CPT 72270
Global XXX ActiveMyelogphy 2/> spine regions
CPT 72270 Billing & Documentation Guide
CPT code 72270 (Myelogphy 2/> spine regions) is classified under Radiology with a global period indicator of XXX. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 1.3, a non-facility practice expense RVU of 2.62, and a malpractice RVU of 0.08, a total non-facility RVU of 4 and facility RVU of 4. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $137.92, though rates vary from $119.97 to $175.82 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 72270, 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 72270 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 72270 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 72270
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 1.3 | 1.3 |
| Practice Expense RVU | 2.62 | 2.62 |
| Malpractice RVU | 0.08 | 0.08 |
| Total RVU | 4 | 4 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 72270
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 | $149.97 | $149.97 | $141.5 - $175.82 | 29 |
| Florida | $136.43 | $136.43 | $131.1 - $141.28 | 3 |
| Georgia | $130.17 | $130.17 | $124.67 - $135.67 | 2 |
| Illinois | $133.24 | $133.24 | $127.49 - $138.33 | 4 |
| Michigan | $129.35 | $129.35 | $126.33 - $132.37 | 2 |
| North Carolina | $126.78 | $126.78 | $126.78 - $126.78 | 1 |
| New York | $146.74 | $146.74 | $128.43 - $155.21 | 5 |
| Ohio | $126.01 | $126.01 | $126.01 - $126.01 | 1 |
| Pennsylvania | $132.39 | $132.39 | $126.28 - $138.49 | 2 |
| Texas | $132.3 | $132.3 | $125.54 - $138.46 | 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 72270
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 72270 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 00600 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 00620 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 00625 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 00626 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 00630 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 01905 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 01935 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 01936 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 01937 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 01938 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
Frequently Asked Questions, CPT 72270
What does CPT code 72270 mean? +
CPT code 72270 represents: Myelogphy 2/> spine regions. It's in the Radiology category with a global period of XXX.
What is the Medicare reimbursement for CPT 72270? +
The 2026 Medicare national average non-facility payment for CPT 72270 is $137.92. Rates range from $119.97 to $175.82 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 72270? +
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 72270? +
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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