Billing code 72196: MRI pelvisMedicare rate & RVUs in Kansas
Report this code for a pelvic MRI performed with contrast when the examination does not include both precontrast and postcontrast imaging.
Medicare pays $246.28 for 72196 in the office in Kansas (Kansas). Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 72196 covers
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.
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 in Kansas
| Payment locality | Office | Facility |
|---|---|---|
| Kansas | $246.28 | Unavailable |
How the 72196 rate is calculated
Each of 72196’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 · 72196
RVUs × geographic indexes × conversion factor
Work1.69
1.69 RVUs× 1.000 GPCI
Practice expense6.22
6.22 RVUs× 1.000 GPCI
Malpractice0.12
0.12 RVUs× 1.000 GPCI
Adjusted RVUs
8.0300
Conversion factor
$33.4009
Medicare rate
$268.21
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 72196
The CMS indicators that decide how 72196 is paid alongside other services.
CMS payment indicators · 72196
MRI pelvis
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| Multiple procedures | 4 | Diagnostic imaging reduction applies to the technical component (and professional component) of additional services. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 1 | Diagnostic test with separate professional (26) and technical (TC) components. |
What modifiers do to the payment
Modifier 26 · payment effect
With and without the modifier
72196 without 26 · national office
$268.21
MRI pelvis
72196-26 · Professional component
$79.49
Pays only the interpretation and report.
72196 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 72195Pelvic MRI
- 72195 is for pelvic MRI without contrast. Use 72196 when contrast is used for the examination.
- 72197MRI pelvis
- 72197 includes pelvic MRI before and after contrast; 72196 is for the contrast-only examination.
- 72193Pelvic CT
- 72193 describes pelvic CT with contrast, not MRI. The modality documented in the imaging report determines which code applies.
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 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
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