CPT 72194
Global XXX ActiveCt pelvis w/o & w/dye
CPT 72194 Billing & Documentation Guide
CPT code 72194 (Ct pelvis w/o & w/dye) is classified under Radiology with a global period indicator of XXX. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 1.19, a non-facility practice expense RVU of 6.22, and a malpractice RVU of 0.09, a total non-facility RVU of 7.5 and facility RVU of 7.5. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $259.95, though rates vary from $219.76 to $345.31 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 72194, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 72194 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
No global period (E/M and other non-procedural services)
MUE Limit (Medically Unlikely Edits)
Submitting more than 1 units of 72194 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 72194
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 1.19 | 1.19 |
| Practice Expense RVU | 6.22 | 6.22 |
| Malpractice RVU | 0.09 | 0.09 |
| Total RVU | 7.5 | 7.5 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 72194
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $288.63 | $288.63 | $269.73 - $345.31 | 29 |
| Florida | $254.05 | $254.05 | $242.88 - $263.62 | 3 |
| Georgia | $241.6 | $241.6 | $228.65 - $254.55 | 2 |
| Illinois | $246.37 | $246.37 | $234.12 - $258.72 | 4 |
| Michigan | $239.06 | $239.06 | $232.82 - $245.3 | 2 |
| North Carolina | $235.5 | $235.5 | $235.5 - $235.5 | 1 |
| New York | $277.49 | $277.49 | $239.23 - $294.89 | 5 |
| Ohio | $232.46 | $232.46 | $232.46 - $232.46 | 1 |
| Pennsylvania | $246.82 | $246.82 | $233.31 - $260.32 | 2 |
| Texas | $247.29 | $247.29 | $231.6 - $262.29 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 72194
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 72194 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 0066T | Column 1 (primary), can be billed with modifier | 9 | CPT Manual or CMS manual coding instruction |
| 0067T | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 01922 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 0558T | Column 1 (primary), can be billed with modifier | Yes | CPT Manual or CMS manual coding instruction |
| 0708T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0709T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 36000 | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 36005 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 36011 | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 36406 | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
Frequently Asked Questions, CPT 72194
What does CPT code 72194 mean? +
CPT code 72194 represents: Ct pelvis w/o & w/dye. It's in the Radiology category with a global period of XXX.
What is the Medicare reimbursement for CPT 72194? +
The 2026 Medicare national average non-facility payment for CPT 72194 is $259.95. Rates range from $219.76 to $345.31 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 72194? +
Radiology codes rely heavily on the professional/technical split: modifier 26 (professional component only) and TC (technical component only). Also common: 50 (bilateral imaging), 76 (repeat by same physician), 77 (repeat by different physician), and LT/RT for laterality.
What bundling edits apply to CPT 72194? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
Get the full PayerReady toolkit
Free access to CPT/ICD-10 lookup, denial appeals, fee comparator, and claim auditing with credentialing enrollment.
Start free →Run this code through our claim audit tool
Check NCCI bundling, MUE limits, and modifier logic before submission.
Try the auditor →Did this page help?
Quick signal so we know what to improve.
If you want a code reference page that doesn't exist yet, email coding@payerready.com.
Tell us what's missing or wrong: coding@payerready.com. We respond within 5 business days.
Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
Powered by 11K CPT · 98K ICD-10 · 860K MPFS rates · 4.5M NCCI edits · 9.5M NPIs. Our data methodology · About our coding team