CPT 72159
Global XXXMr angio spine w/o&w/dye
CPT 72159 Billing & Documentation Guide
CPT code 72159 (Mr angio spine w/o&w/dye) is classified under Radiology with a global period indicator of XXX. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 1.76, a non-facility practice expense RVU of 8.21, and a malpractice RVU of 0.13, a total non-facility RVU of 10.1 and facility RVU of 10.1. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $349.89, though rates vary from $296.58 to $463.01 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 72159, 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 72159 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Restricted coverage (special situations)
No global period (E/M and other non-procedural services)
MUE Limit (Medically Unlikely Edits)
Submitting more than 1 units of 72159 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 72159
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 1.76 | 1.76 |
| Practice Expense RVU | 8.21 | 8.21 |
| Malpractice RVU | 0.13 | 0.13 |
| Total RVU | 10.1 | 10.1 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 72159
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 | $387.73 | $387.73 | $362.66 - $463.01 | 29 |
| Florida | $342.37 | $342.37 | $327.47 - $355.23 | 3 |
| Georgia | $325.68 | $325.68 | $308.57 - $342.79 | 2 |
| Illinois | $332.26 | $332.26 | $315.94 - $348.52 | 4 |
| Michigan | $322.39 | $322.39 | $314.05 - $330.73 | 2 |
| North Carolina | $317.41 | $317.41 | $317.41 - $317.41 | 1 |
| New York | $373.4 | $373.4 | $322.35 - $396.66 | 5 |
| Ohio | $313.53 | $313.53 | $313.53 - $313.53 | 1 |
| Pennsylvania | $332.56 | $332.56 | $314.62 - $350.49 | 2 |
| Texas | $333.11 | $333.11 | $312.36 - $352.88 | 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 72159
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 72159 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 01916 | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
| 0609T | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 0610T | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 0611T | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 0612T | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 0694T | Column 1 (primary), can be billed with modifier | No | 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 |
| 36000 | Column 1 (primary), can be billed with modifier | 9 | Standards of medical/surgical practice |
Frequently Asked Questions, CPT 72159
What does CPT code 72159 mean? +
CPT code 72159 represents: Mr angio spine w/o&w/dye. It's in the Radiology category with a global period of XXX.
What is the Medicare reimbursement for CPT 72159? +
The 2026 Medicare national average non-facility payment for CPT 72159 is $349.89. Rates range from $296.58 to $463.01 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 72159? +
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 72159? +
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 June 1, 2026.
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