Myelogphy 2/> spine regions
CPT code 72270 is used when a radiologist performs myelography—an imaging study using contrast dye—on two or more regions of the spine (cervical, thoracic, or lumbar) to visualize the spinal cord and nerve roots.
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
Conversion factor: 32.3465 · Source: CMS MPFS RVU25A · Confidence: High
NCCI bundling edits
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Billing tips
Document all spine regions examined explicitly (cervical, thoracic, lumbosacral) to justify multi-region coding versus single region (72255 or 72265)
Impact: Single region codes reimburse significantly less; proper documentation ensures full $147.18 payment versus potential 30-40% reduction
Bill the contrast injection separately using CPT 62284 (injection for myelography/CT via lumbar) or 62302 (via cistern/C1-C2) when appropriate
Impact: Injection codes add approximately $150-300 in additional reimbursement when properly documented as separate procedural service
When myelography is followed by CT, bill CT myelography codes (72252, 72253, 72254) instead of plain myelography for higher reimbursement
Impact: CT myelography codes reimburse approximately 50-80% more than plain myelography codes
Verify that documentation specifies at least two distinct anatomical regions; 'complete spine' or 'total spine' terminology alone may trigger downcoding
Impact: Lack of region-specific documentation can result in denial or downcoding to single region code, reducing payment by $50-75
Use modifier 26 for professional component billing when performed in hospital or facility setting; ensure facility bills TC component to avoid payment delays
Impact: Split billing coordination prevents duplicate claim denials and ensures timely payment of both components
Check for prior authorization requirements; many Medicare Advantage and commercial payers require pre-authorization for multi-region myelography
Impact: Lack of authorization can result in 100% denial; obtaining authorization prevents $147.18 payment loss
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