Radiological supervision and interpretation of lumbar discography, reported once for each lumbar disc level injected and evaluated.
- Medicare
- $122.25
- Work RVU
- 0.81
- 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 ↓
- Levels injected including control level
- Concordant or discordant pain response at each level
- Opening pressure and contrast volume
- Signed report with fluoroscopic findings
- Payer authorization or coverage determination
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 ↓
72295 is the imaging code for lumbar discography, billed per level. The disc injection itself is 62290, also per level. There is no combined code, so one physician doing the whole procedure bills both 62290 and 72295 for each disc.
Spine surgeons sometimes request lumbar discography before fusion for discogenic pain, to decide which levels to include. A typical study injects two or three suspected levels plus a control level. Post-discography CT is a separate study, coded with lumbar CT.
Coverage drives most denials. Many commercial plans list provocative discography as not medically necessary or investigational, and Medicare contractors may restrict it. Get a written determination first. Unit counts must match between 62290 and 72295, and both must match the levels in the report. Record the pressure, volume, pain intensity, and whether the pain was concordant at each level, along with the control response.
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 (0.81) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (3.66) adds practice overhead and malpractice, and is what drives the Medicare payment below.
| Work RVU | 0.81 |
| Practice expense RVU | 2.8 |
| Malpractice RVU | 0.05 |
| Total RVU | 3.66 |
| Medicare national rate | $122.25 |
| 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 | $122.25 |
HOPD (APC 5431) Hospital outpatient department | $1,995.02 |
Common denial reasons
The recurring reasons claims for CPT 72295 get rejected.
Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓
- Payer considers discography investigational
- Unit mismatch between 62290 and 72295
- Levels billed exceed levels documented
- No surgical plan tied to the results
- Missing authorization
Frequently asked questions
Source · Generated from the editorial pipeline, verified against 3 cited references ↓
01How many units of 72295 should I bill?
02Is CT after lumbar discography billed separately?
03Does Medicare cover lumbar discography?
Sources & references
Editorial content was developed using the following public sources.
Mira Scribe
Mira Scribe records the discogenic pain history and the levels the surgeon is weighing for fusion, giving payers the reason the test changes treatment.
See how Mira captures CPT 72295 documentation