CPT code 70559: Functional brain MRI, without and with contrast2026 Medicare rate & RVUs

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

What 70559 covers

This code identifies functional MRI of the brain performed both before and after contrast, rather than a routine structural brain MRI. During functional imaging, task-related changes in brain activity are mapped to help localize regions involved in functions such as language or movement. Radiology departments and imaging centers acquire the images, and a radiologist interprets the study. Functional mapping may support neurologic evaluation and presurgical planning when localization of brain function is needed.

Medicare classifies this service as carrier-priced (status C): CMS publishes no national payment, and the Medicare Administrative Contractor sets payment for each claim. The diagnostic test has a professional interpretation portion, reportable with modifier 26, and a technical equipment-and-staff portion, reportable with modifier TC; reporting without either modifier represents the global service. The code describes the combined functional MRI examination with pre- and post-contrast imaging, not a contrast-material 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 70559 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

70559 rates by state

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

How the 70559 rate is calculated

Each of 70559’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.

Payment rules and modifiers for 70559

The CMS indicators that decide how 70559 is paid alongside other services.

What modifiers do to the payment

When to use modifier 26

70559 compared with similar codes

How to choose

70557Brain MRIWithout contrast

70557 is the functional brain MRI option without contrast. Use 70559 when imaging is performed both before and after contrast.

70558Functional brain MRIWith contrast

70558 is the functional brain MRI option with contrast only. 70559 includes imaging both before and after contrast.

70553Brain MRIWithout and with contrast

70553 describes brain MRI with imaging both before and after contrast but without the functional imaging distinction included in 70559.

Codes related to 70559

Related codes aren’t interchangeable: bill the code that matches the service performed.

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