Billing code 72197: MRI pelvisMedicare rate & RVUs

Medicare pays $334.34 for 72197 nationally in the office. Local office rates run $295.49–$453.44.

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

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.

Where 72197 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

72197 rates by state

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

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.

Payment rules and modifiers for 72197

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

What modifiers do to the payment

When to use modifier 26

72197 compared with similar codes

How to choose

72195Pelvic MRI

Choose 72195 for pelvic MRI without contrast. Choose 72197 when both precontrast and postcontrast image sets are performed.

72196MRI pelvis

72196 describes pelvic MRI with contrast only; 72197 describes a study with imaging both before and after contrast.

72198Pelvic MRA

72198 is pelvic MR angiography, focused on vessels. Use 72197 for a general pelvic MRI examination with and without contrast.

72194Ct pelvis w/o & w/dye

72194 is CT imaging of the pelvis without and with contrast. 72197 is the corresponding MRI approach, not CT.

Codes related to 72197

Related codes aren’t interchangeable: bill the code that matches the service performed.

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

Open CMS sourceHow we calculate rates