CPT 72126
Global XXX ActiveCt neck spine w/dye
CPT 72126 Billing & Documentation Guide
CPT code 72126 (Ct neck spine w/dye) is classified under Radiology with a global period indicator of XXX. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 1.19, a non-facility practice expense RVU of 3.76, and a malpractice RVU of 0.09, a total non-facility RVU of 5.04 and facility RVU of 5.04. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $174.2, though rates vary from $149.17 to $226.83 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 72126, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 72126 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
No global period (E/M and other non-procedural services)
MUE Limit (Medically Unlikely Edits)
Submitting more than 1 units of 72126 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 72126
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 1.19 | 1.19 |
| Practice Expense RVU | 3.76 | 3.76 |
| Malpractice RVU | 0.09 | 0.09 |
| Total RVU | 5.04 | 5.04 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 72126
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $191.41 | $191.41 | $179.68 - $226.83 | 29 |
| Florida | $171.61 | $171.61 | $164.33 - $178.09 | 3 |
| Georgia | $163.21 | $163.21 | $155.35 - $171.07 | 2 |
| Illinois | $166.98 | $166.98 | $159.11 - $174.33 | 4 |
| Michigan | $161.91 | $161.91 | $157.8 - $166.01 | 2 |
| North Carolina | $158.84 | $158.84 | $158.84 - $158.84 | 1 |
| New York | $185.82 | $185.82 | $161.17 - $197.2 | 5 |
| Ohio | $157.44 | $157.44 | $157.44 - $157.44 | 1 |
| Pennsylvania | $166.33 | $166.33 | $157.88 - $174.79 | 2 |
| Texas | $166.4 | $166.4 | $156.82 - $175.36 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 72126
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 72126 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 01922 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 0558T | Column 1 (primary), can be billed with modifier | Yes | CPT Manual or CMS manual coding instruction |
| 0708T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0709T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 36000 | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 36005 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 36011 | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 36406 | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 36410 | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 36591 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
Frequently Asked Questions, CPT 72126
What does CPT code 72126 mean? +
CPT code 72126 represents: Ct neck spine w/dye. It's in the Radiology category with a global period of XXX.
What is the Medicare reimbursement for CPT 72126? +
The 2026 Medicare national average non-facility payment for CPT 72126 is $174.2. Rates range from $149.17 to $226.83 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 72126? +
Radiology codes rely heavily on the professional/technical split: modifier 26 (professional component only) and TC (technical component only). Also common: 50 (bilateral imaging), 76 (repeat by same physician), 77 (repeat by different physician), and LT/RT for laterality.
What bundling edits apply to CPT 72126? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
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