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CPT 72170

XR Pelvis 1 or 2 V DR at IOM Health System LP

Fort Wayne, IN

Pricing by billing methodology

Price type

All methodologies

$109

Aggregated across all available billing methodologies for this code.

Case rate

$26

Reflects a negotiated flat case rate paid per episode of care, rather than itemized charges.

Fee schedule

$111

Reflects negotiated fee schedule rates with commercial payers.

Per diem

$111

Reflects a negotiated per diem rate paid per day of care.

Percent of billed charges

$22

Reflects a negotiated percentage of total billed charges.

Other

$111

Reflects a payer-specific billing methodology not covered by the standard categories.

Last updated: Apr 1, 2026

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