CPT 72147Radiology

Mri chest spine w/dye

CPT code 72147 is for an MRI scan of the thoracic spine (mid-back) performed with contrast dye injected into a vein to enhance image detail. This imaging test helps doctors see spinal structures, discs, nerves, and abnormalities more clearly than without contrast.

Showing rates for

National Average

Base Medicare rate

$268.15

This calculator gives a typical-case estimate using standard Medicare modifier rules. Actual payment depends on payer policies, documentation, code-specific CMS status indicators, and locality. Verify before billing.

RVU breakdown

Work RVU

1.78

PE RVU (NF)

6.4

MP RVU

0.11

Total RVU

8.29

Conversion factor: 32.3465 · Source: CMS MPFS RVU25A · Confidence: High

NCCI bundling edits

Loading bundling edits…

Billing tips

Verify medical necessity documentation for contrast administration before billing 72147 instead of 72146 (without contrast)
Impact: Prevents denials and downcoding; contrast-enhanced studies require clinical indication such as tumor evaluation, infection, or post-surgical assessment - inadequate documentation leads to $30-50 reimbursement reduction when downgraded to non-contrast code
Confirm patient's renal function (eGFR/creatinine) is documented before contrast administration
Impact: Prevents medical necessity denials and liability issues; most payers require eGFR >30 for gadolinium contrast; missing lab documentation causes 15-25% claim denial rate
Do not bill 72147 with 72157 (MRI thoracic spine without contrast followed by with contrast) on the same date - 72157 is the comprehensive code
Impact: Prevents bundling denials and potential fraud allegations; billing both results in 100% denial of 72147 as bundled service
When billing globally, ensure both technical and professional components are included; when split billing, coordinate with facility to prevent duplicate or missing claims
Impact: Global billing captures full $268.15 reimbursement; uncoordinated split billing causes payment delays of 30-60 days or permanent loss of payment portion
Link to specific ICD-10 codes that support contrast use (neoplasm, myelopathy, post-operative complications, infection) rather than generic back pain codes
Impact: Increases first-pass claim acceptance by 40-60%; generic diagnoses like M54.6 (thoracic pain) alone frequently trigger medical necessity denials for contrast-enhanced studies
Document and bill for contrast material separately using HCPCS code A9579 (gadolinium-based contrast) when applicable in hospital outpatient or facility settings

Live Field Datano reports yet

Real billers contribute denial patterns and appeal strategies for this code. Once 5+ reports come in, you’ll see live aggregated data here — the only place this exists, free.

Working with CPT 72147?

Get the free Revenue Protection Toolkit — the denial triggers, modifier pitfalls, and bundling conflicts that quietly cost you reimbursement. Instant download.

Help build the field knowledge

MedPayIQ gets smarter as billers contribute. If you've had this code denied, share what happened so others learn from it. Anonymous, no patient info.

Related actions

Frequently asked questions

What is the Medicare reimbursement rate for CPT 72147 in 2025?

The 2025 Medicare national average reimbursement for CPT 72147 is $268.15 for both facility and non-facility settings. This rate includes 8.29 total RVUs multiplied by the 2025 conversion factor of 32.3465. Actual payment may vary by geographic location based on local cost adjustments.

What is the difference between CPT 72146 and 72147?

CPT 72146 is MRI of the thoracic spine without contrast material, while 72147 includes intravenous contrast administration. Code 72147 is used when contrast enhancement is medically necessary to better visualize tumors, infection, vascular abnormalities, or differentiate scar tissue from recurrent disc herniation. The contrast-enhanced study (72147) receives higher reimbursement but requires specific clinical justification.

How many RVUs is CPT code 72147 worth?

CPT 72147 has 8.29 total RVUs in 2025, broken down as: 1.78 work RVUs, 6.4 practice expense RVUs (both facility and non-facility), and 0.11 malpractice RVUs. This RVU value is consistent across facility and non-facility settings, which is common for diagnostic imaging procedures.

Does CPT 72147 require prior authorization?

Prior authorization requirements for CPT 72147 vary by insurance payer. Most Medicare Advantage plans and many commercial insurers require pre-authorization for advanced imaging including contrast-enhanced MRI. Original Medicare does not require authorization but may conduct post-payment audits. Always verify authorization requirements with the specific payer before scheduling to prevent denials.

Can you bill CPT 72147 and 72148 together?

No, you should not bill CPT 72147 (with contrast only) and 72148 (without contrast followed by with contrast) together for the same thoracic spine study. Code 72148 is the comprehensive code that includes both non-contrast and contrast sequences. Billing both would be considered duplicate billing and result in denial of one code.

What diagnosis codes support medical necessity for CPT 72147?

Diagnosis codes supporting CPT 72147 include: neoplasms of spine/spinal cord (C41.2, C72.0, D16.6), spinal cord compression (G95.20), myelopathy (G99.2), postlaminectomy syndrome (M96.1), osteomyelitis/discitis (M46.2x), demyelinating diseases (G35, G37.x), and vascular malformations (Q28.2). Generic back pain codes (M54.6) alone typically do not support contrast necessity without additional clinical documentation.

What modifiers are commonly used with CPT 72147?

The most common modifiers for CPT 72147 are: 26 (professional component only when radiologist bills separately from facility), TC (technical component only when facility bills separately from interpretation), 59 (distinct procedural service when billing multiple MRIs same day), and 76 (repeat procedure by same physician when study must be repeated same day). Modifier 52 (reduced services) applies when the procedure cannot be completed after contrast administration.