Discography cerv/thor spine
Cervical and thoracic spine discography imaging shows hospital outpatient departments charge 15.3x the Medicare benchmark of $127.77, making bill verification essential given potential differences exceeding $1,800.
About the analyst
Michael Glenn reviews CMS datasets and drug pricing at BillRazor Research. He focuses on NADAC acquisition costs and procedure coding accuracy. Expertise: drug pricing, NADAC data, CPT coding.
Code 72285 covers discography imaging of the cervical or thoracic spine, where contrast dye is injected into spinal discs and X-rays are taken to identify disc problems. Patients with chronic neck or upper back pain who haven't responded to other treatments typically receive this diagnostic procedure. This code charges approximately 8.2x the Medicare reimbursement rate, with facility fees varying significantly between outpatient hospitals and imaging centers.
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Common billing errors
Common radiology billing errors include incorrect bundling of imaging procedures, where facilities separately bill components that should be included in comprehensive codes. CT and MRI studies frequently show charges above the benchmark when contrast administration (codes 36000-36299) is billed separately despite being included in the primary imaging code. Duplicate billing occurs when both screening and diagnostic mammography codes are submitted for the same visit, or when bilateral imaging procedures are coded as two separate unilateral studies rather than using appropriate bilateral modifiers. Another frequent error involves confusion between similar imaging codes, such as billing high-resolution CT scans when standard chest CT was performed, creating potential differences of several hundred dollars. Patients should verify that contrast injections aren't separately itemized for procedures already including contrast, confirm bilateral studies use proper coding rather than duplicate unilateral charges, and ensure screening versus diagnostic imaging codes match the actual clinical indication documented in their medical records.
What to check on your bill
When reviewing your radiology bill, first verify the CPT codes match the actual procedures performed—common codes include 70450-70470 for CT scans, 72100-72170 for spine X-rays, and 73000-73700 for extremity imaging. Check that technical and professional components are billed correctly; you should see modifier -TC for the technical component (equipment/technologist) and -26 for professional component (radiologist interpretation), or no modifier if both are included. Confirm the anatomical site and laterality modifiers are accurate—modifier -RT for right side, -LT for left side, and -50 for bilateral procedures when applicable. Review facility fees separately from physician fees, as these appear as distinct line items. Compare your charges against Medicare fee schedules or regional benchmarks, as charges above the benchmark may indicate potential differences worth investigating with your insurance provider or facility billing department.
Facility rate
$128
National Medicare benchmark
Non-facility rate
$3
Office setting benchmark
Data sources
3
23 data points
Key insights for CPT 72285
Facility vs office setting
$125 differenceNon-facility setting is less expensive for this procedure
What this procedure costs across different settings
The same procedure can cost very different amounts depending on where it's performed. These are the Medicare-allowed amounts — what hospitals actually charge can be 3-10x higher.
| Setting | Medicare rate | vs lowest |
|---|---|---|
| Facility (physician office) | $128 | +4159% |
| Non-facility (office) | $3 | Lowest |
| Outpatient (APC) | $1,953 | +64992% |
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About this data
Rates shown are from the 2026 Medicare Physician Fee Schedule, Hospital Outpatient Prospective Payment System (OPPS), Ambulatory Surgery Center Payment System, Clinical Laboratory Fee Schedule, Durable Medical Equipment Fee Schedule, and CMS Inpatient Prospective Payment System (DRG weights). Regional adjustments use CMS Geographic Practice Cost Indices (GPCI). Hospital charges are from CMS Hospital Price Transparency machine-readable files. All data is publicly available under federal law (45 CFR Part 180).
This data is for informational purposes only and does not constitute medical or financial advice. Actual costs depend on insurance coverage, negotiated rates, and individual circumstances.
Related procedures
Related pricing data
Data: Medicare Physician Fee Schedule, CMS Inpatient PPS (IPPS), Outpatient PPS (OPPS), ASC Payment System, Clinical Lab Fee Schedule (CLFS), National Average Drug Acquisition Cost (NADAC). FY 2024 data. All publicly available from CMS.
Methodology: Facility rate applies when the procedure is performed in a hospital or ASC. Non-facility rate applies in a physician office. GPCI adjustments reflect regional cost-of-living differences.
This information is for educational purposes only and is not medical, financial, or legal advice. Actual costs depend on your insurance and provider. We recommend verifying costs directly with your provider. Full methodology · Terms of use