CPT / HCPCS code · 2026 CMS data · Verified 2026-08-31

CPT 72158 RVU and Medicare Payment (2026)

Mri lumbar spine w/o & w/dye — 2.23 work RVU, about $318.31 non-facility Medicare payment at the 2026 conversion factor.

Work RVU
2.23
PE RVU (non-facility)
7.14
PE RVU (facility)
7.14
MP RVU
0.16
Office payment
$318.31
Facility payment
$318.31

How the payment is calculated

Total RVU is work plus practice expense plus malpractice, each adjusted by its GPCI factor, then multiplied by the conversion factor. For 72158 in a non-facility setting with national GPCI: (2.23 + 7.14 + 0.16) × $33.4009 ≈ $318.31. The same code in a facility setting pays about $318.31 because facility PE RVU (7.14) replaces office PE RVU.

What changes by locality

GPCI moves 72158 non-facility payment from $282.09 to $429.43 across CMS localities — from Arkansas to San Jose-sunnyvale-santa Clara (san Benito Cnty). Check your exact locality in the GPCI calculator rather than using a state average.

Related codes

Checking a different code or locality? Open the full RVU calculator to run any of the 7,790 CPT/HCPCS codes with your own GPCI factors.

Frequently asked questions

What is the 2026 work RVU for CPT 72158?

2.23. Work RVU measures physician time, skill, and intensity — it does not change by setting or locality. Total payment adds practice expense and malpractice RVUs plus the conversion factor.

How much does Medicare pay for CPT 72158 in 2026?

About $318.31 non-facility ($318.31 facility) at national GPCI with the 2026 $33.4009 conversion factor. Your locality GPCI moves the number — see the range above.

Does the work RVU change between office and facility?

No. Work RVU (2.23) and malpractice RVU stay fixed; only practice expense changes (7.14 office vs 7.14 facility). That is the entire office-vs-facility payment gap.