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See a sample rate comparisonCPT 72197 Fee Schedule
Medicare rates as of October 2026
CPT 72197 is classified under Radiology Procedures, in the Diagnostic Radiology (Diagnostic Imaging) Procedures subgroup.
Mri Of Pelvis, An Mri (Magnetic Resonance Imaging) Uses A Strong Magnetic Field To View And Create Images Of The Pelvis. A Contrast Agent Is Introduced To Highlight Areas. Multiple Images Are Taken.
| 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 | 26 - Professional component TC - Technical component |
| Complexity Level | Moderate |
| Medicare Fee Schedule | $334.34 national non-facility rate (2026) · View Medicare rates for 72197 |
| Medicaid Fee Schedule | $275.61 median of the 8 states in the free preview · View Medicaid rates for 72197 |
National average reimbursement for CPT 72197 by major payers:
$447.27
BCBS / Anthem
$644.73
UnitedHealthcare
$635.75
Aetna
$701.21
Cigna
Compare published rates across providers.
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CPT 72197
5 of 25 sample ratesHigher to lower in this preview
Henry Smith
$977.21Published rateTerry Wolf
$544.41Published rateStephen Back
$406.54Published rateOm Imaging PLLC
$308.77Published rateDean Fullingim
$91.80Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 72197 vs. Other Diagnostic Radiology (Diagnostic Imaging) Procedures Codes
The table lists codes related to 72197. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| 72195-CPT | Moderate | Mri Of The Pelvis, An Mri (Magnetic Resonance Imaging) Uses A Strong Magnetic Field To View And Create Images Of The Pelvis. A Contrast Agent May Be Introduced To Highlight An Area. Multiple Images May Be Taken. |
| 72196-CPT | Moderate | Mri Of The Pelvis, An Mri (Magnetic Resonance Imaging) Uses A Strong Magnetic Field To View And Create Images Of The Pelvis. A Contrast Agent May Be Introduced To Highlight An Area. Multiple Images May Be Taken. |
| 72197-CPT | Moderate | Mri Of Pelvis, An Mri (Magnetic Resonance Imaging) Uses A Strong Magnetic Field To View And Create Images Of The Pelvis. A Contrast Agent Is Introduced To Highlight Areas. Multiple Images Are Taken. |
| 72198-CPT | Moderate | Mra Of Blood Vessels In Pelvis, An Mr (Magnetic Resonance) Angiogram Is A Detailed Image Of Blood Flow And Blood Vessels In The Pelvis. A Contrast Agent May Be Injected To Make The Area Easier To See. Multiple Images May Be Taken. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 72197. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 72197 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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Frequently Asked Questions
CPT stands for Current Procedural Terminology. CPT codes are a set of medical codes used by physicians, hospitals, and other healthcare providers to describe the services and procedures they provide to patients. They are essential for accurate billing and record-keeping.
Finding the exact cost of a medical procedure can be complex due to varying insurance plans, provider fees, and geographic locations. For the most accurate information tailored to your specific situation, it's best to contact your healthcare provider directly or your insurance company. For a fee schedule lookup tool based on CPT codes and your specific location, you can use services like Payerprice.
To find healthcare service prices for a specific CPT code and your location, you can utilize tools like Payerprice. Payerprice offers a fee schedule lookup tool that allows users to search for prices based on CPT codes and specific geographical areas, providing a more localized and detailed estimate than general resources.
Healthcare pricing transparency is challenging due to several factors, including the complexity of insurance contracts, varying negotiation rates between providers and insurers, the bundling of services, and the lack of a standardized national pricing system. The final cost can also depend on your specific insurance plan's deductibles, co-pays, and out-of-pocket maximums.
The cost of a medical service is influenced by numerous factors, including the type and complexity of the procedure, the healthcare provider's fees, the facility where the service is performed (e.g., hospital vs. outpatient clinic), geographic location, your insurance coverage and negotiation agreements, and whether the provider is in-network or out-of-network.