CPT 72192Radiology

Ct pelvis w/o dye

CPT code 72192 is for a CT scan of the pelvis performed without using contrast dye (the special liquid that helps certain tissues show up better on imaging).

Showing rates for

National Average

Base Medicare rate

$131.00

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

1.09

PE RVU (NF)

2.9

MP RVU

0.06

Total RVU

4.05

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

NCCI bundling edits

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Billing tips

Verify whether study is truly non-contrast before coding - if any contrast was administered, use 72193 (with contrast) or 72194 (without and with contrast) instead
Impact: Prevents $30-80 in lost revenue from undercoding and avoids fraud allegations from overcoding
Split bill between 26 and TC modifiers when appropriate - facility bills TC, radiologist bills 26 separately
Impact: Ensures both parties receive appropriate payment from the total $131 Medicare rate
Document medical necessity clearly - specify why non-contrast study is appropriate (e.g., kidney stone protocol, contrast allergy, renal insufficiency)
Impact: Reduces denial rate by 40-60% according to radiology billing audits
Use specific ICD-10 codes linking to pelvic pathology rather than generic symptoms when possible
Impact: Improves first-pass approval rate and reduces medical necessity denials
Check LCD/NCD requirements for your MAC - some require prior authorization for non-emergent pelvic CT studies
Impact: Prevents complete denial of $131 payment for lack of authorization
When billing same-day with abdominal CT (74150-74178), ensure distinct anatomic areas are documented to support modifier 59 if needed
Impact: Prevents bundling that could result in loss of entire $131 reimbursement

Common denials

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Frequently asked questions

What is the Medicare reimbursement rate for CPT 72192 in 2025?

The 2025 Medicare national average reimbursement for CPT 72192 is $131 for both facility and non-facility settings. This is based on a total RVU of 4.05 multiplied by the 2025 conversion factor of 32.3465. Local rates may vary based on geographic adjustments.

What is the difference between CPT 72192 and 72193?

CPT 72192 is for CT pelvis without contrast material, while 72193 is for CT pelvis with contrast material. The key difference is whether intravenous contrast dye is administered. Code selection must match the actual procedure performed, as documented in the radiology report.

Can CPT 72192 and 74177 be billed together?

Yes, but documentation must clearly support imaging of distinct anatomic areas. Code 74177 is for CT abdomen and pelvis without contrast. If a complete abdomen/pelvis study was performed, use 74176 or 74177, not separate codes. Only bill both when truly separate limited studies of different regions are performed with distinct clinical indications.

Does CPT 72192 require prior authorization?

Prior authorization requirements vary by payer and MAC jurisdiction. Many commercial payers and Medicare Advantage plans require pre-authorization for non-emergent CT studies. Original Medicare generally does not require prior auth but does review for medical necessity. Always verify with the specific payer before scheduling.

How many RVUs is CPT code 72192 worth?

CPT 72192 has a total of 4.05 RVUs in 2025, consisting of 1.09 work RVUs, 2.9 practice expense RVUs (both facility and non-facility), and 0.06 malpractice RVUs according to the CMS Physician Fee Schedule.

What diagnosis codes support medical necessity for CPT 72192?

Common supporting diagnoses include urinary calculi (N20-N23), acute pelvic pain (R10.2), hematuria (R31), pelvic trauma (S30-S39), post-operative complications, diverticulitis (K57), appendicitis evaluation, and suspected masses. The diagnosis must clinically justify why non-contrast pelvic imaging is appropriate.

Can CPT 72192 be billed with modifier 26 for professional component only?

Yes, radiologists typically bill CPT 72192-26 for the professional component (interpretation and report) when the technical component is performed at a facility that bills separately. The facility bills 72192-TC for the technical component. The combined payments equal the global $131 rate.