Imaging · Hip

Radiologic examination of the pelvis capturing one or two views, used to evaluate pelvic bones, sacrum, and coccyx for fractures, arthritis, or other structural abnormalities.

Verified May 8, 2026 · 7 sources ↓

Medicare: $28.06
Total RVUs: 0.84
Global, days
Region: Hip

Drawn from AAPCPcgsoftwareMdclarityCMSNIH

Documentation requirements

What must appear in the operative or office note to support the claim.

Source · Editorial brief grounded in 7 cited references ↓

Clinical indication in the order and report (fracture, pain, arthritis, trauma, pre-op planning, etc.)
Number of views obtained — must be 1 or 2 views to support 72170; 3+ views requires 72190
Anatomic structures included — confirm pelvis, hip bones, sacrum, and/or coccyx as applicable
Radiologist or supervising physician signature on the final interpretation report
Site of service and supervision level documented if billing at an IDTF
Laterality notation if modifier LT or RT is applied, though pelvis imaging is inherently bilateral

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

26 Professional component 52 Reduced services 59 Distinct service 76 Repeat, same physician 77 Repeat, another physician 78 Unplanned return — related 79 Unrelated during global

What this code covers

Source · Editorial summary grounded in 7 cited references ↓

CPT 72170 covers an anteroposterior (AP) pelvic X-ray — one or two views — ordered when a clinician needs a rapid structural survey of the pelvis, hip bones, sacrum, or coccyx. It is the go-to code for initial fracture screening, post-trauma surveys, pre-operative planning, and general pelvic pain workups in both office and emergency settings. When three or more views are obtained, step up to 72190.

Billing splits along technical and professional lines. Hospital outpatient departments and freestanding imaging centers bill the technical component (modifier TC); the interpreting radiologist bills the professional component (modifier 26). Physicians who own their equipment and perform their own reads bill the global service without either modifier. At an IDTF, CMS requires radiologist supervision and a technologist credentialed as ARRT R.T.-R.

For orthopedic practices, 72170 frequently appears same-day with hip or femur imaging codes. When a pediatric patient with hip pain is imaged using the standard pelvis protocol, 72170 is the correct code — the old 73540 (child hips) code is no longer valid. Understand the distinction between 72170 (1–2 views), 72190 (minimum 3 views complete study), and the deleted 72180 to avoid upcoding or downcoding errors.

RVU & reimbursement

Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU	0.17
Practice expense RVU	0.65
Malpractice RVU	0.02
Total RVU	0.84
Medicare national rate	$28.06
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	$28.06
HOPD (APC 5522) Hospital outpatient department	$106.81

Common denial reasons

The recurring reasons claims for CPT 72170 get rejected.

Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓

Upcoding to 72190 when only 1–2 views were taken — view count must match the billed code
Missing or unsigned interpretation report when billing modifier 26 or global service
Billing 72170 and 72190 on the same date without adequate documentation that separate, distinct studies were performed
Technical component billed by the professional group rather than the facility that owns the equipment
Lack of medical necessity documentation — order must state a specific clinical indication, not just 'imaging'

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 7 cited references ↓

01What is the difference between 72170 and 72190?

72170 covers 1 or 2 views of the pelvis. 72190 requires a minimum of 3 views and is considered the complete pelvic study. Bill based on the actual number of views obtained — audit teams cross-reference this against the imaging report.

02Can 72170 and 72190 be billed on the same date?

Rarely and with caution. If two genuinely separate, distinct pelvic studies were performed on the same day for different clinical indications, modifier 59 may apply. Routine same-day billing of both codes without separate orders and separate interpretations will trigger denial.

03When is modifier 26 required on 72170?

Bill modifier 26 when the physician reads and interprets the image but does not own the imaging equipment. The facility or equipment owner bills modifier TC. If the physician owns the equipment and performs the interpretation, bill the global code without either modifier.

04Is 72170 appropriate for pediatric bilateral hip imaging?

Yes. The old 73540 (child hips) code has been deleted. When a pediatric patient undergoes a standard AP pelvis protocol for hip pain evaluation, 72170 is the correct code. Do not use 73521 unless the study specifically includes pelvis plus bilateral hips with additional hip-specific views.

05What supervision and technician credentials does CMS require for 72170 at an IDTF?

CMS requires radiologist supervision and a technologist credentialed as ARRT R.T.-R (certified radiologic technologist in radiography). This is documented in the CMS Independent Diagnostic Testing Facility article A54953.

06Should modifier LT or RT be used with 72170?

Generally no — the pelvis is a bilateral structure and 72170 is not a lateralized code. Some Medicaid payers (such as Rhode Island's fee schedule) accept LT/RT on 72170, but for Medicare and most commercial payers these modifiers are not standard on pelvic AP imaging.

Sources & references

Editorial content was developed using the following public sources. Last verified May 8, 2026.

Mira AI Scribe

Mira's AI scribe captures the number of views obtained, the specific anatomic structures evaluated, the clinical indication driving the order, and any relevant findings dictated in the interpretation. This prevents the most common 72170 denial: a mismatch between the documented view count and the billed code, and ensures the interpretation report is complete enough to support modifier 26 billing without a secondary documentation request.

See how Mira captures CPT 72170 documentation