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72148 CPT Code: MRI Lumbar Spine Without Contrast

Last Updated: December 26, 2025

CPT 72148 represents an MRI of the lumbar spine without contrast. Because lower back pain is incredibly common, this code faces intense pre-authorization and medical necessity scrutiny.

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2026 Medicare National Fee (72148): Non-Facility (Office): $251.89 · Facility (Hospital): $251.89
✓ 3,362 Medicare-Approved ICD-10 Diagnoses on file for 72148:

Billing Requirements

72148 covers the entire lumbar spine. If contrast is injected, you would up-code to 72149 (with contrast) or 72158 (without, followed by with contrast).

Medical Necessity & The Conservative Therapy Rule

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For routine lower back pain (M54.50 ↗), most commercial payers and Medicare Advantage plans require documentation that the patient has failed 4 to 6 weeks of conservative therapy (e.g., physical therapy, NSAIDs) before they will approve 72148.

Exceptions to this rule (where immediate MRI is approved) include "Red Flag" symptoms like severe trauma, suspected epidural abscess, or cauda equina syndrome.

NCCI Edits

If scanning both the lumbar (72148) and cervical (72141) spine on the same day, they are billed as separate line items. Ensure exact component modifiers (26/TC) are used based on equipment ownership.

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