CPT code 72197: MRI pelvis, without and with contrast2026 Medicare rate & RVUs in Colorado

Reports pelvic MRI images obtained before and after contrast to evaluate pelvic organs, soft tissues, or a suspected mass or disease process.

CMS RVU26DEffective Oct 1, 2026One payment locality392.9K Medicare services in 2024

In Colorado, Medicare pays $350.49 for 72197 in the office.

$350.49Office (non-facility)
Not available in this settingHospital or facility
+4.8%vs the national office rate ($334.34)

Check a contract rate as a % of Medicare · 72197 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 72197 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Colorado
  2. What 72197 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 72197 covers

The examination uses magnetic resonance imaging to assess pelvic organs and soft tissues, with image sets acquired before and after contrast. Clinicians may request it to characterize a pelvic mass or evaluate conditions involving structures such as the uterus, ovaries, prostate, rectum, or pelvic soft tissues. A technologist performs the image acquisition, and a radiologist typically interprets the study in an imaging center or hospital department.

Report 72197 when the documented pelvic MRI includes both precontrast and postcontrast imaging; a study performed only without contrast or only with contrast belongs to a different code in this series. The report should identify the pelvic anatomy examined and document the precontrast and postcontrast sequences and the diagnostic interpretation. Medicare recognizes a professional component for interpretation and a technical component for equipment and staff; bill the global service without a component modifier, or use modifier 26 or TC for the respective component. The diagnostic imaging multiple procedure reduction applies to both components.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

How Colorado compares for 72197

Across 109 of 109 payment localities, the office rate for 72197 runs from $295.49 in Arkansas to $453.44 in San Benito County, CA. Colorado pays $350.49. The RVUs are the same everywhere; the geographic indexes change the dollars.

72197 in Colorado vs other payment areas
  1. Colorado · this page$350.49
  2. Los Angeles, CA · California$382.56+$32.07
  3. Washington, DC area · District of Columbia$384.60+$34.11
  4. Miami, FL · Florida$353.06+$2.57
  5. Chicago, IL · Illinois$343.05−$7.44
  6. Manhattan, NY · New York$383.73+$33.24
  7. Alaska · Alaska$384.57+$34.08

Other areas in Colorado first, then benchmark localities. Bars start at $0.

Every other payment area

72197 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$299.88—
ArkansasArkansas$295.49—
ArizonaArizona$325.60—
Bakersfield, CACalifornia$358.31—
Chico, CACalifornia$357.77—
El Centro, CACalifornia$357.80—
Fresno, CACalifornia$357.77—
Hanford, CACalifornia$357.77—

72197 rates by state

Office rate range in each state. Select a state to see its payment localities.

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$295.49

$405.61

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
72197 office rate range by state
State / territoryOffice rate rangeLocalities
AK$384.571
AL$299.881
AR$295.491
AZ$325.601
CA$357.77–$453.4429
CO$350.491
CT$356.701
DC$384.601
DE$331.081
FL$325.71–$353.063
GA$307.59–$339.752
GU$367.331
HI$367.331
IA$309.261
ID$310.951
IL$314.98–$345.924
IN$312.821
KS$307.001
KY$305.341
LA$304.54–$319.902
MA$348.04–$386.592
MD$337.71–$384.603
ME$311.75–$330.062
MI$312.66–$329.012
MN$338.041
MO$298.71–$322.013
MS$297.201
MT$334.331
NC$315.181
ND$331.171
NE$311.221
NH$344.221
NJ$361.40–$380.382
NM$314.071
NV$333.711
NY$319.90–$392.135
OH$312.011
OK$305.631
OR$331.73–$362.672
PA$312.96–$347.212
PR$337.091
RI$343.621
SC$314.001
SD$330.791
TN$308.461
TX$310.82–$348.798
UT$318.371
VA$328.40–$384.602
VI$337.091
VT$329.131
WA$347.63–$395.342
WI$319.841
WV$302.951
WY$332.951

See 72197 in every payment locality

How the 72197 rate is calculated

Each of 72197’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 72197

RVUs × geographic indexes × conversion factor

Office or facility?

Work2.15

2.15 RVUs× 1.000 GPCI

Practice expense7.70

7.70 RVUs× 1.000 GPCI

Malpractice0.16

0.16 RVUs× 1.000 GPCI

Adjusted RVUs

10.0100

Conversion factor

$33.4009

Medicare rate

$334.34

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Colorado inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

8,066

Code
72197
Physician work
2.15
Practice expense
7.70
Malpractice
0.16

GPCI2026.csv

37

Locality
Colorado
Physician work
1.012
Practice expense
1.064
Malpractice
0.781
Office calculation for 72197 in Colorado
ComponentRVULocality factorAdjusted
Physician work2.15× 1.0122.1758
Practice expense7.70× 1.0648.1928
Malpractice0.16× 0.7810.1250
Total RVUs10.4936
Conversion factor× 33.4009

Office rate, Colorado$350.49

Office: (2.15 × 1.012 + 7.7 × 1.064 + 0.16 × 0.781) × $33.4009 = $350.49

Open 72197 in the RVU calculator

Payment rules and modifiers for 72197

The CMS indicators that decide how 72197 is paid alongside other services.

CMS payment indicators · 72197

MRI pelvis, without and with contrast

RuleCMS valueWhat it means
Global periodXXXThe global surgery concept doesn’t apply.
Multiple procedures4Diagnostic imaging reduction applies to the technical component (and professional component) of additional services.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical1Diagnostic test with separate professional (26) and technical (TC) components.

What modifiers do to the payment

Modifier 26 · payment effect

With and without the modifier

72197 without 26 · national office

$334.34

MRI pelvis, without and with contrast

72197-26 · Professional component

$101.54

Pays only the interpretation and report.

When to use modifier 26

How 72197 has changed in Colorado

72197 · Office / nonfacility

$350.49

Effective 2026-10-01

The base rate is $6.01 higher than on 2025-10-01, moving from $344.48 to $350.49 (1.7%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release
  1. January 1, 2026

    RVU26A

    $344.48changed to$350.49

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 2.20 changed to 2.15
    • Practice expense RVU 7.89 changed to 7.70
    • Malpractice RVU 0.15 changed to 0.16
    • Work GPCI 1.008 changed to 1.012
    • Practice expense GPCI 1.053 changed to 1.064
    • Malpractice GPCI 0.827 changed to 0.781

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $359.84changed to$344.48

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 8.05 changed to 7.89
    • Malpractice RVU 0.14 changed to 0.15

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $353.97changed to$359.84

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $371.46changed to$353.97

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 8.22 changed to 8.05
    • Malpractice RVU 0.15 changed to 0.14
    • Work GPCI 1.005 changed to 1.008
    • Practice expense GPCI 1.050 changed to 1.053
    • Malpractice GPCI 0.797 changed to 0.827
  5. January 1, 2023

    RVU23A

    $382.11changed to$371.46

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 8.34 changed to 8.22
    • Malpractice RVU 0.14 changed to 0.15
    • Work GPCI 1.001 changed to 1.005
    • Practice expense GPCI 1.047 changed to 1.050
    • Malpractice GPCI 0.767 changed to 0.797

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $402.64changed to$382.11

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 8.83 changed to 8.34
    • Malpractice RVU 0.12 changed to 0.14

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $406.59changed to$402.64

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 8.68 changed to 8.83
    • Malpractice RVU 0.11 changed to 0.12
    • Work GPCI 1.000 changed to 1.001
    • Practice expense GPCI 1.033 changed to 1.047
    • Malpractice GPCI 0.905 changed to 0.767

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $411.07changed to$406.59

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 8.89 changed to 8.68
    • Malpractice RVU 0.15 changed to 0.11
    • Practice expense GPCI 1.018 changed to 1.033
    • Malpractice GPCI 1.042 changed to 0.905

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $441.04changed to$411.07

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 9.72 changed to 8.89

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $518.87changed to$441.04

    • Conversion factor 35.8887 changed to 35.9996
    • Work RVU 2.26 changed to 2.20
    • Practice expense RVU 11.86 changed to 9.72
    • Practice expense GPCI 1.015 changed to 1.018
    • Malpractice GPCI 1.066 changed to 1.042

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $514.27changed to$518.87

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 11.81 changed to 11.86
    • Practice expense GPCI 1.011 changed to 1.015
    • Malpractice GPCI 1.090 changed to 1.066

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $515.07changed to$514.27

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 11.77 changed to 11.81
    • Malpractice RVU 0.16 changed to 0.15

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $512.50changed to$515.07

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $526.43changed to$512.50

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 12.22 changed to 11.77
    • Malpractice RVU 0.12 changed to 0.16
    • Practice expense GPCI 1.008 changed to 1.011
    • Malpractice GPCI 0.981 changed to 1.090

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $587.33changed to$526.43

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 14.83 changed to 12.22
    • Malpractice RVU 0.13 changed to 0.12
    • Practice expense GPCI 1.004 changed to 1.008
    • Malpractice GPCI 0.872 changed to 0.981

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $587.33

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$350.49Not available in this settingRVU26D
2026-07-01$350.49Not available in this settingRVU26C
2026-04-01$350.49Not available in this settingRVU26B
2026-01-01$350.49Not available in this settingRVU26A
2025-10-01$344.48Not available in this settingRVU25D
2025-07-01$344.48Not available in this settingRVU25C
2025-04-01$344.48Not available in this settingRVU25B
2025-01-01$344.48Not available in this settingRVU25A
2024-10-01$359.84Not available in this settingRVU24D
2024-07-01$359.84Not available in this settingRVU24C
2024-04-01$359.84Not available in this settingRVU24B
2024-03-09$359.84Not available in this settingRVU24AR
2024-01-01$353.97Not available in this settingRVU24A
2023-10-01$371.46Not available in this settingRVU23D
2023-07-01$371.46Not available in this settingRVU23C
2023-04-01$371.46Not available in this settingRVU23B
2023-01-01$371.46Not available in this settingRVU23A
2022-10-01$382.11Not available in this settingRVU22D
2022-07-01$382.11Not available in this settingRVU22C
2022-04-01$382.11Not available in this settingRVU22B
2022-01-01$382.11Not available in this settingRVU22A
2021-10-01$402.64Not available in this settingRVU21D
2021-07-01$402.64Not available in this settingRVU21C
2021-04-01$402.64Not available in this settingRVU21B
2021-01-01$402.64Not available in this settingRVU21A
2020-10-01$406.59Not available in this settingRVU20D
2020-07-01$406.59Not available in this settingRVU20C
2020-04-01$406.59Not available in this settingRVU20B
2020-01-01$406.59Not available in this settingRVU20A
2019-10-01$411.07Not available in this settingRVU19D
2019-07-01$411.07Not available in this settingRVU19C
2019-04-01$411.07Not available in this settingRVU19B
2019-01-01$411.07Not available in this settingRVU19A
2018-10-01$441.04Not available in this settingRVU18D
2018-07-01$441.04Not available in this settingRVU18C
2018-04-01$441.04Not available in this settingRVU18B
2018-01-01$441.04Not available in this settingRVU18AR1
2017-10-01$518.87Not available in this settingRVU17D
2017-07-01$518.87Not available in this settingRVU17C
2017-04-01$518.87Not available in this settingRVU17B
2017-01-01$518.87Not available in this settingRVU17A
2016-10-01$514.27Not available in this settingRVU16D
2016-07-01$514.27Not available in this settingRVU16C
2016-04-01$514.27Not available in this settingRVU16B
2016-01-01$514.27Not available in this settingRVU16A
2015-10-01$515.07Not available in this settingRVU15D
2015-07-01$515.07Not available in this settingRVU15C
2015-04-01$512.50Not available in this settingRVU15B
2015-01-01$512.50Not available in this settingRVU15A
2014-10-01$526.43Not available in this settingRVU14D
2014-07-01$526.43Not available in this settingRVU14C
2014-04-01$526.43Not available in this settingRVU14B
2014-01-01$526.43Not available in this settingRVU14A
2013-10-01$587.33Not available in this settingRVU13D
2013-07-01$587.33Not available in this settingRVU13C
2013-04-01$587.33Not available in this settingRVU13B
2013-01-01$587.33Not available in this settingRVU13AR

Price 72197 for an earlier date of service

Where the Colorado rate applies

Colorado is a Medicare payment area, not a city. Our Census mapping connects it to 485 cities and communities in Colorado. Some span more than one payment area; confirm with the service ZIP.

  • Acres Green
  • Aetna Estates
  • Aguilar
  • Air Force Academy
  • Akron
  • Alamosa
  • Alamosa East
  • Allenspark

Browse all communities in Colorado

72197 billing questions

When should 72197 be selected instead of 72195?

Use 72197 when the pelvic MRI includes imaging both before and after contrast. Code 72195 describes a pelvic MRI performed without contrast.

How does 72197 differ from 72196?

72197 represents imaging before and after contrast; 72196 is for imaging with contrast only. Select according to the sequences actually performed and documented.

Can the professional and technical portions be billed separately?

Yes. Modifier 26 identifies the interpretation, and modifier TC identifies the equipment and staff portion. Billing without either modifier represents the global service.

Does the multiple procedure reduction affect both portions?

Yes. CMS applies the diagnostic imaging multiple procedure reduction to the technical and professional components.

Is 72197 reported per sequence or per pelvic organ?

It represents the pelvic MRI examination, not each sequence or organ evaluated. The report should support that the examination included both precontrast and postcontrast imaging.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 72197PPRRVU2026_Oct_nonQPP.csv, line 8,066 (RVU26D)
Geographic factors for ColoradoGPCI2026.csv, line 37 (RVU26D)

Open CMS sourceHow we calculate rates

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