MRI Lumbar Spine price: Medicare anchor and facility lever
Anchor for MRI Lumbar Spine - CPT 72148
$189.10
Professional (26) $69.69 plus technical (TC) $119.42.
Hospital OPPS facility anchor, this code billed alone: $243.77 (APC 5523, Level 3 Imaging without Contrast; national unadjusted, before wage-index adjustment).
Composite APC 8007: $537.85 (multi-study only, national unadjusted).
Lumbar spine MRI without contrast, CPT 72148, belongs to a spine family of three codes that are easy to confuse. 72148 is without contrast, 72149 is with contrast only, and 72158 is without followed by with. Each has its own anchor, so the first check on any quote is the code.
CPT code
72148
Magnetic resonance imaging, spinal canal and contents, lumbar; without contrast material
CPT 72148 is lumbar spine MRI without contrast. Without and with contrast is 72158 and with contrast only is 72157. Confirm which code was ordered before comparing prices.
The codes this visit can be billed under
| CPT | PFS office or global | PFS facility (professional) | Global period | Hospital single-service APC | Minimum Medicare copay at hospital |
|---|---|---|---|---|---|
| 72148 (this page) | $189.10 | $189.10 | not a surgical global | $243.77 (APC 5523) | $48.76 |
| 72149 | $265.04 | $265.04 | not a surgical global | $356.43 (APC 5572) | $71.29 |
Billed alone in a hospital, 72148 maps to CY2026 APC 5523 at $243.77, with a minimum unadjusted copayment of $48.76. With contrast only (72149) maps to the higher APC 5572 at $356.43, and its global anchor is $265.04. The composite APC at the top of this page applies only when several MRI services are billed on one claim.
Orders for neck and mid-back imaging use separate codes, so a request to scan more than one spine region produces more than one code line, and possibly composite billing in a hospital. Ask how many codes the order will generate.
A Medicare patient scanned in a hospital for 72148 alone faces a minimum unadjusted facility copayment of $48.76 plus the radiologist's coinsurance on $69.69. At a freestanding center billing globally, coinsurance applies to the single $189.10 anchor.
Inside and outside the 72148 anchor
Covered by the anchor
- Scanner time and image acquisition for the lumbar spine
- Radiologist interpretation and written report (professional component, modifier 26)
- Standard image storage and transmission to the ordering clinician
Billed outside it
- Contrast material when a with-contrast code is billed instead
- Sedation or anesthesia, when used
- The ordering visit and any follow-up visit
- A second body area billed under a separate CPT code
Why prices vary for CPT 72148
Spine MRI is a technical-heavy service. Of the CY2026 global anchor, the larger share is the technical component, meaning the scanner, the technologist and the facility. A hospital bills that technical work as an OPPS facility payment and the radiologist bills separately; a freestanding center usually bills both parts as one global fee schedule amount. Who owns the scanner therefore moves the cash price more than who reads the images.
Ask whether the scan will be done in a hospital outpatient department or a freestanding imaging center, and get the cash price for CPT 72148 in each setting in writing.
Questions specific to Lumbar spine MRI
- Is the order for 72148 only, or will another spine region be scanned on the same day?
- Could contrast be added, changing the code to 72149 or 72158?
- Is the quote for one global amount, or a facility amount with a separate reading?
- If two regions are scanned at a hospital, will composite billing apply?
MRI Lumbar Spine: billing questions
What is the difference between 72148, 72149 and 72158?
All three are lumbar spine MRI. 72148 is without contrast, 72149 is with contrast only, and 72158 is without followed by with. Each has its own Medicare anchor, and in a hospital 72149 maps to a higher APC than 72148.
Why might a hospital bill a composite for my spine MRI?
When two or more MRI services are billed together on one claim, CMS composite rules can pay the hospital one composite APC instead of separate APCs. A single 72148 billed alone uses the single-service APC 5523.
Does a Medicare patient pay coinsurance on both the hospital and the radiologist?
Yes in a hospital setting. Part B coinsurance applies to the hospital's outpatient payment and to the radiologist's professional fee, so the patient sees two cost-sharing amounts for one scan.
What is the Medicare hospital copayment for a lumbar MRI without contrast?
In CY2026, 72148 billed alone maps to APC 5523 with a minimum unadjusted copayment of $48.76, before wage-index adjustment. If composite rules apply because several MRI services are on one claim, the hospital is paid differently, so ask how the claim will be billed.