Magnetic resonance imaging of the cervical spine performed only after a contrast agent is given, without a separate non-contrast sequence set.
- Medicare
- $273.89
- Work RVU
- 1.74
- Global, days
- Region
- Spine
Documentation requirements
What must appear in the operative or office note to support the claim.
Source · Editorial brief grounded in 3 cited references ↓
- Reason contrast was required (tumor, infection, postoperative scar)
- Report confirming post-contrast sequences only
- Contrast agent, dose, and renal screening when indicated
- Prior imaging referenced for comparison
- Authorization for 72142
Applicable modifiers
Modifiers commonly billed with this code.
Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual
What this code covers
Source · Editorial summary grounded in 3 cited references ↓
72142 is cervical spine MRI with contrast only. That is an uncommon protocol. Most spine MRI with contrast is done as a without-and-with study (72156), because radiologists want baseline images to compare against the enhanced ones. If the report lists both pre- and post-contrast sequences, the correct code is 72156, not 72142.
Where 72142 shows up legitimately is a short follow-up study, for example a known lesion where only post-contrast images are needed, or a case where a full non-contrast MRI was done on a different date. Ortho and spine surgeons more often order non-contrast cervical MRI (72141) for radiculopathy and myelopathy.
Gadolinium is billed on its own line in the office with the HCPCS code for the agent and the correct units. Commercial plans require prior authorization and will deny if the authorized code differs. Patients with kidney disease need documentation of renal function screening before gadolinium.
RVU & reimbursement
Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.
Source · CMS Physician Fee Schedule, RVU26A · January 2026
Work RVU vs. total RVU
The work RVU (1.74) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (8.2) adds practice overhead and malpractice, and is what drives the Medicare payment below.
| Work RVU | 1.74 |
| Practice expense RVU | 6.32 |
| Malpractice RVU | 0.14 |
| Total RVU | 8.2 |
| Medicare national rate | $273.89 |
| Global period | days |
Payment by site of service
Medicare pays different rates by setting. HOPD typically pays substantially more than ASC for the same procedure.
Source · CMS OPPS Addendum B·ASC HCPCS payment rates·2026
| Setting | Medicare rate (national) |
|---|---|
Office (PFS non-facility) Procedure performed in physician's office | $273.89 |
HOPD (APC 5572) Hospital outpatient department | $356.43 |
Common denial reasons
The recurring reasons claims for CPT 72142 get rejected.
Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓
- Report shows pre- and post-contrast sequences, so 72156 was the correct code
- Authorization for non-contrast MRI
- Gadolinium billed with wrong units
- No clinical reason for contrast
- Missing interpretation for the professional claim
Frequently asked questions
Source · Generated from the editorial pipeline, verified against 3 cited references ↓
01What is the difference between 72142 and 72156?
02Is gadolinium billed separately with cervical MRI?
03Does cervical MRI with contrast need prior authorization?
Sources & references
Editorial content was developed using the following public sources.
Mira Scribe
Mira Scribe captures the clinical concern that calls for contrast, such as a known lesion or suspected infection, so the order and the claim line up.
See how Mira captures CPT 72142 documentation