MRI of the thoracic spine performed with contrast (gadolinium) to evaluate the spinal canal and its contents.
Verified May 8, 2026 · 5 sources ↓
- Medicare
- $271.22
- Total RVUs
- 8.12
- Global, days
- Region
- Spine
Documentation requirements
What must appear in the operative or office note to support the claim.
Source · Editorial brief grounded in 5 cited references ↓
- Specify thoracic spine as the anatomical region imaged — not just 'spine MRI'
- Document that contrast was administered, including agent name and dose
- Include the clinical indication linking the imaging to a specific diagnosis or symptom (e.g., cord compression, myelopathy, neoplasm, infection)
- Radiologist interpretation report must be signed and include findings, impression, and technique section noting contrast use
- If ordered by a surgeon, document medical necessity supporting contrast over non-contrast protocol
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 5 cited references ↓
72147 covers a contrast-enhanced MRI of the thoracic spine — the segment running from T1 through T12. Contrast is administered to improve visualization of pathology such as cord compression, intradural and extradural masses, infectious or inflammatory processes, post-surgical changes, and vascular lesions that may not be apparent on non-contrast sequences alone.
This code sits in a closely related family: 72146 is thoracic MRI without contrast, 72147 is with contrast only, and 72157 is the combined without-and-with sequence. Bill the one that matches what was actually performed. A common RAC audit trigger is billing 72146 and 72147 together on the same date for the same patient — CMS treats the more extensive study (72147) as bundling the less extensive one (72146). If you performed the combined protocol, use 72157 instead.
The global period is XXX, meaning no pre- or post-service work is bundled — each professional component interpretation stands alone. Radiologists bill the professional component with modifier 26 when the facility owns the equipment. Orthopedic surgeons ordering or interpreting in their own imaging suite should confirm their payer's self-referral and in-office ancillary service rules before billing.
RVU & reimbursement
Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.
Source · CMS Physician Fee Schedule, RVU26A · January 2026
| Work RVU | 1.74 |
| Practice expense RVU | 6.26 |
| Malpractice RVU | 0.12 |
| Total RVU | 8.12 |
| Medicare national rate | $271.22 |
| 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 | $271.22 |
HOPD (APC 5572) Hospital outpatient department | $356.43 |
Common denial reasons
The recurring reasons claims for CPT 72147 get rejected.
Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓
- Billing 72146 and 72147 same-day same-patient — RAC flags the less extensive code as bundled into the more extensive one
- Missing or vague clinical indication — payers require a specific diagnosis or symptom justifying contrast use over non-contrast imaging
- Incorrect code when combined without/with contrast protocol was performed — should be 72157, not 72146 plus 72147
- Professional component billed without modifier 26 when the facility owns the equipment
- Prior authorization not obtained for outpatient MRI, which many commercial payers require regardless of clinical urgency
Frequently asked questions
Source · Generated from the editorial pipeline, verified against 5 cited references ↓
01When should I use 72147 instead of 72157?
02Can 72147 be billed same-day as a cervical or lumbar MRI with contrast?
03Does 72147 require prior authorization?
04How does the professional component get billed when a radiologist interprets a hospital-owned MRI?
05What ICD-10 diagnoses support medical necessity for contrast on a thoracic spine MRI?
06Is there a Medically Unlikely Edit (MUE) limit for 72147?
Sources & references
Editorial content was developed using the following public sources. Last verified May 8, 2026.
- 01CMS Physician Fee Schedule 2026
- 02cms.govhttps://www.cms.gov/research-statistics-data-and-systems/monitoring-programs/medicare-ffs-compliance-programs/recovery-audit-program/approved-rac-topics-items/0147-unbundling-of-mri-procedures
- 03cms.govhttps://www.cms.gov/medicare/coding-billing/national-correct-coding-initiative-ncci-edits/medicare-ncci-faq-library
- 04cms.govhttps://www.cms.gov/files/document/02-chapter2-ncci-medicare-policy-manual-2025finalcleanpdf.pdf
- 05cms.govhttps://www.cms.gov/medicare/coding-billing/national-correct-coding-initiative-ncci-edits/medicare-ncci-policy-manual
Mira AI Scribe
Mira's AI scribe captures the contrast agent, dose, and administration route from the radiologist's dictation, along with the specific clinical indication driving the contrast protocol. It flags if the technique section omits contrast confirmation — the most common reason auditors reclassify 72147 to 72146 after the fact.
See how Mira captures CPT 72147 documentation