CPT code 70558: Functional brain MRI, with contrast2026 Medicare rate & RVUs in Missouri
Functional MRI of the brain with contrast supports assessment of brain activity and anatomy, including functional mapping during neurologic or presurgical evaluation.
CMS doesn’t publish an office rate for 70558 in Missouri.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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What 70558 covers
This service is functional magnetic resonance imaging of the brain performed with contrast material. Functional MRI assesses signal changes associated with brain activity, often while the patient performs tasks that engage functions such as language or movement. Imaging may be part of an evaluation for a brain lesion or before neurosurgery, when clinicians need functional information alongside anatomic imaging. The imaging facility performs the scan, and a qualified physician interprets and reports the findings.
Medicare assigns this code carrier-priced status (C): CMS publishes no national payment, and the Medicare Administrative Contractor sets payment for each claim. The service has a professional component for interpretation and a technical component for equipment and staff. Report modifier 26 for the professional component or TC for the technical component; report the global service without either modifier. This code represents the functional brain MRI performed with contrast, not a contrast agent dose.
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 70558 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.
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | Unavailable | Unavailable |
| Metropolitan St. Louis, MO | Unavailable | Unavailable |
| Rest of Missouri | Unavailable | Unavailable |
How the 70558 rate is calculated
Each of 70558’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 · 70558
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 70558
The CMS indicators that decide how 70558 is paid alongside other services.
CMS payment indicators · 70558
Functional brain MRI, with contrast
| 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) | 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
70558 without 26 · national facility
$0.00
Functional brain MRI, with contrast
70558-26 · Professional component
$169.68
Pays only the interpretation and report.
70558 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 70557Brain MRIWithout contrast
- Use 70557 for functional brain MRI without contrast; use 70558 when the functional MRI is performed with contrast.
- 70559Functional brain MRIWithout and with contrast
- 70559 covers functional brain MRI performed both without and with contrast, rather than the with-contrast service alone.
- 70555Functional brain MRIPhysician or psychologist
- 70555 describes functional MRI involving physician or psychologist administration of tests and interpretation; 70558 identifies the with-contrast functional imaging service.
- 70552MRI brainWith contrast
- 70552 is a conventional brain MRI with contrast, not a functional brain MRI service.
70558 billing questions
How does this differ from 70557?
70558 is for functional brain MRI performed with contrast. 70557 is the corresponding functional brain MRI code without contrast.
When should 70559 be used instead?
Use 70559 when the functional brain MRI includes imaging both without contrast and then with contrast. 70558 describes the with-contrast service.
Which modifier identifies the interpretation?
Append modifier 26 when billing only the professional interpretation and report. Modifier TC identifies the technical service; the global service is reported without either modifier.
Does Medicare publish a national payment for 70558?
No. The code has carrier-priced status C, so the Medicare Administrative Contractor sets payment for each claim.
How is 70558 different from 70555?
70558 identifies functional brain MRI performed with contrast. 70555 describes a functional MRI service involving physician or psychologist administration of tests with interpretation and reporting.
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.
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