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 doesn’t publish a rate for 70555 in Vermont.
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.
On this page 11 sections
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
- Vermont · this pageUnavailable
- Los Angeles, CA · CaliforniaUnavailable
- Washington, DC area · District of ColumbiaUnavailable
- Miami, FL · FloridaUnavailable
- Chicago, IL · IllinoisUnavailable
- Manhattan, NY · New YorkUnavailable
- Alaska · AlaskaUnavailable
Other areas in Vermont first, then benchmark localities. Bars start at $0.
Every other payment area
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
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | No published base rate | 1 |
| AL | No published base rate | 1 |
| AR | No published base rate | 1 |
| AZ | No published base rate | 1 |
| CA | No published base rate | 29 |
| CO | No published base rate | 1 |
| CT | No published base rate | 1 |
| DC | No published base rate | 1 |
| DE | No published base rate | 1 |
| FL | No published base rate | 3 |
| GA | No published base rate | 2 |
| GU | No published base rate | 1 |
| HI | No published base rate | 1 |
| IA | No published base rate | 1 |
| ID | No published base rate | 1 |
| IL | No published base rate | 4 |
| IN | No published base rate | 1 |
| KS | No published base rate | 1 |
| KY | No published base rate | 1 |
| LA | No published base rate | 2 |
| MA | No published base rate | 2 |
| MD | No published base rate | 3 |
| ME | No published base rate | 2 |
| MI | No published base rate | 2 |
| MN | No published base rate | 1 |
| MO | No published base rate | 3 |
| MS | No published base rate | 1 |
| MT | No published base rate | 1 |
| NC | No published base rate | 1 |
| ND | No published base rate | 1 |
| NE | No published base rate | 1 |
| NH | No published base rate | 1 |
| NJ | No published base rate | 2 |
| NM | No published base rate | 1 |
| NV | No published base rate | 1 |
| NY | No published base rate | 5 |
| OH | No published base rate | 1 |
| OK | No published base rate | 1 |
| OR | No published base rate | 2 |
| PA | No published base rate | 2 |
| PR | No published base rate | 1 |
| RI | No published base rate | 1 |
| SC | No published base rate | 1 |
| SD | No published base rate | 1 |
| TN | No published base rate | 1 |
| TX | No published base rate | 8 |
| UT | No published base rate | 1 |
| VA | No published base rate | 2 |
| VI | No published base rate | 1 |
| VT | No published base rate | 1 |
| WA | No published base rate | 2 |
| WI | No published base rate | 1 |
| WV | No published base rate | 1 |
| WY | No published base rate | 1 |
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
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
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 3 | Each side paid at 100% (no 150% cap). |
| 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
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.
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.
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
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | Contractor-priced | Contractor-priced | RVU26D |
| 2026-07-01 | Contractor-priced | Contractor-priced | RVU26C |
| 2026-04-01 | Contractor-priced | Contractor-priced | RVU26B |
| 2026-01-01 | Contractor-priced | Contractor-priced | RVU26A |
| 2025-10-01 | Contractor-priced | Contractor-priced | RVU25D |
| 2025-07-01 | Contractor-priced | Contractor-priced | RVU25C |
| 2025-04-01 | Contractor-priced | Contractor-priced | RVU25B |
| 2025-01-01 | Contractor-priced | Contractor-priced | RVU25A |
| 2024-10-01 | Contractor-priced | Contractor-priced | RVU24D |
| 2024-07-01 | Contractor-priced | Contractor-priced | RVU24C |
| 2024-04-01 | Contractor-priced | Contractor-priced | RVU24B |
| 2024-03-09 | Contractor-priced | Contractor-priced | RVU24AR |
| 2024-01-01 | Contractor-priced | Contractor-priced | RVU24A |
| 2023-10-01 | Contractor-priced | Contractor-priced | RVU23D |
| 2023-07-01 | Contractor-priced | Contractor-priced | RVU23C |
| 2023-04-01 | Contractor-priced | Contractor-priced | RVU23B |
| 2023-01-01 | Contractor-priced | Contractor-priced | RVU23A |
| 2022-10-01 | Contractor-priced | Contractor-priced | RVU22D |
| 2022-07-01 | Contractor-priced | Contractor-priced | RVU22C |
| 2022-04-01 | Contractor-priced | Contractor-priced | RVU22B |
| 2022-01-01 | Contractor-priced | Contractor-priced | RVU22A |
| 2021-10-01 | Contractor-priced | Contractor-priced | RVU21D |
| 2021-07-01 | Contractor-priced | Contractor-priced | RVU21C |
| 2021-04-01 | Contractor-priced | Contractor-priced | RVU21B |
| 2021-01-01 | Contractor-priced | Contractor-priced | RVU21A |
| 2020-10-01 | Contractor-priced | Contractor-priced | RVU20D |
| 2020-07-01 | Contractor-priced | Contractor-priced | RVU20C |
| 2020-04-01 | Contractor-priced | Contractor-priced | RVU20B |
| 2020-01-01 | Contractor-priced | Contractor-priced | RVU20A |
| 2019-10-01 | Contractor-priced | Contractor-priced | RVU19D |
| 2019-07-01 | Contractor-priced | Contractor-priced | RVU19C |
| 2019-04-01 | Contractor-priced | Contractor-priced | RVU19B |
| 2019-01-01 | Contractor-priced | Contractor-priced | RVU19A |
| 2018-10-01 | Contractor-priced | Contractor-priced | RVU18D |
| 2018-07-01 | Contractor-priced | Contractor-priced | RVU18C |
| 2018-04-01 | Contractor-priced | Contractor-priced | RVU18B |
| 2018-01-01 | Contractor-priced | Contractor-priced | RVU18AR1 |
| 2017-10-01 | Contractor-priced | Contractor-priced | RVU17D |
| 2017-07-01 | Contractor-priced | Contractor-priced | RVU17C |
| 2017-04-01 | Contractor-priced | Contractor-priced | RVU17B |
| 2017-01-01 | Contractor-priced | Contractor-priced | RVU17A |
| 2016-10-01 | Contractor-priced | Contractor-priced | RVU16D |
| 2016-07-01 | Contractor-priced | Contractor-priced | RVU16C |
| 2016-04-01 | Contractor-priced | Contractor-priced | RVU16B |
| 2016-01-01 | Contractor-priced | Contractor-priced | RVU16A |
| 2015-10-01 | Contractor-priced | Contractor-priced | RVU15D |
| 2015-07-01 | Contractor-priced | Contractor-priced | RVU15C |
| 2015-04-01 | Contractor-priced | Contractor-priced | RVU15B |
| 2015-01-01 | Contractor-priced | Contractor-priced | RVU15A |
| 2014-10-01 | Contractor-priced | Contractor-priced | RVU14D |
| 2014-07-01 | Contractor-priced | Contractor-priced | RVU14C |
| 2014-04-01 | Contractor-priced | Contractor-priced | RVU14B |
| 2014-01-01 | Contractor-priced | Contractor-priced | RVU14A |
| 2013-10-01 | Contractor-priced | Contractor-priced | RVU13D |
| 2013-07-01 | Contractor-priced | Contractor-priced | RVU13C |
| 2013-04-01 | Contractor-priced | Contractor-priced | RVU13B |
| 2013-01-01 | Contractor-priced | Contractor-priced | RVU13AR |
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
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
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