72195

Mri pelvis w/o dye

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Code typePrimary
Payment statusActive (A)
Global periodNone

Pricing with Related Codes

Line
Qty
Global fee
Pro fee
Primary72195Mri pelvis w/o dye
1
$227.46
$227.46
Add-on0649TQuan mr tiss w/mri 1orgn
0
$0.00/ unit
$0.00/ unit
Add-on0698TQuan mr tiss w/mri mlt orgn
0
$0.00/ unit
$0.00/ unit
Whole procedure · 1.42 wRVU credited
$227.46
$227.46
How these numbers were computed
  • status=CThis code is not separately payable under the Physician Fee Schedule (status C) — amounts shown are $0.

RVU Breakdown

Component
Office
Facility
Work
1.42
1.42
Practice expense
5.30
5.30
Malpractice
0.09
0.09
Total RVU
6.81
6.81

Payment Policy & Modifiers

Allowed adjustments
Multiple procedure MPPRApplies
Technical component of multiple diagnostic-imaging services reduced 50%. Add-on codes are exempt.
Assistant surgeon -80/81/8216% · documented
Assistant at surgery (mod 80/81/82) paid at 16% if medical necessity is documented.
Prof / tech split -26 / -TCSplit
Has professional (-26) and technical (-TC) components, each priced separately.
Not applicable to this code
Bilateral -50Co-surgeon -62Team surgeon -66