CPT code 75565: Cardiac MRI, velocity flow mapping2026 Medicare rate & RVUs in Pennsylvania
Reports cardiac MRI velocity flow mapping added to a primary cardiac MRI to measure blood-flow direction and velocity in the heart or great vessels.
Medicare pays $42.37–$47.15 for 75565 in the office in Pennsylvania, from Rest of Pennsylvania to Metropolitan Philadelphia, PA. Which amount applies depends on the service address.
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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On this page 9 sections
What 75565 covers
This add-on captures and analyzes blood-flow velocity during cardiac MRI, such as flow across a valve or through a vessel. It can help quantify regurgitant flow or assess a suspected shunt, including in congenital heart disease. An MRI technologist performs the acquisition, with interpretation by a radiologist or cardiologist. The service is used with a primary cardiac MRI examination, not as a stand-alone study.
Report 75565 only when velocity flow mapping is performed in addition to the primary cardiac MRI; the record should support the mapping acquisition and its interpretation. CMS treats it as an add-on paid within the primary procedure's global period. The diagnostic test has professional and technical components: modifier 26 identifies interpretation, modifier TC identifies equipment and staff, and reporting without either modifier represents the global service.
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 75565 pays more and less in Pennsylvania
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Philadelphia, PA | $47.15 | Unavailable |
| Rest of Pennsylvania | $42.37 | Unavailable |
How the 75565 rate is calculated
Each of 75565’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 · 75565
RVUs × geographic indexes × conversion factor
Work0.24
0.24 RVUs× 1.000 GPCI
Practice expense1.11
1.11 RVUs× 1.000 GPCI
Malpractice0.01
0.01 RVUs× 1.000 GPCI
Adjusted RVUs
1.3600
Conversion factor
$33.4009
Medicare rate
$45.43
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 75565
The CMS indicators that decide how 75565 is paid alongside other services.
CMS payment indicators · 75565
Cardiac MRI, velocity flow mapping
| Rule | CMS value | What it means |
|---|---|---|
| Global period | ZZZ | Add-on code: falls within the primary procedure’s global period. |
| 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
75565 without 26 · national office
$45.43
Cardiac MRI, velocity flow mapping
75565-26 · Professional component
$11.36
Pays only the interpretation and report.
75565 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 75557Cardiac MRIMorphology and function, no contrast
- 75557 identifies the primary cardiac MRI without stress imaging or contrast. Add 75565 only when velocity flow mapping is also performed.
- 75561Cardiac MRIMorphology and function with contrast
- 75561 identifies a primary cardiac MRI with contrast and without stress imaging. It does not, by itself, identify velocity flow mapping.
- 75563Cardiac MRIStress imaging with contrast
- 75563 identifies a primary cardiac MRI with stress imaging and contrast. 75565 is a separate add-on when velocity flow mapping is performed with that examination.
75565 billing questions
Can 75565 be billed by itself?
No. It is an add-on for velocity flow mapping performed with a primary cardiac MRI, such as 75557, 75559, 75561, or 75563.
How is 75565 different from the primary cardiac MRI code?
The primary code identifies the cardiac MRI examination, including whether stress imaging or contrast is used. 75565 separately identifies additional velocity flow mapping performed during that examination.
When should modifier 26 or TC be used?
Use modifier 26 for the professional interpretation and modifier TC for the technical service, including equipment and staff. Without either modifier, the claim represents the global service.
What documentation supports reporting 75565?
Document that velocity flow mapping was acquired and interpreted as part of the cardiac MRI, along with the clinical reason for assessing flow, such as suspected regurgitation or a shunt.
Is 75565 paid separately from the primary MRI's global period?
CMS treats 75565 as an add-on paid within the primary procedure's global period.
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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