CPT code 70555: Functional brain MRI, physician or psychologist2026 Medicare rate & RVUs in Vermont

Functional brain MRI maps task-related brain activity; report this code when a physician or psychologist participates in the examination and interpretation.

CMS RVU26DEffective Oct 1, 2026One payment locality257 Medicare services in 2024

CMS doesn’t publish a rate for 70555 in Vermont.

Contractor-pricedOffice (non-facility)
Contractor-pricedHospital or facility

Check a contract rate as a % of Medicare · 70555 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 70555 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Vermont
  2. What 70555 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 70555 covers

This service is functional MRI of the brain used to map activity associated with tasks such as language or movement. A physician or psychologist participates in the examination; the professional service includes interpretation and a report. Functional mapping is commonly used when clinicians need to identify important functional areas in relation to a planned brain procedure, including evaluations of brain lesions or seizure disorders. It is performed in hospital and imaging-center settings.

Medicare assigns status C, carrier priced: CMS publishes no national payment, and the Medicare Administrative Contractor sets payment for each claim. Report modifier 26 for the professional interpretation, modifier TC for the technical service, or neither modifier for the global service. When performed bilaterally, each side is paid separately. Code 70554 is the related technologist-performed functional brain MRI service; choose between these codes according to whether a physician or psychologist participates in the examination.

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.

How Vermont compares for 70555

70555 in Vermont vs other payment areas
  1. Vermont · this pageUnavailable
  2. Los Angeles, CA · CaliforniaUnavailable
  3. Washington, DC area · District of ColumbiaUnavailable
  4. Miami, FL · FloridaUnavailable
  5. Chicago, IL · IllinoisUnavailable
  6. Manhattan, NY · New YorkUnavailable
  7. Alaska · AlaskaUnavailable

Other areas in Vermont first, then benchmark localities. Bars start at $0.

Every other payment area

70555 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama——
ArkansasArkansas——
ArizonaArizona——
Bakersfield, CACalifornia——
Chico, CACalifornia——
El Centro, CACalifornia——
Fresno, CACalifornia——
Hanford, CACalifornia——

70555 rates by state

Office rate range in each state. Select a state to see its payment localities.

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

View every state and territory as a table
70555 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

See 70555 in every payment locality

How the 70555 rate is calculated

Each of 70555’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 · 70555

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.00

0.00 RVUs× 1.000 GPCI

Practice expense0.00

0.00 RVUs× 1.000 GPCI

Malpractice0.00

0.00 RVUs× 1.000 GPCI

Adjusted RVUs

0.0000

Conversion factor

$33.4009

Medicare rate

$0.00

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 70555

The CMS indicators that decide how 70555 is paid alongside other services.

CMS payment indicators · 70555

Functional brain MRI, physician or psychologist

RuleCMS valueWhat it means
Global periodXXXThe global surgery concept doesn’t apply.
Multiple procedures0No multiple-procedure reduction.
Bilateral (modifier 50)3Each side paid at 100% (no 150% cap).
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical1Diagnostic test with separate professional (26) and technical (TC) components.

What modifiers do to the payment

Modifier 26 · payment effect

With and without the modifier

70555 without 26 · national facility

$0.00

Functional brain MRI, physician or psychologist

70555-26 · Professional component

$114.23

Pays only the interpretation and report.

When to use modifier 26

How 70555 has changed in Vermont

70555 · Office / nonfacility

Rate unavailable

Effective 2026-10-01

A rate is unavailable in one of these releases, so a change cannot be calculated.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release
Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01Contractor-pricedContractor-pricedRVU26D
2026-07-01Contractor-pricedContractor-pricedRVU26C
2026-04-01Contractor-pricedContractor-pricedRVU26B
2026-01-01Contractor-pricedContractor-pricedRVU26A
2025-10-01Contractor-pricedContractor-pricedRVU25D
2025-07-01Contractor-pricedContractor-pricedRVU25C
2025-04-01Contractor-pricedContractor-pricedRVU25B
2025-01-01Contractor-pricedContractor-pricedRVU25A
2024-10-01Contractor-pricedContractor-pricedRVU24D
2024-07-01Contractor-pricedContractor-pricedRVU24C
2024-04-01Contractor-pricedContractor-pricedRVU24B
2024-03-09Contractor-pricedContractor-pricedRVU24AR
2024-01-01Contractor-pricedContractor-pricedRVU24A
2023-10-01Contractor-pricedContractor-pricedRVU23D
2023-07-01Contractor-pricedContractor-pricedRVU23C
2023-04-01Contractor-pricedContractor-pricedRVU23B
2023-01-01Contractor-pricedContractor-pricedRVU23A
2022-10-01Contractor-pricedContractor-pricedRVU22D
2022-07-01Contractor-pricedContractor-pricedRVU22C
2022-04-01Contractor-pricedContractor-pricedRVU22B
2022-01-01Contractor-pricedContractor-pricedRVU22A
2021-10-01Contractor-pricedContractor-pricedRVU21D
2021-07-01Contractor-pricedContractor-pricedRVU21C
2021-04-01Contractor-pricedContractor-pricedRVU21B
2021-01-01Contractor-pricedContractor-pricedRVU21A
2020-10-01Contractor-pricedContractor-pricedRVU20D
2020-07-01Contractor-pricedContractor-pricedRVU20C
2020-04-01Contractor-pricedContractor-pricedRVU20B
2020-01-01Contractor-pricedContractor-pricedRVU20A
2019-10-01Contractor-pricedContractor-pricedRVU19D
2019-07-01Contractor-pricedContractor-pricedRVU19C
2019-04-01Contractor-pricedContractor-pricedRVU19B
2019-01-01Contractor-pricedContractor-pricedRVU19A
2018-10-01Contractor-pricedContractor-pricedRVU18D
2018-07-01Contractor-pricedContractor-pricedRVU18C
2018-04-01Contractor-pricedContractor-pricedRVU18B
2018-01-01Contractor-pricedContractor-pricedRVU18AR1
2017-10-01Contractor-pricedContractor-pricedRVU17D
2017-07-01Contractor-pricedContractor-pricedRVU17C
2017-04-01Contractor-pricedContractor-pricedRVU17B
2017-01-01Contractor-pricedContractor-pricedRVU17A
2016-10-01Contractor-pricedContractor-pricedRVU16D
2016-07-01Contractor-pricedContractor-pricedRVU16C
2016-04-01Contractor-pricedContractor-pricedRVU16B
2016-01-01Contractor-pricedContractor-pricedRVU16A
2015-10-01Contractor-pricedContractor-pricedRVU15D
2015-07-01Contractor-pricedContractor-pricedRVU15C
2015-04-01Contractor-pricedContractor-pricedRVU15B
2015-01-01Contractor-pricedContractor-pricedRVU15A
2014-10-01Contractor-pricedContractor-pricedRVU14D
2014-07-01Contractor-pricedContractor-pricedRVU14C
2014-04-01Contractor-pricedContractor-pricedRVU14B
2014-01-01Contractor-pricedContractor-pricedRVU14A
2013-10-01Contractor-pricedContractor-pricedRVU13D
2013-07-01Contractor-pricedContractor-pricedRVU13C
2013-04-01Contractor-pricedContractor-pricedRVU13B
2013-01-01Contractor-pricedContractor-pricedRVU13AR

Price 70555 for an earlier date of service

Where the Vermont rate applies

Vermont is a Medicare payment area, not a city. Our Census mapping connects it to 180 cities and communities in Vermont. Some span more than one payment area; confirm with the service ZIP.

  • Albany
  • Alburgh
  • Algiers
  • Arlington
  • Ascutney
  • Bakersfield
  • Barnet
  • Barre

Browse all communities in Vermont

70555 billing questions

How does this differ from 70554?

Use 70555 when a physician or psychologist participates in the functional MRI examination. Code 70554 describes the technologist-performed functional brain MRI service.

When should modifier 26 or TC be used?

Use modifier 26 for the professional interpretation and report, and modifier TC for the technical service. Report the global service without either modifier.

How does Medicare price this code?

It has carrier-priced status C. CMS publishes no national payment; the Medicare Administrative Contractor sets payment for each claim.

How are bilateral services treated?

When the service is performed bilaterally, each side is paid separately.

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

Open CMS sourceHow we calculate rates

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