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CMS RVU26D · Effective 2026-10-01

72196 in Modesto

Office / nonfacility

$287.25

Base rate per service

Facility setting

Not available in this setting

Base rate per service

Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.

MRI

About 72196: Pelvic MRI with contrast only

Report this code for a pelvic MRI performed with contrast when the examination does not include both precontrast and postcontrast imaging.

This service covers MRI imaging of the pelvis performed with contrast, commonly a gadolinium-based agent. A radiologic technologist acquires the images in a hospital or outpatient imaging center, and a radiologist interprets them. Pelvic MRI may be ordered to assess a mass, characterize soft-tissue findings, or evaluate suspected infection when contrast-enhanced imaging is requested. The documented examination must support the pelvic region and use of contrast.

Choose this code for a contrast-only examination, rather than a study that includes imaging both before and after contrast. The imaging report and order should identify the pelvic anatomy, contrast use, and findings. The service may be billed globally, or the interpretation and imaging equipment and staff portions may be billed separately with modifiers 26 and TC. When multiple diagnostic imaging services are performed, the CMS multiple procedure reduction applies to both the technical and professional components.

CMS billing rules for 72196

Professional and technical components
Diagnostic test with a professional component (modifier 26, interpretation) and a technical component (modifier TC, equipment and staff); billing without a modifier is the global service.
Multiple procedures
Diagnostic imaging multiple procedure reduction applies to the technical and professional components.

Where the value comes from

  • Work RVU1.69 · 21%
  • Practice expense (office) RVU6.22 · 77%
  • Malpractice RVU0.12 · 1%

2.8K

Medicare services in 2024 · #2228 by national volume

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.

72196 compared with similar codes

Office rates for Modesto, from the same CMS release.

72195

Pelvic MRI

Without contrast

$243.87

72195 is for pelvic MRI without contrast. Use 72196 when contrast is used for the examination.

72197

MRI pelvis

Without and with contrast

$357.77

72197 includes pelvic MRI before and after contrast; 72196 is for the contrast-only examination.

72193

Pelvic CT

Contrast-enhanced

$242.80

72193 describes pelvic CT with contrast, not MRI. The modality documented in the imaging report determines which code applies.

The same code, a different location

How does Modesto compare?

In Bakersfield, the office rate for 72196 is $287.66—$0.41 higher than the $287.25 rate in Modesto. Both use the same code, release and participation basis.

72196 across payment areas

Same release and payment basis · bars start at $0

  1. Modesto · This locality

    $287.25

  2. Bakersfield

    $287.66

    $0.41 higher than Modesto

  3. Chico

    $287.25

    The same base rate than Modesto

  4. El Centro

    $287.27

    $0.02 higher than Modesto

  5. Fresno

    $287.25

    The same base rate than Modesto

  6. Hanford-Corcoran

    $287.25

    The same base rate than Modesto

  7. Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty)

    $307.20

    $19.95 higher than Modesto

Other payment areas listed in California appear first, followed by selected cross-country examples. The chart compares amounts, not distance.

Across 109 of 109 CMS payment localities with a supported office rate, 72196 ranges from $236.97 in Arkansas to $364.39 in San Jose-Sunnyvale-Santa Clara (San Benito Cnty). This is a geographic range, not an average.

The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.

Compare all 108 other payment areas

  • Madera

    California · 72196

    Office

    $287.25

    Facility

    Unavailable

    The same base rate than Modesto for the office setting.

  • Merced

    California · 72196

    Office

    $287.25

    Facility

    Unavailable

    The same base rate than Modesto for the office setting.

  • Napa

    California · 72196

    Office

    $335.86

    Facility

    Unavailable

    $48.61 higher than Modesto for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 72196

    Office

    $306.09

    Facility

    Unavailable

    $18.84 higher than Modesto for the office setting.

  • Redding

    California · 72196

    Office

    $287.25

    Facility

    Unavailable

    The same base rate than Modesto for the office setting.

  • Rest Of California

    California · 72196

    Office

    $287.25

    Facility

    Unavailable

    The same base rate than Modesto for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 72196

    Office

    $288.58

    Facility

    Unavailable

    $1.33 higher than Modesto for the office setting.

  • Sacramento-Roseville-Folsom

    California · 72196

    Office

    $302.25

    Facility

    Unavailable

    $15.00 higher than Modesto for the office setting.

  • Salinas

    California · 72196

    Office

    $301.13

    Facility

    Unavailable

    $13.88 higher than Modesto for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 72196

    Office

    $308.79

    Facility

    Unavailable

    $21.54 higher than Modesto for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 72196

    Office

    $356.58

    Facility

    Unavailable

    $69.33 higher than Modesto for the office setting.

  • San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)

    California · 72196

    Office

    $356.45

    Facility

    Unavailable

    $69.20 higher than Modesto for the office setting.

  • San Jose-Sunnyvale-Santa Clara (San Benito Cnty)

    California · 72196

    Office

    $364.39

    Facility

    Unavailable

    $77.14 higher than Modesto for the office setting.

  • San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)

    California · 72196

    Office

    $363.83

    Facility

    Unavailable

    $76.58 higher than Modesto for the office setting.

  • San Luis Obispo-Paso Robles

    California · 72196

    Office

    $296.19

    Facility

    Unavailable

    $8.94 higher than Modesto for the office setting.

  • Santa Cruz-Watsonville

    California · 72196

    Office

    $312.20

    Facility

    Unavailable

    $24.95 higher than Modesto for the office setting.

  • Santa Maria-Santa Barbara

    California · 72196

    Office

    $302.42

    Facility

    Unavailable

    $15.17 higher than Modesto for the office setting.

  • Santa Rosa-Petaluma

    California · 72196

    Office

    $315.41

    Facility

    Unavailable

    $28.16 higher than Modesto for the office setting.

  • Stockton

    California · 72196

    Office

    $287.25

    Facility

    Unavailable

    The same base rate than Modesto for the office setting.

  • Vallejo

    California · 72196

    Office

    $335.66

    Facility

    Unavailable

    $48.41 higher than Modesto for the office setting.

  • Visalia

    California · 72196

    Office

    $287.25

    Facility

    Unavailable

    The same base rate than Modesto for the office setting.

  • Yuba City

    California · 72196

    Office

    $287.25

    Facility

    Unavailable

    The same base rate than Modesto for the office setting.

  • Dc + Md/Va Suburbs

    District of Columbia · 72196

    Office

    $308.69

    Facility

    Unavailable

    $21.44 higher than Modesto for the office setting.

  • Miami

    Florida · 72196

    Office

    $282.86

    Facility

    Unavailable

    $4.39 lower than Modesto for the office setting.

  • Chicago

    Illinois · 72196

    Office

    $274.83

    Facility

    Unavailable

    $12.42 lower than Modesto for the office setting.

  • Manhattan

    New York · 72196

    Office

    $307.83

    Facility

    Unavailable

    $20.58 higher than Modesto for the office setting.

  • Alaska*

    Alaska · 72196

    Office

    $308.14

    Facility

    Unavailable

    $20.89 higher than Modesto for the office setting.

  • Alabama

    Alabama · 72196

    Office

    $240.50

    Facility

    Unavailable

    $46.75 lower than Modesto for the office setting.

  • Arkansas

    Arkansas · 72196

    Office

    $236.97

    Facility

    Unavailable

    $50.28 lower than Modesto for the office setting.

  • Arizona

    Arizona · 72196

    Office

    $261.19

    Facility

    Unavailable

    $26.06 lower than Modesto for the office setting.

  • Colorado

    Colorado · 72196

    Office

    $281.31

    Facility

    Unavailable

    $5.94 lower than Modesto for the office setting.

  • Connecticut

    Connecticut · 72196

    Office

    $286.18

    Facility

    Unavailable

    $1.07 lower than Modesto for the office setting.

  • Delaware

    Delaware · 72196

    Office

    $265.59

    Facility

    Unavailable

    $21.66 lower than Modesto for the office setting.

  • Fort Lauderdale

    Florida · 72196

    Office

    $274.15

    Facility

    Unavailable

    $13.10 lower than Modesto for the office setting.

  • Rest Of Florida

    Florida · 72196

    Office

    $261.08

    Facility

    Unavailable

    $26.17 lower than Modesto for the office setting.

  • Atlanta

    Georgia · 72196

    Office

    $272.51

    Facility

    Unavailable

    $14.74 lower than Modesto for the office setting.

  • Rest Of Georgia

    Georgia · 72196

    Office

    $246.54

    Facility

    Unavailable

    $40.71 lower than Modesto for the office setting.

  • Hawaii, Guam

    Hawaii · 72196

    Office

    $294.98

    Facility

    Unavailable

    $7.73 higher than Modesto for the office setting.

  • Iowa

    Iowa · 72196

    Office

    $248.13

    Facility

    Unavailable

    $39.12 lower than Modesto for the office setting.

  • Idaho

    Idaho · 72196

    Office

    $249.48

    Facility

    Unavailable

    $37.77 lower than Modesto for the office setting.

  • East St. Louis

    Illinois · 72196

    Office

    $255.65

    Facility

    Unavailable

    $31.60 lower than Modesto for the office setting.

  • Rest Of Illinois

    Illinois · 72196

    Office

    $252.39

    Facility

    Unavailable

    $34.86 lower than Modesto for the office setting.

  • Suburban Chicago

    Illinois · 72196

    Office

    $277.31

    Facility

    Unavailable

    $9.94 lower than Modesto for the office setting.

  • Indiana

    Indiana · 72196

    Office

    $250.98

    Facility

    Unavailable

    $36.27 lower than Modesto for the office setting.

  • Kansas

    Kansas · 72196

    Office

    $246.28

    Facility

    Unavailable

    $40.97 lower than Modesto for the office setting.

  • Kentucky

    Kentucky · 72196

    Office

    $244.81

    Facility

    Unavailable

    $42.44 lower than Modesto for the office setting.

  • New Orleans

    Louisiana · 72196

    Office

    $256.50

    Facility

    Unavailable

    $30.75 lower than Modesto for the office setting.

  • Rest Of Louisiana

    Louisiana · 72196

    Office

    $244.15

    Facility

    Unavailable

    $43.10 lower than Modesto for the office setting.

  • Metropolitan Boston

    Massachusetts · 72196

    Office

    $310.39

    Facility

    Unavailable

    $23.14 higher than Modesto for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 72196

    Office

    $279.31

    Facility

    Unavailable

    $7.94 lower than Modesto for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 72196

    Office

    $285.23

    Facility

    Unavailable

    $2.02 lower than Modesto for the office setting.

  • Rest Of Maryland

    Maryland · 72196

    Office

    $270.94

    Facility

    Unavailable

    $16.31 lower than Modesto for the office setting.

  • Rest Of Maine

    Maine · 72196

    Office

    $250.07

    Facility

    Unavailable

    $37.18 lower than Modesto for the office setting.

  • Southern Maine

    Maine · 72196

    Office

    $264.86

    Facility

    Unavailable

    $22.39 lower than Modesto for the office setting.

  • Detroit

    Michigan · 72196

    Office

    $263.69

    Facility

    Unavailable

    $23.56 lower than Modesto for the office setting.

  • Rest Of Michigan

    Michigan · 72196

    Office

    $250.65

    Facility

    Unavailable

    $36.60 lower than Modesto for the office setting.

  • Minnesota

    Minnesota · 72196

    Office

    $271.41

    Facility

    Unavailable

    $15.84 lower than Modesto for the office setting.

  • Metropolitan Kansas City

    Missouri · 72196

    Office

    $255.44

    Facility

    Unavailable

    $31.81 lower than Modesto for the office setting.

  • Metropolitan St. Louis

    Missouri · 72196

    Office

    $258.25

    Facility

    Unavailable

    $29.00 lower than Modesto for the office setting.

  • Rest Of Missouri

    Missouri · 72196

    Office

    $239.44

    Facility

    Unavailable

    $47.81 lower than Modesto for the office setting.

  • Mississippi

    Mississippi · 72196

    Office

    $238.29

    Facility

    Unavailable

    $48.96 lower than Modesto for the office setting.

  • Montana**

    Montana · 72196

    Office

    $268.20

    Facility

    Unavailable

    $19.05 lower than Modesto for the office setting.

  • North Carolina

    North Carolina · 72196

    Office

    $252.84

    Facility

    Unavailable

    $34.41 lower than Modesto for the office setting.

  • North Dakota**

    North Dakota · 72196

    Office

    $265.83

    Facility

    Unavailable

    $21.42 lower than Modesto for the office setting.

  • Nebraska

    Nebraska · 72196

    Office

    $249.72

    Facility

    Unavailable

    $37.53 lower than Modesto for the office setting.

  • New Hampshire

    New Hampshire · 72196

    Office

    $276.23

    Facility

    Unavailable

    $11.02 lower than Modesto for the office setting.

  • Northern Nj

    New Jersey · 72196

    Office

    $305.28

    Facility

    Unavailable

    $18.03 higher than Modesto for the office setting.

  • Rest Of New Jersey

    New Jersey · 72196

    Office

    $289.97

    Facility

    Unavailable

    $2.72 higher than Modesto for the office setting.

  • New Mexico

    New Mexico · 72196

    Office

    $251.77

    Facility

    Unavailable

    $35.48 lower than Modesto for the office setting.

  • Nevada**

    Nevada · 72196

    Office

    $267.75

    Facility

    Unavailable

    $19.50 lower than Modesto for the office setting.

  • Nyc Suburbs/Long Island

    New York · 72196

    Office

    $314.52

    Facility

    Unavailable

    $27.27 higher than Modesto for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 72196

    Office

    $291.33

    Facility

    Unavailable

    $4.08 higher than Modesto for the office setting.

  • Queens

    New York · 72196

    Office

    $311.40

    Facility

    Unavailable

    $24.15 higher than Modesto for the office setting.

  • Rest Of New York

    New York · 72196

    Office

    $256.63

    Facility

    Unavailable

    $30.62 lower than Modesto for the office setting.

  • Ohio

    Ohio · 72196

    Office

    $250.17

    Facility

    Unavailable

    $37.08 lower than Modesto for the office setting.

  • Oklahoma

    Oklahoma · 72196

    Office

    $245.09

    Facility

    Unavailable

    $42.16 lower than Modesto for the office setting.

  • Portland

    Oregon · 72196

    Office

    $291.15

    Facility

    Unavailable

    $3.90 higher than Modesto for the office setting.

  • Rest Of Oregon

    Oregon · 72196

    Office

    $266.19

    Facility

    Unavailable

    $21.06 lower than Modesto for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 72196

    Office

    $278.52

    Facility

    Unavailable

    $8.73 lower than Modesto for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 72196

    Office

    $250.95

    Facility

    Unavailable

    $36.30 lower than Modesto for the office setting.

  • Puerto Rico

    Puerto Rico · 72196

    Office

    $270.43

    Facility

    Unavailable

    $16.82 lower than Modesto for the office setting.

  • Rhode Island

    Rhode Island · 72196

    Office

    $275.70

    Facility

    Unavailable

    $11.55 lower than Modesto for the office setting.

  • South Carolina

    South Carolina · 72196

    Office

    $251.82

    Facility

    Unavailable

    $35.43 lower than Modesto for the office setting.

  • South Dakota**

    South Dakota · 72196

    Office

    $265.55

    Facility

    Unavailable

    $21.70 lower than Modesto for the office setting.

  • Tennessee

    Tennessee · 72196

    Office

    $247.45

    Facility

    Unavailable

    $39.80 lower than Modesto for the office setting.

  • Austin

    Texas · 72196

    Office

    $279.91

    Facility

    Unavailable

    $7.34 lower than Modesto for the office setting.

  • Beaumont

    Texas · 72196

    Office

    $249.23

    Facility

    Unavailable

    $38.02 lower than Modesto for the office setting.

  • Brazoria

    Texas · 72196

    Office

    $265.91

    Facility

    Unavailable

    $21.34 lower than Modesto for the office setting.

  • Dallas

    Texas · 72196

    Office

    $267.32

    Facility

    Unavailable

    $19.93 lower than Modesto for the office setting.

  • Fort Worth

    Texas · 72196

    Office

    $265.29

    Facility

    Unavailable

    $21.96 lower than Modesto for the office setting.

  • Galveston

    Texas · 72196

    Office

    $266.52

    Facility

    Unavailable

    $20.73 lower than Modesto for the office setting.

  • Houston

    Texas · 72196

    Office

    $268.71

    Facility

    Unavailable

    $18.54 lower than Modesto for the office setting.

  • Rest Of Texas

    Texas · 72196

    Office

    $257.23

    Facility

    Unavailable

    $30.02 lower than Modesto for the office setting.

  • Utah

    Utah · 72196

    Office

    $255.34

    Facility

    Unavailable

    $31.91 lower than Modesto for the office setting.

  • Virginia

    Virginia · 72196

    Office

    $263.50

    Facility

    Unavailable

    $23.75 lower than Modesto for the office setting.

  • Virgin Islands

    United States Virgin Islands · 72196

    Office

    $270.43

    Facility

    Unavailable

    $16.82 lower than Modesto for the office setting.

  • Vermont

    Vermont · 72196

    Office

    $264.15

    Facility

    Unavailable

    $23.10 lower than Modesto for the office setting.

  • Rest Of Washington

    Washington · 72196

    Office

    $279.00

    Facility

    Unavailable

    $8.25 lower than Modesto for the office setting.

  • Seattle (King Cnty)

    Washington · 72196

    Office

    $317.46

    Facility

    Unavailable

    $30.21 higher than Modesto for the office setting.

  • Wisconsin

    Wisconsin · 72196

    Office

    $256.71

    Facility

    Unavailable

    $30.54 lower than Modesto for the office setting.

  • West Virginia

    West Virginia · 72196

    Office

    $242.72

    Facility

    Unavailable

    $44.53 lower than Modesto for the office setting.

  • Wyoming**

    Wyoming · 72196

    Office

    $267.17

    Facility

    Unavailable

    $20.08 lower than Modesto for the office setting.

See how rates vary across the country

72196 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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.

$236.97

$325.82

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

View all state and territory rates as a table
State / territoryRate rangeLocalities
AK$308.141
AL$240.501
AR$236.971
AZ$261.191
CA$287.25–$364.3929
CO$281.311
CT$286.181
DC$308.691
DE$265.591
FL$261.08–$282.863
GA$246.54–$272.512
GU$294.981
HI$294.981
IA$248.131
ID$249.481
IL$252.39–$277.314
IN$250.981
KS$246.281
KY$244.811
LA$244.15–$256.502
MA$279.31–$310.392
MD$270.94–$308.693
ME$250.07–$264.862
MI$250.65–$263.692
MN$271.411
MO$239.44–$258.253
MS$238.291
MT$268.201
NC$252.841
ND$265.831
NE$249.721
NH$276.231
NJ$289.97–$305.282
NM$251.771
NV$267.751
NY$256.63–$314.525
OH$250.171
OK$245.091
OR$266.19–$291.152
PA$250.95–$278.522
PR$270.431
RI$275.701
SC$251.821
SD$265.551
TN$247.451
TX$249.23–$279.918
UT$255.341
VA$263.50–$308.692
VI$270.431
VT$264.151
WA$279.00–$317.462
WI$256.711
WV$242.721
WY$267.171

Explore 72196 on the national rate map →

Where does this rate apply?

Modesto is a Medicare payment area. Our Census mapping connects it to 33 cities and communities in California, including the examples shown here.

Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.

Browse all communities in California →

Use this rate

What is a percentage of Medicare worth?

Turn a percentage into dollars for 72196 in Modesto. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$315.98

$287.25 × 110% = $315.98

A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.

Working with a whole code list?

Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.

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How this local rate is calculated

Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 72196 in Modesto.

PPRRVU2026_Oct_nonQPP.csv

8,063

Code
72196
Physician work
1.69
Practice expense
6.22
Malpractice
0.12

GPCI2026.csv

16

Locality
Modesto
Physician work
1.017
Practice expense
1.096
Malpractice
0.536
Office / nonfacility calculation for 72196 in Modesto
ComponentRVULocality factorAdjusted
Physician work1.69× 1.0171.7187
Practice expense6.22× 1.0966.8171
Malpractice0.12× 0.5360.0643
Total RVUs8.6002
Conversion factor× 33.4009

Office / nonfacility rate, Modesto$287.25

Values as parsed from CMS release RVU26D, effective 2026-10-01. The amount is rounded to the nearest cent only at the end.

Open 72196 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work1.691.017
Practice expense6.221.096
Malpractice0.120.536

(1.69 × 1.017 + 6.22 × 1.096 + 0.12 × 0.536) × $33.4009 = $287.25

The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.

How this rate has changed

72196 · Office / nonfacility

$287.25

Effective 2026-10-01

The base rate is $4.72 higher than on 2025-10-01, moving from $282.53 to $287.25 (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

    $282.53changed to$287.25

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.73 changed to 1.69
    • Practice expense RVU 6.33 changed to 6.22
    • Malpractice RVU 0.11 changed to 0.12
    • Work GPCI 1.014 changed to 1.017
    • Practice expense GPCI 1.093 changed to 1.096
    • Malpractice GPCI 0.560 changed to 0.536

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: $282.53

    Held through RVU25B, RVU25C, RVU25D.

Explore release dates and calculate this code in an earlier period →

Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.

Inspect every release and its CMS source
Effective fromOffice / nonfacilityFacilityCMS release
2026-10-01$287.25Not available in this settingRVU26D
2026-07-01$287.25Not available in this settingRVU26C
2026-04-01$287.25Not available in this settingRVU26B
2026-01-01$287.25Not available in this settingRVU26A
2025-10-01$282.53Not available in this settingRVU25D
2025-07-01$282.53Not available in this settingRVU25C
2025-04-01$282.53Not available in this settingRVU25B
2025-01-01$282.53Not available in this settingRVU25A

72196 billing questions

How does this differ from 72195?

72196 represents pelvic MRI performed with contrast; 72195 represents pelvic MRI without contrast. Select the code that matches the sequences documented in the imaging report.

When should 72197 be used instead?

Use 72197 when the pelvic MRI includes imaging both before and after contrast. Use 72196 when the examination is performed with contrast only.

Can the interpretation and imaging service be billed separately?

Yes. Modifier 26 identifies the professional interpretation, and modifier TC identifies the technical service. Billing without either modifier represents the global service.

What happens when another diagnostic imaging service is performed?

The CMS multiple procedure reduction applies to both the professional and technical components when multiple diagnostic imaging services are performed.

What documentation supports 72196?

The order and imaging report should establish that the study covers the pelvis and was performed with contrast, without the precontrast and postcontrast protocol represented by 72197.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.

Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.

RVUs for 72196PPRRVU2026_Oct_nonQPP.csv, line 8,063 (RVU26D)
Geographic factors for ModestoGPCI2026.csv, line 16 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet