CPT code 70553: Brain MRI, without and with contrast2026 Medicare rate & RVUs in Missouri
Brain MRI with noncontrast and postcontrast sequences in one session evaluates suspected tumors, active demyelination, infection, or other enhancing lesions.
Medicare pays $284.11–$305.60 for 70553 in the office in Missouri, from Rest of Missouri to Metropolitan St. Louis, MO. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
Your location
On this page 9 sections
What 70553 covers
Brain MRI under this code covers the brain and brain stem using diagnostic noncontrast sequences followed by contrast-enhanced sequences during one examination. Sequences may include T1, T2, FLAIR, and diffusion imaging before intravenous gadolinium, with additional imaging afterward. Radiologists or neuroradiologists interpret examinations performed in hospital radiology departments, outpatient imaging centers, or physician offices. Typical reasons to obtain both phases include assessment of a brain tumor or metastases, active demyelination, intracranial infection, or a pituitary lesion.
Report one unit for the combined examination, rather than reporting 70551 and 70552 for its separate phases. Documentation should establish that diagnostic images were obtained before and after contrast administration; the administration record supports the agent and amount if the supply is separately reported. The interpreting physician reports the professional component with modifier 26, while the provider furnishing equipment and staff reports the technical component with modifier TC. An entity furnishing both components reports the global service without either modifier. Medicare's diagnostic imaging multiple-procedure reduction affects professional and technical components when this examination is performed with other eligible imaging services under the applicable same-session criteria.
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
Where 70553 pays more and less in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
3 payment localities
$284.11 to $305.60
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | $302.39 | Unavailable |
| Metropolitan St. Louis, MO | $305.60 | Unavailable |
| Rest of Missouri | $284.11 | Unavailable |
How the 70553 rate is calculated
Each of 70553’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 70553
RVUs × geographic indexes × conversion factor
Work2.23
2.23 RVUs× 1.000 GPCI
Practice expense7.10
7.10 RVUs× 1.000 GPCI
Malpractice0.16
0.16 RVUs× 1.000 GPCI
Adjusted RVUs
9.4900
Conversion factor
$33.4009
Medicare rate
$316.97
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 70553
The CMS indicators that decide how 70553 is paid alongside other services.
CMS payment indicators · 70553
Brain MRI, without and with contrast
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| Multiple procedures | 4 | Diagnostic imaging reduction applies to the technical component (and professional component) of additional services. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 1 | Diagnostic test with separate professional (26) and technical (TC) components. |
What modifiers do to the payment
Modifier 26 · payment effect
With and without the modifier
70553 without 26 · national office
$316.97
Brain MRI, without and with contrast
70553-26 · Professional component
$105.21
Pays only the interpretation and report.
70553 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 70552MRI brainWith contrast
- Use 70552 when diagnostic brain imaging is performed only after contrast administration. Use 70553 when the examination includes both diagnostic noncontrast and postcontrast brain sequences.
- 70546Head MR angiographyWithout and with contrast
- Code 70546 evaluates intracranial arteries with MRA performed without and with contrast. Code 70553 evaluates brain tissue; report both when separate, complete examinations are performed.
- 70543Regional MRIWithout and with contrast
- Code 70543 examines the orbits, face, or neck without and with contrast, rather than the brain. Report it alongside 70553 only when both regions receive separate, complete examinations.
- 70559Functional brain MRIWithout and with contrast
- Code 70559 describes brain MRI without and with contrast during an open intracranial procedure. Code 70553 describes the corresponding diagnostic examination outside that setting.
70553 billing questions
Can 70551 and 70552 be billed together instead of 70553?
No. When diagnostic noncontrast and contrast-enhanced brain sequences are acquired in one examination, report 70553 rather than billing the separate phases.
If the radiologist decides to add contrast after reviewing the noncontrast images, which code applies?
Report 70553 if diagnostic postcontrast sequences are performed during the same examination. The documentation should support the decision to add contrast.
Is the gadolinium contrast included in 70553?
When the billing entity supplies the agent and separate supply reporting is permitted, report the appropriate HCPCS code for the product and administered amount.
How should a hospital-based radiologist bill this study?
The radiologist reports 70553-26 for the interpretation; the hospital reports the technical service on its facility claim. An entity furnishing both components reports 70553 globally without a component modifier.
Does the multiple-procedure reduction apply when brain MRI and MRA head are done together?
When 70553 and an eligible head MRA are furnished to the same patient in the same session under Medicare's imaging reduction criteria, the reduction can affect both professional and technical payment. The lower-paid component is determined separately for each type of payment.
How does 70553 differ from 70559?
Code 70559 describes brain MRI without and with contrast during an open intracranial procedure. Use 70553 for the corresponding diagnostic examination outside that setting.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
Fee sheets · Coming soon
Put 70553 and the rest of your codes on one sheet
Your codes at your locality, with payer contracts beside Medicare.
Join the waitlist