75572

ActiveGlobal n/a

Ct hrt w/3d image

2026 Medicare payment

Estimated allowed amounts. Pick a locality or enter a ZIP; toggle modifiers to see how the payment rules change the number; add the add-on codes to price the whole procedure.

Locality

or ZIP

Show values as

Component

Modifiers

Line	Qty	Non-facility (office)	Facility (hospital/ASC)
75572Ct hrt w/3d image	1	$229.46	$229.46
add-on0722TQuan ct tiss charac w/ct	0	$0.00/ unit	$0.00/ unit
add-on0993TN-invas assmt car rsk w/ct	0	$0.00/ unit	$0.00/ unit

Conversion factor: Locality: national average GPCIs

RVU breakdown (national)

Relative value units before geographic adjustment. Payment = (work×GPCI_w + PE×GPCI_pe + MP×GPCI_mp) × CF

Row	Work RVU	PE RVU (office)	PE RVU (facility)	MP RVU	Total (office)
75572	1.71	5.06	5.06	0.10	6.87
75572-TC	0.00	4.44	4.44	0.03	4.47
75572-26	1.71	0.62	0.62	0.07	2.40

Payment policy for 75572

CMS's indicator fields, translated. These control which modifiers are payable and how.

Professional/technical (PC/TC)

pctc=1

Diagnostic test

Has professional (-26) and technical (-TC) components, each priced separately.

Multiple procedures

mult_surg=4

Imaging TC reduction

Technical component of multiple diagnostic-imaging services reduced 50%.

Bilateral (modifier 50)

bilt_surg=0

150% rule doesn't apply

Bilateral adjustment does not apply (e.g., the code is unilateral by definition or physiology).

Assistant surgeon (80/81/82)

asst_surg=0

Payable with documentation

Assistant at surgery (mod 80/81/82) paid at 16% if medical necessity is documented.

Co-surgeons (modifier 62)

co_surg=0

Not permitted

Co-surgeons (mod 62) may not be paid for this procedure.

Team surgery (modifier 66)

team_surg=0

Not permitted

Team surgery (mod 66) may not be paid for this procedure.

Source: pfs.data.cms.gov "Indicators for 2026", retrieved 2026-07-16; conversion factors $33.4009 / $33.5675 (QP) per CMS-1832-F. Estimated amounts — not billing or coding advice.