CPT 72191Radiology

Ct angiograph pelv w/o&w/dye

CPT 72191 is a specialized CT scan of the pelvic blood vessels that uses contrast dye injected twice—once without dye and once with dye—to create detailed images of arteries and veins in the pelvis.

Showing rates for

National Average

Base Medicare rate

$299.85

This calculator gives a typical-case estimate using standard Medicare modifier rules. Actual payment depends on payer policies, documentation, code-specific CMS status indicators, and locality. Verify before billing.

RVU breakdown

Work RVU

1.81

PE RVU (NF)

7.33

MP RVU

0.13

Total RVU

9.27

Conversion factor: 32.3465 · Source: CMS MPFS RVU25A · Confidence: High

NCCI bundling edits

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Billing tips

Ensure documentation clearly specifies both non-contrast and post-contrast phases were acquired; many denials occur when only 'with and without contrast' is documented without phase-specific imaging descriptions
Impact: Prevents downcoding to 72192 (non-contrast only at $183.18) or 72193 (contrast only), protecting $116.67-$299.85 in revenue
Verify medical necessity with appropriate ICD-10 codes such as vascular disease, tumor evaluation, or preoperative planning; routine screening is not covered
Impact: Reduces denial rate by 30-40% and eliminates costly appeals process
When billing globally, do not append modifier 26 or TC; only use component modifiers when services are split between professional and technical providers
Impact: Ensures full $299.85 payment instead of reduced component-only reimbursement
Check for bilateral lower extremity CTA (75635) performed same day; if pelvis is included as part of runoff study, 72191 may be considered bundled
Impact: Prevents $299.85 denial and potential fraud flags; use comprehensive runoff codes when appropriate
Document contrast volume, rate, and timing protocols specific to angiographic imaging; standard CT contrast protocols may not support medical necessity for CTA code
Impact: Reduces audit risk and supports higher-value CTA code versus standard CT pelvis codes
Bill on same date of service as the scan performance, not the interpretation date, unless delayed wet-read exception applies
Impact: Ensures timely filing and prevents administrative denials that delay payment by 30-60 days

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Frequently asked questions

What is the difference between CPT 72191 and 72193?

CPT 72191 requires both non-contrast and post-contrast imaging phases, while 72193 is performed with contrast only. Code 72191 reimburses at $299.85 compared to 72193's rate, and is appropriate when pre-contrast images are medically necessary to distinguish calcification from contrast enhancement or assess baseline vascular anatomy.

How much does Medicare pay for CPT 72191 in 2025?

Medicare pays $299.85 for CPT 72191 under the 2025 national average rate. This rate applies to both facility and non-facility settings. The code has a total RVU of 9.27 multiplied by the 2025 conversion factor of 32.3465.

Can CPT 72191 be billed with an abdominal CTA on the same day?

Generally yes, but only if there are distinct clinical indications for separate pelvic and abdominal vascular assessments. If part of a comprehensive vascular study, consider using code 74175 for combined CT angiography of abdomen and pelvis instead. Modifier 59 may be required if billing separately, with documentation supporting medical necessity for both studies.

What diagnosis codes support medical necessity for CPT 72191?

Common supporting ICD-10 codes include I74.5 (embolism/thrombosis of iliac artery), I77.0 (arteriovenous fistula), I71.4 (abdominal aortic aneurysm extending to iliac vessels), C76.3 (malignant neoplasm of pelvis requiring vascular mapping), and Z01.812 (preoperative examination for vascular assessment). Routine screening without symptoms is not covered.

Do I need modifier 26 or TC for CPT 72191?

Use modifier 26 only if you are billing for professional interpretation without owning the equipment. Use modifier TC if billing only for the technical component (equipment, technologist, supplies). If your practice provides both services (common in hospital-owned imaging centers), bill globally without any modifier to receive the full $299.85 reimbursement.

How many RVUs is CPT code 72191 worth?

CPT 72191 has a total of 9.27 RVUs for 2025, consisting of 1.81 work RVUs, 7.33 practice expense RVUs, and 0.13 malpractice RVUs. These RVU values are the same for both facility and non-facility settings.

What are common reasons for CPT 72191 claim denials?

The most common denials include lack of documented medical necessity for angiographic protocol, insufficient documentation of both pre- and post-contrast phases, bundling with other imaging studies performed the same day, and downcoding to standard pelvic CT codes when documentation does not clearly describe vascular-specific imaging protocols and findings.