CPT 72190 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 • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • 26 - Professional component • TC - Technical component |
| Complexity Level | Low |
National average reimbursement for CPT 72190 by major payers:

$52.72

$46.60

$53.16

$60.95
| 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 72190 | ||||||
United | 72190 | $30.87 | 1073502985 - CHU CHEN | 42484572 - (MA) MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC. | MA | Pediatrics Physician (208000000X) |
United | 72190 | $49.49 | 1447576319 - ELIZABETH WESTEN | 200362623 - SLOCUM DICKSON MEDICAL GROUP PLLC | NY | Maternal & Fetal Medicine Physician (207VM0101X) |
United | 72190 | $14.34 | 1104098631 - HELEN DOLAN | 200362623 - SLOCUM DICKSON MEDICAL GROUP PLLC | NY | Family Nurse Practitioner (363LF0000X) |
United | 72190 | $63.72 | 1861456444 - SCOTT PEPLINSKI | 200362623 - SLOCUM DICKSON MEDICAL GROUP PLLC | NY | Diagnostic Radiology Physician (2085R0202X) |
United | 72190 | $63.72 | 1245996628 - NANCY WALLACE | 200362623 - SLOCUM DICKSON MEDICAL GROUP PLLC | NY | Family Nurse Practitioner (363LF0000X) |
United | 72190 | $32.04 | 1588379333 - KAREN ALLARD | 200362623 - SLOCUM DICKSON MEDICAL GROUP PLLC | NY | Family Nurse Practitioner (363LF0000X) |
United | 72190 | $35.15 | 1124627674 - LAUREN PLATT | 200362623 - SLOCUM DICKSON MEDICAL GROUP PLLC | NY | Medical Physician Assistant (363AM0700X) |
United | 72190 | $15.97 | 1225034457 - ANA BOTERO | 471859521 - (FL) BAPTIST HEALTH MEDICAL GROUP ONCOLOGY LLC | FL | Radiation Oncology Physician (2085R0001X) |
United | 72190 | $36.16 | 1942643754 - MONICA CHATWAL | 593238640 - H LEE MOFFITT CANCER CTR & RES INST LIFE TIME CANCER SCRN CTR INC | GA | Student in an Organized Health Care Education/Training Program (390200000X) |
United | 72190 | $30.73 | 1235793340 - MORGAN MCBRIDE | 593238640 - H LEE MOFFITT CANCER CTR & RES INST LIFE TIME CANCER SCRN CTR INC | FL | Physician Assistant (363A00000X) |
United | 72190 | $36.15 | 1952331654 - ALBERTO CHIAPPORI | 593238640 - H LEE MOFFITT CANCER CTR & RES INST LIFE TIME CANCER SCRN CTR INC | FL | Medical Oncology Physician (207RX0202X) |
United | 72190 | $17.46 | 1942643754 - MONICA CHATWAL | 593238640 - H LEE MOFFITT CANCER CTR & RES INST LIFE TIME CANCER SCRN CTR INC | GA | Student in an Organized Health Care Education/Training Program (390200000X) |
United | 72190 | $45.59 | 1437696408 - DANIELLE LASKOWITZ | 593238640 - H LEE MOFFITT CANCER CTR & RES INST LIFE TIME CANCER SCRN CTR INC | FL | Physician Assistant (363A00000X) |
United | 72190 | $32.04 | 1164469755 - NATHANIEL GOULD | 200362623 - SLOCUM DICKSON MEDICAL GROUP PLLC | NY | Physical Medicine & Rehabilitation Physician (208100000X) |
United | 72190 | $32.04 | 1437562451 - ALEXANDER HARRIS | 200362623 - SLOCUM DICKSON MEDICAL GROUP PLLC | NY | Ophthalmology Physician (207W00000X) |
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 72190 vs. Other Diagnostic Radiology (Diagnostic Imaging) Procedures Codes
The CPT 72190 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 72190 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 72190. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 72190 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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