CPT code 76016: MR safety review, physician or QHP determination2026 Medicare rate & RVUs in California

Medicare pays $76.21–$95.50 for 76016 in the office in California, from Chico, CA to San Benito County, CA. 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.

What 76016 covers

This service covers a physician or qualified health care professional’s individualized assessment of whether and under what conditions a patient with an implant or possible retained foreign body can undergo MRI. It may be needed when device records, patient history, or other available information require clinical judgment beyond routine screening. The determination is part of MRI safety work, not the MRI image acquisition or interpretation. It is distinct from assessment performed by clinical staff and from a customized medical physics examination.

Report the service when the physician or QHP performs and documents the safety determination; retain the relevant device or foreign-body information and the reasoning supporting the decision. The code has professional and technical components: bill modifier 26 for the interpretation, modifier TC for equipment and staff, or neither modifier for the global service. When diagnostic imaging multiple procedure reduction applies, it affects both the technical and professional components.

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 76016 pays more and less in California

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

29 of 29 payment localities

How the 76016 rate is calculated

Each of 76016’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 76016

The CMS indicators that decide how 76016 is paid alongside other services.

What modifiers do to the payment

When to use modifier 26

76016 compared with similar codes

How to choose

76014MRI safety assessmentInitial 15 minutes

Choose 76014 for the clinical-staff implant or foreign-body assessment; choose 76016 when a physician or QHP makes the individualized safety determination.

76015MR safety assessmentAdditional 30 minutes

76015 reports additional clinical-staff assessment time. It is not the physician or QHP determination represented by 76016.

76017MR safetyMedical physics examination

76017 is a customized medical physics examination. 76016 is the physician or QHP’s clinical MR safety determination.

76018MRI implant preparationElectrical stimulation system

76018 addresses electrical preparation of an implanted device; 76016 reports the broader physician or QHP safety decision.

Codes related to 76016

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