Imaging · Hip

Radiologic examination of the pelvis requiring a minimum of three separate views, capturing the pelvic bones, hip joints, and surrounding structures.

Verified May 8, 2026 · 5 sources ↓

Medicare: $43.42
Total RVUs: 1.3
Global, days
Region: Hip

Drawn from PcgsoftwareCMSGenhealth

Documentation requirements

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

Source · Editorial brief grounded in 5 cited references ↓

Operative or clinical note must specify that a minimum of three views were obtained — not just 'pelvic X-ray series'
Imaging report must document each view by name (AP, lateral, oblique, inlet, outlet, Judet, etc.)
Indication for the study must be documented and supported by a diagnosis code consistent with pelvic imaging
For split billing (modifier 26/TC), the interpreting physician's signed report must be dated and timed separately from the technical acquisition
IDTF settings require documentation of supervising physician credentials and technologist qualifications on file
For repeat same-day imaging, medical necessity rationale must be documented to support modifier 76 or 77

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

What this code covers

Source · Editorial summary grounded in 5 cited references ↓

CPT 72190 covers a complete pelvic X-ray series — minimum three views. That view-count threshold is the critical distinction from 72170, which covers one to two views. When a radiologist orders or performs a full pelvic study, 72190 is the correct code; 72170 is not an add-on or companion — billing both on the same date is an NCCI bundling error since 72190 is the upcoded, comprehensive version.

The code sits in the Diagnostic Radiology family for spine and pelvis imaging. It applies across a range of clinical scenarios: trauma workups (pelvic ring fractures, acetabular fractures), post-operative surveillance after hip or pelvic surgery, evaluation of arthritis or avascular necrosis, and oncologic staging. Top billing specialties per CMS PUF data are Diagnostic Radiology, Orthopedic Surgery, and Portable X-Ray Suppliers — the last reflecting high-volume SNF and inpatient portable studies.

Global period is XXX (not a surgical service). When the interpreting radiologist and the imaging facility are separate entities, split billing applies: modifier 26 for the professional component (interpretation and report) and modifier TC for the technical component (equipment, technologist, film). A physician who both performs and interprets in a fully owned facility bills the global code with no modifier. IDTFs billing 72190 must supervise interpretation with a board-certified radiologist or neurologist and use a credentialed general radiographer or medical physicist for the technical component.

RVU & reimbursement

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

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU	0.24
Practice expense RVU	1.03
Malpractice RVU	0.03
Total RVU	1.3
Medicare national rate	$43.42
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	$43.42
HOPD (APC 5522) Hospital outpatient department	$106.81

Common denial reasons

The recurring reasons claims for CPT 72190 get rejected.

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

Billing 72190 and 72170 together on the same date — 72190 bundles 72170 and the edit will reject the lesser code
Fewer than three views documented in the radiology report — downcodes to 72170 on audit
Missing or unsigned radiology interpretation report when billing modifier 26
Diagnosis code does not support pelvic imaging (ICD-10 mismatch triggers medical necessity denial)
Modifier 91 appended to a repeated pelvic X-ray — 91 is a lab repeat modifier and is invalid on imaging codes; use 76 or 77 instead

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 5 cited references ↓

01What separates 72190 from 72170?

View count. 72170 covers one to two views of the pelvis. 72190 requires a minimum of three views. The distinction must be explicit in the radiology report — listing each view by name, not just noting 'complete study.'

02Can I bill 72170 and 72190 together on the same date?

No. 72190 is the comprehensive code and bundles 72170 under NCCI edits. Submitting both will result in rejection of 72170. Bill only 72190 when three or more views are obtained.

03When should I use modifier 26 versus TC versus no modifier on 72190?

Use modifier 26 when a radiologist interprets images acquired by a separate facility. Use TC when the facility provides equipment and technologist services but a separate physician reads the study. Bill globally (no modifier) only when one entity owns the equipment and the interpreting physician — common in private office or clinic settings.

04Is 72180 still a valid code?

No. CPT 72180 was deleted in 1997. Any claim submitted with 72180 will reject. If you encounter it in older charge masters or templates, replace it with 72190 (three or more views) or 72170 (one to two views) depending on what was actually performed.

05What modifier applies if the same pelvic X-ray series is repeated the same day by the same provider?

Use modifier 76 for a repeat procedure by the same physician on the same day. Use modifier 77 if a different physician repeats the study. Document the medical necessity for the repeat in the clinical record — equipment malfunction alone is not sufficient justification.

06Does 72190 have a global period?

The global period for 72190 is XXX, meaning global surgery rules do not apply. There is no pre- or post-operative period attached. Each imaging encounter is billed independently.

07What are the IDTF requirements for billing 72190?

Per CMS Article A58559, IDTFs must have a board-certified radiologist or neurologist supervise interpretation and use a credentialed general radiographer or medical physicist for the technical component. Missing either credential on file is a compliance risk at audit.

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 pelvic views obtained, the named projections documented in the operative or clinical note, and the clinical indication driving the imaging order. That data automatically flags if the note supports 72190 (three or more views) versus 72170 (one to two views) before the claim drops — preventing the most common audit downcode on pelvic X-ray series.

See how Mira captures CPT 72190 documentation