CPT 72191 Pelvic CT Angiography Reimbursement

CPT code 72191 represents pelvic computed tomographic angiography (CTA), a contrast-enhanced CT study that visualizes the arterial and venous vasculature of the pelvis with computerized image selection and reconstruction. Nationally, this imaging code matters for vascular diagnosis, preoperative planning, and emergency evaluation of pelvic bleeding or ischemia. Utilization patterns for pelvic CTA influence imaging capacity, contrast media use, and radiology workflow.

Key payers discussed in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of coverage considerations, typical sites of service, and operational implications for radiology departments and outpatient imaging centers. The publication summarizes reimbursement benchmarks where available, common billing modifiers used with advanced imaging services, and relevant clinical contexts in which pelvic CTA is commonly ordered (for example, assessment of pelvic trauma, vascular occlusive disease, and preprocedural mapping).

This national-level brief provides clinicians, billing professionals, and policy analysts with concise context on CPT code 72191, highlighting service definition, typical delivery settings, and the types of benchmarks and policy updates that affect coding and payment for pelvic CTA. Data not available in the input is noted where applicable.

Billing Code Overview

CPT code 72191 describes a computerized tomographic angiography (CTA) of the pelvic blood vessels. The procedure involves intravenous contrast administration, with optional noncontrast imaging, to visualize arterial and venous anatomy of the pelvis. After image acquisition, a computerized process selects and reconstructs the most relevant views for diagnostic interpretation.

Service type: Imaging — CT angiography (CTA)

Typical site of service: Outpatient imaging center, hospital radiology department, or ambulatory surgery center

Data not available in the input.

Clinical Context

A 68-year-old patient with progressive lower extremity claudication and known peripheral arterial disease is referred for vascular imaging to evaluate pelvic and proximal lower extremity arterial inflow. The patient presents to the outpatient radiology suite or hospital imaging department after a focused vascular exam and review of symptoms and prior noninvasive testing (e.g., ankle-brachial index, arterial Doppler ultrasound) that suggest iliac or pelvic arterial stenosis or occlusion. Intravenous contrast is administered unless contraindicated. The CT technologist performs a contrast-enhanced pelvic CT angiography acquisition, with possible noncontrast sequences per protocol. The interpreting radiologist reconstructs multiplanar and 3D angiographic images using workstation software to select optimal vessel views, documents arterial anatomy, stenosis extent, occlusion, and any aneurysm or dissection, and provides a formal report to the referring vascular surgeon or interventionalist for management planning. Typical sites of service include outpatient radiology centers, hospital outpatient departments, and inpatient radiology suites.

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	Use when billing only the physician interpretation of the CTA separate from technical imaging services.
`TC`

Taxonomy Code	Specialty	Notes
208100000X	Radiology	Diagnostic radiologists commonly interpret CTA of the pelvis.
208XP1002X	Vascular Surgery	Vascular surgeons request and use pelvic CTA for surgical planning.
207RG0100X	Diagnostic Radiology - Interventional	Interventional radiologists perform and interpret vascular imaging and subsequent interventions.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`I70.2`	Atherosclerosis of native arteries of the extremities	Common cause of pelvic/iliac arterial stenosis evaluated by pelvic CTA.
`I74.3`	Embolism and thrombosis of arteries of lower extremity	CTA can identify embolic occlusion location in pelvic inflow vessels.
`I82.0`	Budd-Chiari syndrome (Note: not pelvic arterial)	(Inappropriate for pelvic CTA)
`I77.1`	Stricture of artery	CTA identifies arterial strictures in pelvic vessels.
`I72.3`	Aneurysm of artery of lower extremity including iliac artery	Pelvic CTA evaluates iliac aneurysms and extent for repair planning.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`71260`	Computed tomography, thorax; with contrast material(s)	May be performed if simultaneous evaluation of thoracic aorta or proximal arterial sources is required in the same episode.
`72192`	Computed tomography angiography, lower extremity runoff, with contrast, including noncontrast images when performed, and image post-processing	Often performed in conjunction with or sequentially after pelvic CTA to evaluate distal runoff to the legs.
`74175`	Computed tomography, abdomen and pelvis with contrast, including CTA components when performed	May be used when abdominal and pelvic vascular imaging are concurrently needed; can overlap with pelvic CTA depending on protocol.
`70498`	Computed tomography, head/brain with CTA (selective)	(Not directly related to pelvis) Included as an example of CTA technique in other regions.
`75710`	Angiography, pelvic, radiological supervision and interpretation	Catheter angiography code used if invasive diagnostic or therapeutic angiography follows CTA for intervention planning.

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Summary & Overview

CPT 72191: Pelvic CT Angiography (CTA)