MRI of the pelvis performed with contrast only, used for bone, joint, and soft tissue questions in the pelvic region.
- Medicare
- $268.21
- Work RVU
- 1.69
- Global, days
- Region
- Hip
Documentation requirements
What must appear in the operative or office note to support the claim.
Source · Editorial brief grounded in 3 cited references ↓
- Indication: tumor, infection, bilateral osteonecrosis, or pelvic fracture
- Field of view: whole pelvis versus single hip
- Report confirming contrast-only sequences
- Gadolinium agent and dose
- Authorization number
Applicable modifiers
Modifiers commonly billed with this code.
Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual
What this code covers
Source · Editorial summary grounded in 3 cited references ↓
72196 is pelvic MRI with contrast only, no separate non-contrast set. Like other contrast-only MRI codes, it is less common than the without-and-with version (72197). If the report shows both phases, 72197 is correct.
Orthopedic uses for pelvic MRI include sacral and pelvic insufficiency fractures, osteonecrosis of both femoral heads, pelvic bone tumors, and infection. Contrast is mostly for tumor or infection. Note the difference between pelvis MRI and hip joint MRI: a study focused on one hip joint is coded with the lower extremity joint MRI codes (73721 to 73723). A wide field pelvis study that covers both hips and the pelvic bones uses 72195 to 72197.
MR arthrography of the hip is coded with the lower extremity joint codes plus the injection, not with pelvis codes. Authorization, gadolinium supply billing, and renal screening rules work the same as other contrast MRI.
RVU & reimbursement
Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.
Source · CMS Physician Fee Schedule, RVU26A · January 2026
Work RVU vs. total RVU
The work RVU (1.69) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (8.03) adds practice overhead and malpractice, and is what drives the Medicare payment below.
| Work RVU | 1.69 |
| Practice expense RVU | 6.22 |
| Malpractice RVU | 0.12 |
| Total RVU | 8.03 |
| Medicare national rate | $268.21 |
| Global period | days |
Payment by site of service
Medicare pays different rates by setting. HOPD typically pays substantially more than ASC for the same procedure.
Source · CMS OPPS Addendum B·ASC HCPCS payment rates·2026
| Setting | Medicare rate (national) |
|---|---|
Office (PFS non-facility) Procedure performed in physician's office | $268.21 |
HOPD (APC 5572) Hospital outpatient department | $356.43 |
Common denial reasons
The recurring reasons claims for CPT 72196 get rejected.
Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓
- Single hip study coded as pelvis MRI
- Both phases performed but contrast-only code billed
- Authorization for a different MRI code
- No reason given for contrast
- Hip arthrogram coded as pelvis MRI
Frequently asked questions
Source · Generated from the editorial pipeline, verified against 3 cited references ↓
01Is hip MRI coded as pelvis MRI?
02What is the difference between 72196 and 72197?
03How is a hip MR arthrogram coded?
Sources & references
Editorial content was developed using the following public sources.
Mira Scribe
Mira Scribe notes describe whether the concern is one hip or the whole pelvis and why contrast is needed, so the right MRI code gets ordered and billed.
See how Mira captures CPT 72196 documentation