$222.24
70540 describes the same anatomic regions without contrast; 70542 is for an examination performed with contrast.
On this page
CMS RVU26D · Effective 2026-10-01
70542 MRI with contrast Medicare reimbursement rates in Delaware
Reports an MRI examination of the orbit, face, or neck performed with contrast, such as imaging to evaluate a mass or inflammatory process. Compare 70542 office and facility rates across CMS payment localities in Delaware.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 70542 in Delaware?
Delaware has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$263.91
1 of 1 localities have a supported rate.
Payment area: Delaware
One mapped payment locality.
Facility setting
No supported rate
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Radiology
About 70542: MRI of orbit, face, or neck with contrast
Reports an MRI examination of the orbit, face, or neck performed with contrast, such as imaging to evaluate a mass or inflammatory process.
This code covers MRI of the orbit, face, and/or neck when contrast is administered. A radiology technologist performs the scan, and a radiologist interprets the images. Examples include evaluating an orbital or facial soft-tissue abnormality or characterizing a neck mass. The code is for these anatomic regions, not a brain MRI or MR angiography examination.
Select this code when the documented examination uses contrast without also including a precontrast imaging portion; use the without-and-with-contrast code when both portions are performed. The order, imaging report, and contrast documentation should support the body region examined and the contrast protocol. The service may be billed globally, or its interpretation and technical work may be reported separately with modifier 26 or TC, respectively. When multiple diagnostic imaging procedures are performed, CMS multiple procedure reduction applies to both the professional and technical components.
CMS billing rules for 70542
- Professional and technical components
- Diagnostic test with a professional component (modifier 26, interpretation) and a technical component (modifier TC, equipment and staff); billing without a modifier is the global service.
- Multiple procedures
- Diagnostic imaging multiple procedure reduction applies to the technical and professional components.
Where the value comes from
- Work RVU1.58 · 20%
- Practice expense (office) RVU6.29 · 79%
- Malpractice RVU0.11 · 1%
786
Medicare services in 2024 · #3166 by national volume
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.
70542 compared with similar codes
Office rates for Delaware, from the same CMS release.
$333.72
70543 includes precontrast and postcontrast imaging, while 70542 is for imaging with contrast only.
$313.96
70553 is an MRI of the brain with and without contrast. Choose based on the anatomy imaged; it is not the orbit, face, or neck code.
Compare 70542 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Delaware →
Office / nonfacility
$263.91
Facility
Unavailable
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 70542 in Delaware.
PPRRVU2026_Oct_nonQPP.csv
7,832
- Code
- 70542
- Physician work
- 1.58
- Practice expense
- 6.29
- Malpractice
- 0.11
GPCI2026.csv
40
- Locality
- Delaware
- Physician work
- 1.005
- Practice expense
- 0.988
- Malpractice
- 0.899
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.58 | × 1.005 | 1.5879 |
| Practice expense | 6.29 | × 0.988 | 6.2145 |
| Malpractice | 0.11 | × 0.899 | 0.0989 |
| Total RVUs | 7.9013 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Delaware$263.91
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.58 | 1.005 |
| Practice expense | 6.29 | 0.988 |
| Malpractice | 0.11 | 0.899 |
(1.58 × 1.005 + 6.29 × 0.988 + 0.11 × 0.899) × $33.4009 = $263.91
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
70542 billing questions
How does this differ from 70540?
70542 is for the orbit, face, or neck MRI with contrast. Use 70540 when the examination is performed without contrast.
When should 70543 be reported instead?
Use 70543 when the MRI includes both precontrast and postcontrast imaging. This code represents the contrast-only examination.
Can the interpretation and scan be billed separately?
Yes. Modifier 26 identifies the professional interpretation, and modifier TC identifies the technical service. Without either modifier, the claim represents the global service.
Does a multiple procedure reduction apply?
Yes. CMS applies the diagnostic imaging multiple procedure reduction to the professional and technical components when applicable.
What documentation supports reporting this code?
The record should identify the orbit, face, and/or neck examined, show that contrast was administered, and include the imaging findings and interpretation.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
7,82970540,,Mri orbit/face/neck w/o dye,A,,1.32,5.31,,5.31,NA,0.09,6.72,6.72,1,XXX,0.00,0.00,0.00,4,0,0,0,0,9,,33.4009,09,0,88,7.73,7.73,0.10
7,83070540,26,Mri orbit/face/neck w/o dye,A,,1.32,0.46,,0.46,,0.07,1.85,1.85,1,XXX,0.00,0.00,0.00,4,0,0,0,0,9,,33.4009,09,0,88,0.00,0.00,0.00
7,83170540,TC,Mri orbit/face/neck w/o dye,A,,0.00,4.85,,4.85,NA,0.02,4.87,4.87,1,XXX,0.00,0.00,0.00,4,0,0,0,0,9,,33.4009,01,0,88,7.27,7.27,0.03
7,83270542,,Mri orbit/face/neck w/dye,A,,1.58,6.29,,6.29,NA,0.11,7.98,7.98,1,XXX,0.00,0.00,0.00,4,0,0,0,0,9,,33.4009,09,0,88,11.19,11.19,0.14
7,83370542,26,Mri orbit/face/neck w/dye,A,,1.58,0.57,,0.57,,0.08,2.23,2.23,1,XXX,0.00,0.00,0.00,4,0,0,0,0,9,,33.4009,09,0,88,0.00,0.00,0.00
7,83470542,TC,Mri orbit/face/neck w/dye,A,,0.00,5.72,,5.72,NA,0.03,5.75,5.75,1,XXX,0.00,0.00,0.00,4,0,0,0,0,9,,33.4009,02,0,88,10.62,10.62,0.06
7,83570543,,Mri orbt/fac/nck w/o &w/dye,A,,2.10,7.84,,7.84,NA,0.15,10.09,10.09,1,XXX,0.00,0.00,0.00,4,0,0,0,0,9,,33.4009,09,0,88,11.37,11.37,0.17
3704112,CO,01,COLORADO,1.012,1.064,0.781
3813102,CT,00,CONNECTICUT,1.020,1.077,1.210
3912202,DC,01,DC + MD/VA SUBURBS,1.054,1.178,1.113
4012102,DE,01,DELAWARE,1.005,0.988,0.899
4109102,FL,03,FORT LAUDERDALE,1.000,1.013,1.808
4209102,FL,04,MIAMI,1.000,1.041,2.529
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503