CPT CODERadiologyStatus A

CPT Code 72148Complete Billing & Coding Guide (2026)MRI lumbar spine without contrast

Reviewed by AAPC-Certified Coders2026 Medicare Fee ScheduleCMS + AMA Sources
Medicare Payment
$192
Non-facility · National avg
Facility
$192
Total RVU
5.74
Global
XXX
Payment
$192
non-facility
Work RVU
1.44
physician effort
Global Period
XXX
no post-op
Bundling Edits
8
NCCI pairs

About CPT 72148

CPT 72148 covers MRI of the lumbar spine without contrast. Most commonly billed spine MRI. For MRI with contrast, use 72149; with and without, use 72158.

Documentation specificity, correct ICD-10 linkage, and modifier accuracy determine whether 72148 pays cleanly or triggers a denial. Verify CMS National Physician Fee Schedule status, applicable Medicare LCDs, and any payer-specific medical policies before submission.

Pro Tip

72148 has 8 NCCI bundling edit pairs documented. Run your scrubber against the NCCI quarterly update before submission. When clinically warranted, use modifier 59 or the X-modifiers (XE, XS, XP, XU) to bypass an indicator-1 edit, with chart documentation supporting the distinct service.

Code Properties

Global Period
XXX
Not applicable (E/M, diagnostic, etc.)
Status Indicator
A
Active. Payment under Medicare PFS.
Conversion Factor
$33.4009
CMS national rate
Effective Date
2026-04-01
per CMS publication

RVU Breakdown

Every CPT code’s Medicare payment is calculated from three Relative Value Unit components: physician work, practice expense, and malpractice. Together they multiply by the conversion factor to produce the payment amount.

RVU Composition
5.74 total RVU
1.44
4.20
Work RVU
1.44 · 25%
Physician time + skill
Practice Expense
4.20 · 73%
Office & equipment
Malpractice
0.10 · 2%
Liability insurance
Non-Facility
Private office · urgent care · ambulatory
Most billed
$191.72
5.74 RVU × $33.4009 CF
Facility
Hospital · ASC · nursing home
$191.72
5.74 RVU × $33.4009 CF

Payment = Total RVU × Conversion Factor ($33.4009) × Geographic Adjustment (GPCI). National averages shown. Actual payment varies by locality.

Medicare Payment by State

Medicare adjusts payment by locality based on GPCI (Geographic Practice Cost Index). Higher cost-of-living areas like California and New York pay more. Rural states pay less. Top 12 states shown.

AK
$223
DC
$220
CA
$218
WA
$212
NJ
$212
NY
$211
MA
$210
HI
$210
CT
$204
CO
$201
OR
$199
MD
$199

Showing top 12 of 53 states. Full locality data available in CMS PFS Locality file.

NCCI Bundling Edits

8 pairs

These codes trigger National Correct Coding Initiative edits when billed with 72148. An indicator of 0 means the pair cannot be unbundled. Indicator 1 means modifier 59 or X-modifiers may allow separate billing with supporting documentation.

Common Denial Risk

Billing 72148 alongside a bundled code without the correct modifier generates CARC 97 denials. Payers often flag these as audit risks. Document medical necessity for the separate service and apply modifier 59 or the appropriate X-modifier (XE, XS, XP, XU) only when clinically justified.

AR Recovery Note

Radiology bundling traps usually involve component coding (TC/26 splits) plus contrast-with vs without coding pairs. CO-97 denials on 72148 often resolve once the right component modifier is appended on resubmission.

Applicable Modifiers

Modifiers commonly paired with 72148 based on its category. Apply only when the clinical circumstance warrants. Incorrect modifier use is a top audit target.

26
Professional component — physician interpretation/report only (no technical component)
When to use · When the physician only interprets/reads a diagnostic test performed by another entity (e.g., reading an echo performed at a hospital).
33
Preventive services — when the primary purpose is delivery of an evidence-based service per USPSTF A or B recommendation
When to use · Screening services (colonoscopy, mammography, etc.) to indicate the primary purpose is preventive. Waives cost-sharing under ACA.
76
Repeat procedure or service by same physician
When to use · When the same physician repeats the exact same procedure on the same day (e.g., repeat EKG after treatment, repeat X-ray after reduction).
77
Repeat procedure by another physician
When to use · When a different physician repeats the same procedure on the same day.
91
Repeat clinical diagnostic laboratory test on the same day for the same patient
When to use · When the same lab test is repeated on the same day for clinical reasons (not equipment malfunction).
GA
Waiver of liability statement issued as required by payer policy (ABN on file)
When to use · Medicare: when an Advance Beneficiary Notice (ABN) has been signed by the patient for services that may not be covered.
GY
Item or service statutorily excluded or does not meet the definition of any Medicare benefit
When to use · Service is never covered by Medicare (e.g., cosmetic procedures). May bill patient directly.
GZ
Item or service expected to be denied as not reasonable and necessary — no ABN on file
When to use · When a service is expected to be denied by Medicare and no ABN was obtained. Provider cannot bill the patient.
AR Recovery Note

Component split modifiers (26 professional, TC technical) are the most under-applied modifiers in diagnostic billing. Practices that bill global on services where they only provided the read silently invite refund requests. We split components correctly at submission.

Supporting ICD-10 Diagnoses

These diagnosis codes commonly support medical necessity for CPT 72148. Using the correct ICD-10 prevents CARC 50 denials. Payer rejects when the diagnosis doesn’t support the procedure.

1
Magnetic resonance imaging of the spine for back pain
Internal Medicine
M46See ICD-10-CM tabular index
M47See ICD-10-CM tabular index
M48See ICD-10-CM tabular index
M50See ICD-10-CM tabular index
M51See ICD-10-CM tabular index
M53See ICD-10-CM tabular index
M54See ICD-10-CM tabular index
2
MRI lumbar spine without contrast — low back pain, lumbago, lumbar radiculopathy, lumbar disc herniation, spinal stenosis, lumbar sprain, spondylosis
Radiology
M54.50Low back pain, unspecified
M54.5Low back pain
M54.40See ICD-10-CM tabular index
M51.16See ICD-10-CM tabular index
M51.17See ICD-10-CM tabular index
G55See ICD-10-CM tabular index
M48.06See ICD-10-CM tabular index
M48.07See ICD-10-CM tabular index
S33.100ASee ICD-10-CM tabular index
M47.816See ICD-10-CM tabular index
M47.817See ICD-10-CM tabular index
3
MRI lumbar spine — low back pain, radiculopathy, stenosis
Radiology
M54.50Low back pain, unspecified
M51.16See ICD-10-CM tabular index
M54.41See ICD-10-CM tabular index
G89.29See ICD-10-CM tabular index
M48.06See ICD-10-CM tabular index
AR Recovery Note

Imaging CO-50 denials trace to medical-policy criteria mismatches. Cardiac MRI, cardiac CT, nuclear cardiology, and advanced imaging all face strict commercial payer policies. We pre-verify the indication against the payer's policy before submission, not after the denial.

Free 90-Day AR Recovery Audit

Find the revenue leakage in your 72148 claims.

Wrong modifier, missing documentation, bundling without justification, stale ICD-10 linkage: these are the silent revenue killers on Radiology claims. Our AAPC-certified team audits your last 90 days of 72148 claims, surfaces the recoverable dollars, and appeals them. Free, no obligation.

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FAQ

Everything about CPT 72148

What does CPT code 72148 cover?

CPT 72148 covers MRI of the lumbar spine without contrast. Most commonly billed spine MRI. For MRI with contrast, use 72149; with and without, use 72158.

What is the Medicare payment for CPT 72148?

The national average Medicare payment for CPT 72148 is approximately $191.72 in a non-facility setting and $191.72 in a facility setting. Actual payment varies by locality based on GPCI adjustments. Total RVU is 5.74 with a conversion factor of $33.4009.

What is the global period for CPT 72148?

CPT 72148 has no global period (indicator XXX). There are no post-operative day restrictions tied to this code. Refer to CMS National Physician Fee Schedule rules and any applicable NCCI edits when billing on the same date as other services.

What codes bundle with CPT 72148?

CPT 72148 has NCCI Procedure-to-Procedure edits with 8+ codes including 01922, 0609T, 0610T. Modifier indicator 0 means the edit cannot be bypassed. Indicator 1 means modifier 59 or X-modifiers may allow separate billing with documentation.

CMS Medicare Physician Fee ScheduleNCCI Edits · Current QuarterAMA CPT Code Set

CPT codes and descriptions are copyright of the American Medical Association. RVU values reflect current CMS publications. Actual payment varies by locality. Commercial payer rates vary by contract.

Free 90-Day AR Recovery Audit

We audit your last 90 days of claims and surface the revenue leakage: wrong modifiers, missed bundling appeals, ICD-10 specificity gaps. AAPC-certified coders. 2.49% of collections. No setup fees.