CPT code 76016: MR safety review, physician or QHP determination2026 Medicare rate & RVUs in South Dakota
Reports a physician or qualified health care professional’s individualized MR safety determination when an implant or possible foreign body requires clinical review before MRI.
In South Dakota, Medicare pays $70.70 for 76016 in the office.
Check a contract rate as a % of Medicare · 76016 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
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.
How South Dakota compares for 76016
Across 109 of 109 payment localities, the office rate for 76016 runs from $63.89 in Arkansas to $95.50 in San Benito County, CA. South Dakota pays $70.70. The RVUs are the same everywhere; the geographic indexes change the dollars.
- South Dakota · this page$70.70
- Los Angeles, CA · California$81.29+$10.59
- Washington, DC area · District of Columbia$82.04+$11.34
- Miami, FL · Florida$76.43+$5.73
- Chicago, IL · Illinois$74.36+$3.66
- Manhattan, NY · New York$82.22+$11.52
- Alaska · Alaska$84.19+$13.49
Other areas in South Dakota first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $64.78 | — |
| ArkansasArkansas | $63.89 | — |
| ArizonaArizona | $70.01 | — |
| Bakersfield, CACalifornia | $76.38 | — |
| Chico, CACalifornia | $76.21 | — |
| El Centro, CACalifornia | $76.22 | — |
| Fresno, CACalifornia | $76.21 | — |
| Hanford, CACalifornia | $76.21 | — |
| Madera, CACalifornia | $76.21 | — |
| Merced, CACalifornia | $76.21 | — |
| Modesto, CACalifornia | $76.21 | — |
| Napa, CACalifornia | $88.27 | — |
| Oxnard, CACalifornia | $80.91 | — |
| Redding, CACalifornia | $76.21 | — |
| Rest of CaliforniaCalifornia | $76.21 | — |
| Riverside, CACalifornia | $76.76 | — |
| Sacramento, CACalifornia | $79.97 | — |
| Salinas, CACalifornia | $79.67 | — |
| San Diego, CACalifornia | $81.52 | — |
| Marin County, CACalifornia | $93.46 | — |
| San Francisco, CACalifornia | $93.40 | — |
| San Benito County, CACalifornia | $95.50 | — |
| Santa Clara County, CACalifornia | $95.27 | — |
| San Luis Obispo, CACalifornia | $78.38 | — |
| Santa Cruz, CACalifornia | $82.29 | — |
| Santa Maria, CACalifornia | $79.96 | — |
| Santa Rosa, CACalifornia | $83.13 | — |
| Stockton, CACalifornia | $76.21 | — |
| Vallejo, CACalifornia | $88.19 | — |
| Visalia, CACalifornia | $76.21 | — |
| Yuba City, CACalifornia | $76.21 | — |
| ColoradoColorado | $74.91 | — |
| ConnecticutConnecticut | $76.44 | — |
| DelawareDelaware | $71.14 | — |
| Fort Lauderdale, FLFlorida | $73.82 | — |
| Rest of FloridaFlorida | $70.43 | — |
| Atlanta, GAGeorgia | $73.01 | — |
| Rest of GeorgiaGeorgia | $66.69 | — |
| Hawaii, Guam, HIHawaii | $78.02 | — |
| IowaIowa | $66.52 | — |
| IdahoIdaho | $66.90 | — |
| East St. Louis, ILIllinois | $69.47 | — |
| Rest of IllinoisIllinois | $68.36 | — |
| Suburban Chicago, ILIllinois | $74.60 | — |
| IndianaIndiana | $67.27 | — |
| KansasKansas | $66.14 | — |
| KentuckyKentucky | $66.07 | — |
| New Orleans, LALouisiana | $69.06 | — |
| Rest of LouisianaLouisiana | $65.94 | — |
| Metropolitan Boston, MAMassachusetts | $82.22 | — |
| Rest of MassachusettsMassachusetts | $74.46 | — |
| Baltimore area, MDMaryland | $76.20 | — |
| Rest of MarylandMaryland | $72.48 | — |
| Rest of MaineMaine | $67.15 | — |
| Southern Maine, MEMaine | $70.74 | — |
| Detroit, MIMichigan | $71.19 | — |
| Rest of MichiganMichigan | $67.64 | — |
| MinnesotaMinnesota | $72.10 | — |
| Metropolitan Kansas City, MOMissouri | $68.70 | — |
| Metropolitan St. Louis, MOMissouri | $69.39 | — |
| Rest of MissouriMissouri | $64.81 | — |
| MississippiMississippi | $64.37 | — |
| MontanaMontana | $71.81 | — |
| North CarolinaNorth Carolina | $67.83 | — |
| North DakotaNorth Dakota | $70.82 | — |
| NebraskaNebraska | $66.89 | — |
| New HampshireNew Hampshire | $73.67 | — |
| Northern New JerseyNew Jersey | $81.24 | — |
| Rest of New JerseyNew Jersey | $77.40 | — |
| New MexicoNew Mexico | $67.96 | — |
| NevadaNevada | $71.58 | — |
| NYC suburbs and Long Island, NYNew York | $84.04 | — |
| Poughkeepsie and northern NYC suburbs, NYNew York | $77.84 | — |
| Queens, NYNew York | $82.99 | — |
| Rest of New YorkNew York | $68.79 | — |
| OhioOhio | $67.44 | — |
| OklahomaOklahoma | $66.04 | — |
| Portland, OROregon | $77.30 | — |
| Rest of OregonOregon | $71.11 | — |
| Metropolitan Philadelphia, PAPennsylvania | $74.56 | — |
| Rest of PennsylvaniaPennsylvania | $67.58 | — |
| Puerto RicoPuerto Rico | $72.34 | — |
| Rhode IslandRhode Island | $73.67 | — |
| South CarolinaSouth Carolina | $67.73 | — |
| TennesseeTennessee | $66.45 | — |
| Austin, TXTexas | $74.59 | — |
| Beaumont, TXTexas | $67.15 | — |
| Brazoria, TXTexas | $71.15 | — |
| Dallas, TXTexas | $71.55 | — |
| Fort Worth, TXTexas | $71.07 | — |
| Galveston, TXTexas | $71.33 | — |
| Houston, TXTexas | $72.24 | — |
| Rest of TexasTexas | $69.08 | — |
| UtahUtah | $68.62 | — |
| VirginiaVirginia | $70.46 | — |
| Virgin Islands, VIUnited States Virgin Islands | $72.34 | — |
| VermontVermont | $70.48 | — |
| Rest of WashingtonWashington | $74.34 | — |
| King County, WAWashington | $83.94 | — |
| WisconsinWisconsin | $68.54 | — |
| West VirginiaWest Virginia | $65.92 | — |
| WyomingWyoming | $71.38 | — |
76016 rates by state
Office rate range in each state. Select a state to see its payment localities.
Explore a state
Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
$63.89
$85.85
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $84.19 | 1 |
| AL | $64.78 | 1 |
| AR | $63.89 | 1 |
| AZ | $70.01 | 1 |
| CA | $76.21–$95.50 | 29 |
| CO | $74.91 | 1 |
| CT | $76.44 | 1 |
| DC | $82.04 | 1 |
| DE | $71.14 | 1 |
| FL | $70.43–$76.43 | 3 |
| GA | $66.69–$73.01 | 2 |
| GU | $78.02 | 1 |
| HI | $78.02 | 1 |
| IA | $66.52 | 1 |
| ID | $66.90 | 1 |
| IL | $68.36–$74.60 | 4 |
| IN | $67.27 | 1 |
| KS | $66.14 | 1 |
| KY | $66.07 | 1 |
| LA | $65.94–$69.06 | 2 |
| MA | $74.46–$82.22 | 2 |
| MD | $72.48–$82.04 | 3 |
| ME | $67.15–$70.74 | 2 |
| MI | $67.64–$71.19 | 2 |
| MN | $72.10 | 1 |
| MO | $64.81–$69.39 | 3 |
| MS | $64.37 | 1 |
| MT | $71.81 | 1 |
| NC | $67.83 | 1 |
| ND | $70.82 | 1 |
| NE | $66.89 | 1 |
| NH | $73.67 | 1 |
| NJ | $77.40–$81.24 | 2 |
| NM | $67.96 | 1 |
| NV | $71.58 | 1 |
| NY | $68.79–$84.04 | 5 |
| OH | $67.44 | 1 |
| OK | $66.04 | 1 |
| OR | $71.11–$77.30 | 2 |
| PA | $67.58–$74.56 | 2 |
| PR | $72.34 | 1 |
| RI | $73.67 | 1 |
| SC | $67.73 | 1 |
| SD | $70.70 | 1 |
| TN | $66.45 | 1 |
| TX | $67.15–$74.59 | 8 |
| UT | $68.62 | 1 |
| VA | $70.46–$82.04 | 2 |
| VI | $72.34 | 1 |
| VT | $70.48 | 1 |
| WA | $74.34–$83.94 | 2 |
| WI | $68.54 | 1 |
| WV | $65.92 | 1 |
| WY | $71.38 | 1 |
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.
How the rate is built · 76016
RVUs × geographic indexes × conversion factor
Work0.59
0.59 RVUs× 1.000 GPCI
Practice expense1.51
1.51 RVUs× 1.000 GPCI
Malpractice0.05
0.05 RVUs× 1.000 GPCI
Adjusted RVUs
2.1500
Conversion factor
$33.4009
Medicare rate
$71.81
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact South Dakota inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
8,647
- Code
- 76016
- Physician work
- 0.59
- Practice expense
- 1.51
- Malpractice
- 0.05
GPCI2026.csv
94
- Locality
- South Dakota
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.336
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.59 | × 1.000 | 0.5900 |
| Practice expense | 1.51 | × 1.000 | 1.5100 |
| Malpractice | 0.05 | × 0.336 | 0.0168 |
| Total RVUs | 2.1168 | ||
| Conversion factor | × 33.4009 | ||
Office rate, South Dakota$70.70
Office: (0.59 × 1 + 1.51 × 1 + 0.05 × 0.336) × $33.4009 = $70.70
Payment rules and modifiers for 76016
The CMS indicators that decide how 76016 is paid alongside other services.
CMS payment indicators · 76016
MR safety review, physician or QHP determination
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| Multiple procedures | 4 | Diagnostic imaging reduction applies to the technical component (and professional component) of additional services. |
| 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
76016 without 26 · national office
$71.81
MR safety review, physician or QHP determination
76016-26 · Professional component
$27.72
Pays only the interpretation and report.
How 76016 has changed in South Dakota
76016 · Office / nonfacility
$70.70
Effective 2026-10-01
The base rate is $0.54 higher than on 2025-10-01, moving from $70.16 to $70.70 (0.8%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
January 1, 2026
RVU26A
$70.16changed to$70.70
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 0.60 changed to 0.59
- Practice expense RVU 1.55 changed to 1.51
- Malpractice GPCI 0.382 changed to 0.336
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
No ratechanged to$70.16
Held through RVU25B, RVU25C, RVU25D.
January 1, 2013
RVU13AR
Earliest loaded release: No rate
Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D, RVU16A, RVU16B, RVU16C, RVU16D, RVU17A, RVU17B, RVU17C, RVU17D, RVU18AR1, RVU18B, RVU18C, RVU18D, RVU19A, RVU19B, RVU19C, RVU19D, RVU20A, RVU20B, RVU20C, RVU20D, RVU21A, RVU21B, RVU21C, RVU21D, RVU22A, RVU22B, RVU22C, RVU22D, RVU23A, RVU23B, RVU23C, RVU23D, RVU24A, RVU24AR, RVU24B, RVU24C, RVU24D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $70.70 | Not available in this setting | RVU26D |
| 2026-07-01 | $70.70 | Not available in this setting | RVU26C |
| 2026-04-01 | $70.70 | Not available in this setting | RVU26B |
| 2026-01-01 | $70.70 | Not available in this setting | RVU26A |
| 2025-10-01 | $70.16 | Not available in this setting | RVU25D |
| 2025-07-01 | $70.16 | Not available in this setting | RVU25C |
| 2025-04-01 | $70.16 | Not available in this setting | RVU25B |
| 2025-01-01 | $70.16 | Not available in this setting | RVU25A |
| 2024-10-01 | Not in this release | Not in this release | RVU24D |
| 2024-07-01 | Not in this release | Not in this release | RVU24C |
| 2024-04-01 | Not in this release | Not in this release | RVU24B |
| 2024-03-09 | Not in this release | Not in this release | RVU24AR |
| 2024-01-01 | Not in this release | Not in this release | RVU24A |
| 2023-10-01 | Not in this release | Not in this release | RVU23D |
| 2023-07-01 | Not in this release | Not in this release | RVU23C |
| 2023-04-01 | Not in this release | Not in this release | RVU23B |
| 2023-01-01 | Not in this release | Not in this release | RVU23A |
| 2022-10-01 | Not in this release | Not in this release | RVU22D |
| 2022-07-01 | Not in this release | Not in this release | RVU22C |
| 2022-04-01 | Not in this release | Not in this release | RVU22B |
| 2022-01-01 | Not in this release | Not in this release | RVU22A |
| 2021-10-01 | Not in this release | Not in this release | RVU21D |
| 2021-07-01 | Not in this release | Not in this release | RVU21C |
| 2021-04-01 | Not in this release | Not in this release | RVU21B |
| 2021-01-01 | Not in this release | Not in this release | RVU21A |
| 2020-10-01 | Not in this release | Not in this release | RVU20D |
| 2020-07-01 | Not in this release | Not in this release | RVU20C |
| 2020-04-01 | Not in this release | Not in this release | RVU20B |
| 2020-01-01 | Not in this release | Not in this release | RVU20A |
| 2019-10-01 | Not in this release | Not in this release | RVU19D |
| 2019-07-01 | Not in this release | Not in this release | RVU19C |
| 2019-04-01 | Not in this release | Not in this release | RVU19B |
| 2019-01-01 | Not in this release | Not in this release | RVU19A |
| 2018-10-01 | Not in this release | Not in this release | RVU18D |
| 2018-07-01 | Not in this release | Not in this release | RVU18C |
| 2018-04-01 | Not in this release | Not in this release | RVU18B |
| 2018-01-01 | Not in this release | Not in this release | RVU18AR1 |
| 2017-10-01 | Not in this release | Not in this release | RVU17D |
| 2017-07-01 | Not in this release | Not in this release | RVU17C |
| 2017-04-01 | Not in this release | Not in this release | RVU17B |
| 2017-01-01 | Not in this release | Not in this release | RVU17A |
| 2016-10-01 | Not in this release | Not in this release | RVU16D |
| 2016-07-01 | Not in this release | Not in this release | RVU16C |
| 2016-04-01 | Not in this release | Not in this release | RVU16B |
| 2016-01-01 | Not in this release | Not in this release | RVU16A |
| 2015-10-01 | Not in this release | Not in this release | RVU15D |
| 2015-07-01 | Not in this release | Not in this release | RVU15C |
| 2015-04-01 | Not in this release | Not in this release | RVU15B |
| 2015-01-01 | Not in this release | Not in this release | RVU15A |
| 2014-10-01 | Not in this release | Not in this release | RVU14D |
| 2014-07-01 | Not in this release | Not in this release | RVU14C |
| 2014-04-01 | Not in this release | Not in this release | RVU14B |
| 2014-01-01 | Not in this release | Not in this release | RVU14A |
| 2013-10-01 | Not in this release | Not in this release | RVU13D |
| 2013-07-01 | Not in this release | Not in this release | RVU13C |
| 2013-04-01 | Not in this release | Not in this release | RVU13B |
| 2013-01-01 | Not in this release | Not in this release | RVU13AR |
Where the South Dakota rate applies
South Dakota is a Medicare payment area, not a city. Our Census mapping connects it to 485 cities and communities in South Dakota. Some span more than one payment area; confirm with the service ZIP.
- Aberdeen
- Agar
- Agency Village
- Akaska
- Albee
- Alcester
- Alexandria
- Allen
76016 billing questions
How does 76016 differ from 76014?
76016 represents a physician or QHP’s individualized MR safety determination. 76014 is the clinical-staff implant or foreign-body assessment.
When is modifier 26 or TC appropriate?
Use modifier 26 for the professional interpretation and TC for the technical service. Without either modifier, the claim represents the global service.
Does a multiple procedure reduction affect this code?
Yes. CMS applies diagnostic imaging multiple procedure reduction to both the professional and technical components.
What documentation supports reporting 76016?
Document the implant or possible foreign-body concern, the information reviewed, the physician or QHP’s safety decision, and any conditions or precautions for MRI.
Is 76016 a timed clinical-staff assessment?
No. It reports the physician or QHP determination; 76014 and 76015 describe clinical-staff assessment services.
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
Show the CMS file lines behind this rate
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