CPT 72170 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | • Radiology Procedures • Diagnostic Radiology (Diagnostic Imaging) Procedures |
| Common Place of Service | • 11 - Office • 23 - Emergency Room |
| Common Modifiers | • None • 26 - Professional component • TC - Technical component |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 72170 |
National average reimbursement for CPT 72170 by major payers:
$35.48
$33.26
$36.49
$42.24
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 72170 | ||||||
United | 72170 | $6.30 | 1306841119 - VICTOR TORRES | 593081973 - (FL) LAKE HEALTH CARE CENTER INC | FL | Foot & Ankle Surgery Podiatrist (213ES0103X) |
United | 72170 | $78.16 | 1871955591 - REGINA FIACCO | 204985038 - (AK) MEDICAL NETWORK OF ALASKA, LLC | AK | Foot & Ankle Surgery Podiatrist (213ES0103X) |
United | 72170 | $6.42 | 1053986380 - VICTORIA NOLTE | 270492585 - (FL) CERTIFIED FOOT ANKLE SPECIALISTS | MD | Podiatrist (213E00000X) |
United | 72170 | $19.46 | 1144430125 - BENJAMIN BROWN | 720276883 | LA | Neurological Surgery Physician (207T00000X) |
United | 72170 | $29.60 | 1689806465 - PAUL RICHARD | 650703990 - (FL) NEUROSCIENCE & SPINE ASSOCIATES | FL | Neurological Surgery Physician (207T00000X) |
United | 72170 | $11.77 | 1386903805 - MARILYN HENG | 592579938 - UNIVERSITY OF MIAMI | FL | Orthopaedic Trauma Physician (207XX0801X) |
United | 72170 | $22.00 | 1548451040 - WILLIAM KUHN | 910655392 - KADLEC REGIONAL MEDICAL CENTER | FL | Neurological Surgery Physician (207T00000X) |
United | 72170 | $14.60 | 1588634968 - CITRUS PODIATRY CENTER PA | 593055043 - (FL) CITRUS PODIATRY CENTER PA | FL | Podiatrist (213E00000X) |
United | 72170 | $35.72 | 1164427878 - SETH GASSER | 592929608 - (FL) MUSCULOSKELETAL INSTITUTE INC. FLORIDA ORTHOPAEDIC INSTITUTE | FL | Sports Medicine (Orthopaedic Surgery) Physician (207XX0005X) |
United | 72170 | $119.08 | 1285020446 - REBECCA REYNOLDS | 426004813 | IA | Neurological Surgery Physician (207T00000X) |
United | 72170 | $20.40 | 1356621130 - JOHNATHAN THOMPSON | 261111426 - (MS) ORTHOONE ORTHOPAEDICS & SPORTS MEDICINE, PLLC | GA | Orthopaedic Trauma Physician (207XX0801X) |
United | 72170 | $20.93 | 1356574651 - DOCK ANDERSON | 451154796 | FL | Foot & Ankle Surgery Podiatrist (213ES0103X) |
United | 72170 | $31.77 | 1982259461 - MAURICIO MANDEL BRIGIDO | 260089066 | FL | Neurological Surgery Physician (207T00000X) |
United | 72170 | $39.86 | 1184049827 - ELIZABETH DAVIS | 273846421 - FOOT AND ANKLE SPECIALISTS OF THE MID ATLANTIC, LLC | NC | Foot & Ankle Surgery Podiatrist (213ES0103X) |
United | 72170 | $6.67 | 1508847500 - KENNETH VIVES | 50531835 - (FL) NEUROSURGERY SPINE SPECIALISTS | FL | Neurological Surgery Physician (207T00000X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 72170 vs. Other Diagnostic Radiology (Diagnostic Imaging) Procedures Codes
The CPT 72170 code is part of the Radiology Procedures services used for Diagnostic Radiology (Diagnostic Imaging) Procedures. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 72170 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 72170-CPT | Low | Radiologic Examination, Pelvis; Anteroposterior Only |
| 72190-CPT | Low | X-Ray Pelvis;Complete Minimum Of 3 Views |
| 72191-CPT | Moderate | Computed Tomographic Angiography, Pelvis, With Contrast Material(S), Including Noncontrast Images, If Performed, And Image Postprocessing |
| 72192-CPT | Low | Ct Pelvis; W/O Contrast Material |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 72170. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 72170 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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