HCPCS Level II C8918: Magnetic Resonance Angiography with Contrast, Pelvis

HCPCS Level II code C8918 represents contrast-enhanced magnetic resonance angiography (MRA) of the pelvis, a diagnostic imaging procedure used to assess pelvic arterial and venous anatomy and detect stenosis, occlusion, or aneurysmal disease. Nationally, MRA of the pelvis is an important noninvasive alternative to catheter angiography, influencing care pathways for vascular and oncologic patients and affecting imaging utilization and reimbursement patterns across payers.

Key payers covered include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise national view of clinical context for pelvic MRA, common site-of-service considerations, and the payer landscape addressed in the analysis. The publication outlines benchmarks for utilization and payment where available, summarizes relevant policy and coverage features that affect access and billing, and explains coding and documentation considerations relevant to claims processing for pelvic contrast-enhanced MRA.

The report is organized to help coders, billing managers, and policy analysts understand where C8918 fits in imaging service lines, typical settings for performance, and payer-related factors that commonly influence authorization and claim adjudication. Data not provided in the input are noted explicitly where applicable.

Billing Code Overview

HCPCS Level II code C8918 describes magnetic resonance angiography with contrast, pelvis. This service involves contrast-enhanced MR imaging focused on the pelvic vasculature to evaluate arterial and venous anatomy, stenosis, occlusion, or other vascular pathology. The service type is diagnostic imaging (contrast-enhanced magnetic resonance angiography). The typical site of service is an outpatient imaging center or hospital outpatient radiology department.

Data not available in the input.

Clinical Context

A 62-year-old patient with a history of peripheral arterial disease and chronic pelvic ischemic pain is referred for C8918 — magnetic resonance angiography with contrast of the pelvis — to evaluate pelvic arterial anatomy and identify stenosis, occlusion, or aneurysm. The typical clinical workflow begins with an outpatient order from a vascular surgeon, interventional radiologist, or primary care clinician. Pre-procedure steps include screening for MRI contraindications (implanted devices, severe claustrophobia), assessing renal function (eGFR) for gadolinium-based contrast safety, and obtaining informed consent. On the day of service the patient arrives to an outpatient imaging center or hospital radiology department; an MRI technologist reviews screening, places IV access, and performs the contrast-enhanced pelvic MRA protocol. Images are processed and interpreted by a radiologist (diagnostic read), who issues a final report documenting arterial findings and procedural details. Post-procedure monitoring is brief for contrast reaction observation; results are communicated to the referring clinician for management planning such as medical therapy, endovascular intervention, or surgical referral.

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	Use when billing only the physician interpretation of the pelvic MRA separated from technical services.

Taxonomy Code	Specialty	Notes
`2080S0002X`	Diagnostic Radiology	Primary specialty that performs and interprets pelvic MRA studies.
`207RX0400X`	Vascular & Interventional Radiology	Performs image-guided vascular procedures and may order or interpret MRA in context of interventions.
`207L00000X`	Vascular Surgery	Refers patients for pelvic vascular imaging and uses results for surgical planning.
`261QR0400X`	Internal Medicine - Cardiology	Evaluates cardiovascular etiologies of pelvic ischemia and may order MRA for vascular assessment.
`207K00000X`	General Surgery	May be involved in management decisions informed by pelvic MRA findings.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`I70.2`	Atherosclerosis of native arteries of the extremities	Pelvic MRA evaluates aortoiliac and pelvic arterial atherosclerotic disease contributing to claudication and ischemic pain.
`I77.1`	Stricture of artery	Used when imaging is needed to localize arterial narrowing in the pelvis for treatment planning.
`I71.4`	Abdominal aortic aneurysm, without rupture	Pelvic MRA can assess iliac artery involvement and extension of aneurysmal disease into the pelvis.
`R07.9`	Chest pain, unspecified	While not pelvic-specific, pelvic vascular pathology can present with atypical pain; included when broader vascular assessment is considered.
`N28.9`	Disorder of kidney and ureter, unspecified	Renal insufficiency affects contrast selection and dosing prior to gadolinium-enhanced pelvic MRA — relevant for safety screening.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`70544`	Magnetic resonance angiography, head; without contrast material	Not directly performed with pelvic MRA but conceptually related; included for modality reference when other vascular territories are imaged.
`74185`	Magnetic resonance angiography, abdomen; with contrast material(s) and without contrast material, including non-contrast images, if performed, and image post-processing	Often performed in conjunction with pelvic MRA when vascular disease spans abdomen and pelvis; sequential or combined studies may be ordered.
`73725`	Magnetic resonance angiography, lower extremity, run-off, with or without contrast material(s)	Performed when peripheral arterial disease extends to lower extremities; may be ordered alongside pelvic MRA for comprehensive vascular mapping.
`72195`	Magnetic resonance angiography, pelvis; without contrast material	Related non-contrast pelvic MRA option; used when gadolinium is contraindicated or when non-contrast evaluation is sufficient.
`70496`	Computed tomography, maxillofacial area; with contrast material and without contrast material, with further vascular CT angiography — non-related modality but illustrative of cross-modality vascular imaging	Not directly related but demonstrates alternative vascular imaging strategies when CT angiography is indicated.

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Summary & Overview