 72265 be billed with 62304?
03Is IV contrast lumbar CT the same code?
Sources & references
Editorial content was developed using the following public sources.
Mira Scribe
Mira Scribe notes capture the prior fusion levels, implanted devices, and the surgeon's specific question, which is what supports a CT myelogram on review.
See how Mira captures CPT 72132 documentation