CPT code 70559: Functional brain MRI, without and with contrast2026 Medicare rate & RVUs in Missouri
Functional brain MRI with pre- and post-contrast imaging maps task-related brain activity when functional localization is part of the diagnostic examination.
CMS doesn’t publish an office rate for 70559 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 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 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 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.
How the rate is built · 70559
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 70559
The CMS indicators that decide how 70559 is paid alongside other services.
CMS payment indicators · 70559
Functional brain MRI, without and 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
70559 without 26 · national facility
$0.00
Functional brain MRI, without and with contrast
70559-26 · Professional component
$156.65
Pays only the interpretation and report.
70559 compared with similar codes
Compare codes · National
4 codes, side by side
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.
70559 billing questions
When should 70559 be chosen over 70557 or 70558?
Choose 70559 for functional brain MRI with imaging both before and after contrast. 70557 is the without-contrast option, and 70558 is the with-contrast option.
How does 70559 differ from 70553?
70559 includes functional brain imaging. 70553 is the brain MRI option with the same contrast sequence but without the functional imaging distinction.
Can the professional and technical portions be reported separately?
Yes. Modifier 26 identifies the professional interpretation, and modifier TC identifies the technical service; reporting without either modifier represents the global service.
Does one unit represent a dose of contrast?
No. The code describes the combined functional MRI examination, not a quantity of contrast material.
How does Medicare price 70559?
It has carrier-priced status (status C), so the Medicare Administrative Contractor sets payment for each claim rather than CMS publishing a national payment.
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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