CPT 72194 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 | Moderate |
| Medicare Fee Schedule | View Medicare rates for 72194 |
National average reimbursement for CPT 72194 by major payers:
$302.40
$354.46
$369.67
$434.03
| 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 72194 | ||||||
United | 72194 | $504.36 | 1073672192 - RADIOLOGY ASSOCIATES OF NORTH TEXAS PA | 751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PA | TX | Body Imaging Physician (2085B0100X) |
United | 72194 | $157.00 | 1831488519 - NEAL DESAI | 751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PA | TX | Vascular & Interventional Radiology Physician (2085R0204X) |
United | 72194 | $688.19 | 1912986944 - JACQUELINE EUBANY | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | CA | Clinical Cardiac Electrophysiology Physician (207RC0001X) |
United | 72194 | $103.19 | 1962764704 - ANITA VINJIRAYER | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | TX | Anesthesiology Physician (207L00000X) |
United | 72194 | $157.00 | 1053439935 - GREGORY POE | 751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PA | TX | Diagnostic Radiology Physician (2085R0202X) |
United | 72194 | $103.19 | 1669764924 - DAVID DELMAN | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | OR | Neurology Physician (2084N0400X) |
United | 72194 | $103.19 | 1275508863 - JEANINE THOMAS | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Hospitalist Physician (208M00000X) |
United | 72194 | $181.91 | 1619207008 - SHARITA NAGARAJ | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | NY | Surgery Physician (208600000X) |
United | 72194 | $53.06 | 1346650942 - JACK SHORT | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AR | Critical Care Medicine (Internal Medicine) Physician (207RC0200X) |
United | 72194 | $99.57 | 1255478004 - CHRISTOPHER RAIO | 111888924 - GOOD SAMARITAN HOSPTIAL MEDICAL CENTER | NY | Emergency Medicine Physician (207P00000X) |
United | 72194 | $53.06 | 1255726386 - SURAJUDEEN BOLARINWA | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | DC | Adult Reconstructive Orthopaedic Surgery Physician (207XS0114X) |
United | 72194 | $585.00 | 1508150988 - RICHARD HOLT | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Physical Medicine & Rehabilitation Physician (208100000X) |
United | 72194 | $504.36 | 1124286737 - JOSHUA MARTIN | 751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PA | TX | Diagnostic Radiology Physician (2085R0202X) |
United | 72194 | $143.95 | 1366428401 - AARON ASKEW | 931261079 - THE ORTHOPEDIC AND NEUROSURGICAL CENTER OF THE CASCADES | OR | Orthopaedic Trauma Physician (207XX0801X) |
United | 72194 | $103.19 | 1881361780 - BRIANNE SNIDER | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | WI | Occupational Therapist (225X00000X) |
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 72194 vs. Other Diagnostic Radiology (Diagnostic Imaging) Procedures Codes
The CPT 72194 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 72194 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 |
|---|---|---|
| 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 |
| 72194-CPT | Moderate | Ct Pelvis;W/O,Then W/Contrast Mater |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 72194. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 72194 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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