How much does Medicare pay for CPT 72156?

Medicare allowed an average of $142.72 per service and paid $110.84 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $1107.80, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 72156?

Mri scan of upper spinal canal before and after contrast. It was billed 74,572 times to 72,043 Medicare beneficiaries by 3,094 providers in 2024.

Does 72156 pay differently in an office than a hospital?

Yes. The allowed amount averaged $213.97 in an office setting and $106.66 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 72156 most?

Diagnostic Radiology, with 68,729 services from 2,845 clinicians. Next are Independent Diagnostic Testing Facility (IDTF), Interventional Radiology, Neurology.

CPT 72156

Mri scan of upper spinal canal before and after contrast

$142.72Medicare-allowed amount per service, averaged across 74,572 services

Providers submitted

$1107.80

Asking price, not received

Medicare allowed

$142.72

The fee schedule figure

Medicare paid

$110.84

Balance is patient coinsurance

Providers submitted an average of $1107.80 for this code and Medicare allowed $142.72 — 7.8× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $110.84 (78%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $213.97
Hospital / facility: $106.66

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 25,057 services were billed in an office setting and 49,515 in a facility.

Services: 74,572
Beneficiaries: 72,043
Providers billing it: 3,094
Total allowed: $10,642,916

What Medicare pays for CPT 72156

Across 74,572 services billed by 3,094 providers to 72,043 beneficiaries, Medicare allowed an average of $142.72 per service. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 72156

Specialty	Services	Beneficiaries	Avg allowed	Providers
Diagnostic Radiology	68,729	66,402	$136.41	2,845
Independent Diagnostic Testing Facility (IDTF)	3,692	3,550	$252.24	158
Interventional Radiology	810	796	$122.23	35
Neurology	663	648	$193.82	29
Nuclear Medicine	119	117	$140.44	5
Neurosurgery	95	86	$244.73	2
Undefined Physician type	89	85	$101.41	3
Internal Medicine	68	67	$133.05	4
Physician Assistant	67	66	$194.29	1
Nurse Practitioner	62	56	$142.00	2
Orthopedic Surgery	61	53	$205.23	3
Radiation Oncology	45	45	$105.15	3
Family Practice	34	34	$169.88	2
Pediatric Medicine	21	21	$154.20	1
Sports Medicine	17	17	$155.74	1

72156 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
New York	6,846	$160.19	$110.52	184
California	6,715	$163.51	$112.23	248
Texas	6,566	$142.09	$108.82	250
Florida	4,167	$170.78	$132.18	175
Massachusetts	3,760	$144.72	$101.93	116
Illinois	3,484	$125.38	$92.95	149
Michigan	3,180	$119.48	$90.45	122
Pennsylvania	2,843	$122.32	$89.78	141
Minnesota	2,755	$175.13	$131.26	147
Ohio	2,375	$119.41	$91.17	102
Virginia	2,282	$144.79	$108.19	87
Missouri	2,134	$105.89	$82.55	91
North Carolina	2,111	$132.83	$105.17	101
Arizona	1,834	$151.51	$116.54	76
Maryland	1,800	$186.80	$135.40	67
Tennessee	1,569	$129.47	$104.80	69
New Jersey	1,559	$195.54	$136.57	67
Georgia	1,407	$141.13	$109.01	74
Colorado	1,323	$131.03	$96.26	60
Washington	1,269	$134.85	$96.37	59
South Carolina	1,259	$128.22	$104.07	56
Connecticut	986	$124.81	$91.95	46
Indiana	831	$130.47	$101.04	46
Wisconsin	808	$110.22	$83.04	45
Kansas	746	$116.53	$94.10	38
Oregon	744	$115.66	$86.66	34
Mississippi	638	$102.48	$82.42	29
Alabama	627	$150.24	$124.25	33
Louisiana	599	$138.28	$113.83	32
Nebraska	569	$114.84	$92.36	29
Iowa	540	$107.83	$86.80	24
Nevada	520	$175.65	$141.98	23
Kentucky	517	$119.02	$95.80	25
Utah	442	$122.25	$93.61	24
Rhode Island	433	$135.02	$96.22	16
Arkansas	412	$106.17	$85.79	20
Oklahoma	393	$113.55	$89.48	23
District of Columbia	382	$159.39	$112.34	14
New Hampshire	373	$107.79	$81.99	23
Delaware	363	$126.90	$95.12	18
Montana	320	$111.10	$83.52	13
South Dakota	311	$102.61	$77.43	10
North Dakota	289	$102.28	$77.88	13
Idaho	278	$122.35	$95.98	14
Vermont	232	$117.72	$87.23	10
New Mexico	219	$125.86	$96.31	13
Alaska	213	$187.31	$113.71	6
West Virginia	209	$126.74	$96.69	13
Hawaii	81	$163.39	$116.23	5
Maine	81	$119.17	$92.83	3
Wyoming	78	$147.24	$116.08	5
Puerto Rico	45	$175.76	$137.24	3
ZZ	23	$104.22	$81.39	1
Guam	21	$325.02	$201.31	1
XX	11	$108.80	$66.22	1

Related codes

72125Ct scan of upper spine without contrast$46.99
72100X-ray of lower and sacral spine$23.76
72148Mri scan of lower spinal canal without contrast$116.92
72110X-ray of lower and sacral spine$34.78
72170X-ray of pelvis$13.01
72141Mri scan of upper spinal canal without contrast$108.96
72131Ct scan of lower spine without contrast$53.06
72197Mri scan of pelvis before and after contrast$191.31
72146Mri scan of middle spinal canal without contrast$99.42
72128Ct scan of middle spine without contrast$46.63
72158Mri scan of lower spinal canal before and after contrast$149.73
72192Ct scan of pelvis without contrast$53.35

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.