Radiological supervision and interpretation of cervical or thoracic discography, reported once for each disc level studied.
- Medicare
- $144.96
- Work RVU
- 1.13
- 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 ↓
- Each disc level injected
- Pain response and concordance at each level, including control
- Contrast volume and pressure details
- Fluoroscopic images and findings in a signed report
- Payer coverage check or authorization
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 ↓
72285 is the imaging portion of cervical or thoracic discography. The injection into each disc is reported with 62291, and the supervision and interpretation is 72285. Payers expect both reported per level, with matching units. Unlike myelography, there is no combined code, so the same physician bills both the injection and the imaging codes for each disc.
Discography is a provocative test: contrast is injected into the disc to see whether it reproduces the patient's usual pain and to show internal disc disruption. Some spine surgeons use it before cervical fusion to decide which levels are pain generators. CT after discography is billed separately with the appropriate spine CT code.
Coverage is the bigger problem. Many commercial payers consider provocative discography not medically necessary or investigational, and some Medicare contractors limit it. Check the policy before scheduling. Document the pressure, volume, pain response, and concordance at each level, including the control level.
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 (1.13) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (4.34) adds practice overhead and malpractice, and is what drives the Medicare payment below.
| Work RVU | 1.13 |
| Practice expense RVU | 3.16 |
| Malpractice RVU | 0.05 |
| Total RVU | 4.34 |
| Medicare national rate | $144.96 |
| 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 | $144.96 |
HOPD (APC 5431) Hospital outpatient department | $1,995.02 |
Common denial reasons
The recurring reasons claims for CPT 72285 get rejected.
Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓
- Payer policy treats discography as investigational
- Units billed do not match levels injected
- Injection code missing or unit mismatch
- No surgical decision documented as depending on the result
- Missing interpretation
Frequently asked questions
Source · Generated from the editorial pipeline, verified against 3 cited references ↓
01Is 72285 billed per level?
02Is there a combined code for discography?
03Do payers cover cervical discography?
Sources & references
Editorial content was developed using the following public sources.
Mira Scribe
Mira Scribe notes capture the surgeon's fusion planning question and which levels are in doubt, which is the reasoning payers want before approving discography.
See how Mira captures CPT 72285 documentation