Billing code 70551: Brain MRIMedicare rate & RVUs in Illinois
Magnetic resonance imaging of the brain, including the brainstem, performed without contrast for stroke, seizure, cognitive decline, or other neurologic workups.
Medicare pays $184.75–$202.20 for 70551 in the office in Illinois, from Rest Of Illinois to Suburban Chicago. 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.
On this page 9 sections
What 70551 covers
This study images the cerebral hemispheres, posterior fossa, and brainstem using noncontrast sequences such as T1, T2, FLAIR, diffusion-weighted, and susceptibility imaging. It is ordered for suspected acute stroke, new seizures, cognitive decline, red-flag headache, and follow-up of known structural lesions. Focused noncontrast examinations of the internal auditory canals or pituitary are also reported within the brain MRI series. Technologists acquire the images in hospital radiology departments, emergency settings, and freestanding imaging centers, and a radiologist or neuroradiologist interprets them.
Report 70551 when no contrast is administered for the brain MRI. The report should state the indication, sequences obtained, findings, and impression. Medicare recognizes a professional component (modifier 26) for interpretation and a technical component (modifier TC) for the scanner, staff, and supplies. Billing without a modifier represents the global service when one entity furnishes both components. When eligible diagnostic imaging services are performed for the same patient on the same date, the multiple procedure reduction applies to professional and technical components, with each component ranked separately.
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 70551 pays more and less in Illinois
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
4 payment localities
$184.75 to $202.20
| Payment locality | Office | Facility |
|---|---|---|
| Chicago | $200.78 | Unavailable |
| East St. Louis | $187.27 | Unavailable |
| Rest Of Illinois | $184.75 | Unavailable |
| Suburban Chicago | $202.20 | Unavailable |
How the 70551 rate is calculated
Each of 70551’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 · 70551
RVUs × geographic indexes × conversion factor
Work1.44
1.44 RVUs× 1.000 GPCI
Practice expense4.31
4.31 RVUs× 1.000 GPCI
Malpractice0.10
0.10 RVUs× 1.000 GPCI
Adjusted RVUs
5.8500
Conversion factor
$33.4009
Medicare rate
$195.40
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 70551
The CMS indicators that decide how 70551 is paid alongside other services.
CMS payment indicators · 70551
Brain MRI
| 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
70551 without 26 · national office
$195.40
Brain MRI
70551-26 · Professional component
$67.80
Pays only the interpretation and report.
70551 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 70553Brain MRI
- 70553 applies when noncontrast brain imaging is followed by contrast-enhanced brain imaging in the same session. Use 70551 when the brain MRI is performed without contrast.
- 70544Head MRA
- 70544 is MR angiography of intracranial vessels; 70551 evaluates brain tissue. Both can be reported when both distinct studies are performed and documented.
- 70450Head CT
- 70450 is a CT scan of the head without contrast. Choose by modality: CT uses x-rays, while 70551 uses magnetic resonance.
- 70540MRI
- 70540 covers noncontrast MRI of the orbits, face, or neck. Noncontrast studies of the brain, pituitary, or internal auditory canals are reported with 70551.
70551 billing questions
If the radiologist adds contrast after reviewing the noncontrast images, can 70551 and 70552 be billed together?
No. When noncontrast brain images are followed by contrast-enhanced brain images in the same session, report 70553 alone.
How is an internal auditory canal or pituitary MRI coded?
These focused studies are reported with the brain MRI codes based on contrast use. A noncontrast internal auditory canal or pituitary study is reported as 70551.
Which modifier does a hospital-based radiologist use?
The reading radiologist appends modifier 26 for the interpretation, and the hospital bills for the technical portion on its facility claim. A freestanding center that furnishes and bills for both components reports the global service without a component modifier.
Can MRA of the head be billed on the same day as 70551?
Yes, when a separate head MRA is performed and documented. Eligible same-day diagnostic imaging services are subject to multiple procedure reductions, with professional and technical components ranked separately.
Is diffusion-weighted imaging billed separately?
No. Diffusion and other standard sequences acquired during the exam are part of the brain MRI and are not separately reportable.
When are 70557-70559 used instead of 70551?
Those codes describe brain MRI performed during an open intracranial procedure. A routine diagnostic brain MRI is selected from 70551-70553 based on contrast use.
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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