$255.34
Choose 72195 for a pelvic MRI without contrast; 72196 is for a study performed with contrast.
On this page
CMS RVU26D · Effective 2026-10-01
72195 Pelvic MRI Medicare reimbursement rates in Utah
MRI of the pelvis without contrast is reported for diagnostic evaluation of pelvic organs, soft tissues, or bones when the ordered imaging protocol uses no contrast. Compare 72195 office and facility rates across CMS payment localities in Utah.
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.
What does Medicare pay for 72195 in Utah?
Utah has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$216.53
1 of 1 localities have a supported rate.
Payment area: Utah
One mapped payment locality.
Facility setting
No supported rate
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Radiology
About 72195: Pelvic MRI without contrast
MRI of the pelvis without contrast is reported for diagnostic evaluation of pelvic organs, soft tissues, or bones when the ordered imaging protocol uses no contrast.
This service uses magnetic resonance imaging to create diagnostic images of the pelvis without administered contrast. A technologist typically performs the scan in an imaging department or hospital, and a radiologist interprets the images. Common clinical questions include the evaluation of pelvic pain, a suspected pelvic mass, or other pelvic soft-tissue or bony findings when a noncontrast protocol is appropriate.
Select this code when the completed study covers the pelvis and is performed without contrast; use the documented imaging protocol to distinguish it from a study performed with contrast or both without and with contrast. The order and report should support the pelvic region examined and contrast status. The service may be billed globally, or the interpretation may be reported with modifier 26 and the equipment and staff service with modifier TC. The diagnostic imaging multiple procedure reduction applies to both the technical and professional components.
CMS billing rules for 72195
- 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 RVU1.42 · 21%
- Practice expense (office) RVU5.30 · 78%
- Malpractice RVU0.09 · 1%
99.3K
Medicare services in 2024 · #560 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.
72195 compared with similar codes
Office rates for Utah, from the same CMS release.
$318.37
Choose 72197 when the study includes imaging both without and with contrast. 72195 is limited to the noncontrast protocol.
$126.67
72192 is CT of the pelvis without contrast. 72195 is MRI of the pelvis without contrast; select based on the modality performed.
$319.20
72198 describes MR angiography of the pelvis, used for vascular imaging. 72195 is a pelvic MRI rather than an angiographic study.
Compare 72195 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Utah →
Office / nonfacility
$216.53
Facility
Unavailable
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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 72195 in Utah.
PPRRVU2026_Oct_nonQPP.csv
8,060
- Code
- 72195
- Physician work
- 1.42
- Practice expense
- 5.30
- Malpractice
- 0.09
GPCI2026.csv
104
- Locality
- Utah
- Physician work
- 1.000
- Practice expense
- 0.940
- Malpractice
- 0.898
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.42 | × 1.000 | 1.4200 |
| Practice expense | 5.30 | × 0.940 | 4.9820 |
| Malpractice | 0.09 | × 0.898 | 0.0808 |
| Total RVUs | 6.4828 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Utah$216.53
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.42 | 1 |
| Practice expense | 5.3 | 0.94 |
| Malpractice | 0.09 | 0.898 |
(1.42 × 1 + 5.3 × 0.94 + 0.09 × 0.898) × $33.4009 = $216.53
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.
72195 billing questions
How does this differ from 72196?
72195 describes a pelvic MRI performed without contrast. Use 72196 when contrast is administered for the study.
When is 72197 used instead?
72197 is for a pelvic MRI performed first without and then with contrast. Do not use 72195 for that combined protocol.
Can the interpretation and scan be billed separately?
Yes. Modifier 26 identifies the professional interpretation, and modifier TC identifies the technical service. Without either modifier, the claim represents the global service.
Does the multiple procedure reduction affect only the technical service?
No. The diagnostic imaging multiple procedure reduction applies to both the technical and professional components.
What documentation supports reporting 72195?
The imaging order and report should identify the pelvis as the region examined and show that the study was performed without contrast.
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.
8,05772194,,Ct pelvis w/o & w/dye,A,,1.19,6.22,,6.22,NA,0.09,7.50,7.50,1,XXX,0.00,0.00,0.00,4,0,0,0,0,9,,33.4009,09,0,88,5.77,5.77,0.09
8,05872194,26,Ct pelvis w/o & w/dye,A,,1.19,0.42,,0.42,,0.07,1.68,1.68,1,XXX,0.00,0.00,0.00,4,0,0,0,0,9,,33.4009,09,0,88,0.00,0.00,0.00
8,05972194,TC,Ct pelvis w/o & w/dye,A,,0.00,5.80,,5.80,NA,0.02,5.82,5.82,1,XXX,0.00,0.00,0.00,4,0,0,0,0,9,,33.4009,02,0,88,5.35,5.35,0.02
8,06072195,,Mri pelvis w/o dye,A,,1.42,5.30,,5.30,NA,0.09,6.81,6.81,1,XXX,0.00,0.00,0.00,4,0,0,0,0,9,,33.4009,09,0,88,7.78,7.78,0.10
8,06172195,26,Mri pelvis w/o dye,A,,1.42,0.51,,0.51,,0.07,2.00,2.00,1,XXX,0.00,0.00,0.00,4,0,0,0,0,9,,33.4009,09,0,88,0.00,0.00,0.00
8,06272195,TC,Mri pelvis w/o dye,A,,0.00,4.79,,4.79,NA,0.02,4.81,4.81,1,XXX,0.00,0.00,0.00,4,0,0,0,0,9,,33.4009,01,0,88,7.27,7.27,0.03
8,06372196,,Mri pelvis w/dye,A,,1.69,6.22,,6.22,NA,0.12,8.03,8.03,1,XXX,0.00,0.00,0.00,4,0,0,0,0,9,,33.4009,09,0,88,11.21,11.21,0.15
10104412,TX,15,GALVESTON,1.008,0.993,0.828
10204412,TX,18,HOUSTON,1.008,0.993,1.376
10304412,TX,99,REST OF TEXAS,1.000,0.949,0.903
10403502,UT,09,UTAH,1.000,0.940,0.898
10514512,VT,50,VERMONT,1.000,0.990,0.506
10611302,VA,00,VIRGINIA,1.000,0.983,0.706
10709202,VI,50,VIRGIN ISLANDS,1.000,1.011,0.985