Billing code 75561: Cardiac MRIMedicare rate & RVUs in Illinois
Cardiac MRI with contrast evaluates heart structure and function when detailed assessment is needed without pharmacologic or exercise stress imaging.
Medicare pays $343.95–$376.96 for 75561 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 75561 covers
This cardiac MRI evaluates heart structure and function using images acquired before and after intravenous contrast, without stress imaging. It can assess ventricular size and performance, chamber anatomy, myocardium, and cardiac masses; contrast-enhanced tissue assessment may help evaluate conditions such as cardiomyopathy, myocarditis, scar, or selected congenital abnormalities. A technologist performs the scan in a hospital or outpatient imaging facility, and a radiologist or cardiologist interprets the study.
Report 75561 when the performed protocol includes contrast-enhanced morphology and function imaging without a stress component. Documentation should identify the clinical indication, contrast administration, imaging performed, and findings supporting the structural and functional assessment. Medicare recognizes professional and technical components: use modifier 26 for the interpretation, modifier TC for equipment and staff, or neither modifier when billing the global service. When multiple diagnostic imaging procedures are performed, the diagnostic imaging multiple-procedure reduction applies to both the professional and technical 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 75561 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
$343.95 to $376.96
| Payment locality | Office | Facility |
|---|---|---|
| Chicago | $373.53 | Unavailable |
| East St. Louis | $348.13 | Unavailable |
| Rest Of Illinois | $343.95 | Unavailable |
| Suburban Chicago | $376.96 | Unavailable |
How the 75561 rate is calculated
Each of 75561’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 · 75561
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 2.54Practice expense 8.24Malpractice 0.15
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 75561
The CMS indicators that decide how 75561 is paid alongside other services.
CMS payment indicators · 75561
Cardiac 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
75561 without 26 · national office
$365.07
Cardiac MRI
75561-26 · Professional component
$119.91
Pays only the interpretation and report.
75561 compared with similar codes
Compare codes
75561 vs 75557 vs 75559 vs 75563 vs 75565: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 75557Cardiac MRI
- 75557 describes cardiac morphology and function imaging without contrast. Use 75561 when the performed study includes contrast-enhanced imaging.
- 75559Cardiac MRI
- 75559 includes stress imaging but not contrast. 75561 is the contrast-enhanced morphology and function study without stress imaging.
- 75563Cardiac MRI
- 75563 includes both stress imaging and contrast. Choose 75561 when contrast is used but the cardiac MRI does not include stress imaging.
- 75565Cardiac MRI
- 75565 covers additional cardiac MRI velocity flow mapping and is an add-on, not a substitute for the primary morphology and function study.
75561 billing questions
How does 75561 differ from 75557?
75561 is for cardiac MRI with contrast; 75557 is the corresponding morphology and function study without contrast. Choose based on the protocol performed and documented.
When is a stress cardiac MRI code more appropriate?
Use a stress cardiac MRI code when the study includes stress imaging. 75561 describes the contrast-enhanced morphology and function study without a stress component.
Can the professional and technical portions be billed separately?
Yes. Report modifier 26 for the professional interpretation or TC for the technical service; billing without either modifier represents the global service.
Can 75565 be reported with 75561?
75565 is an add-on for cardiac MRI velocity flow mapping and may be reported with 75561 when that additional mapping service is performed and documented.
How does the multiple-procedure reduction affect 75561?
When multiple diagnostic imaging procedures are performed, the CMS multiple-procedure reduction applies to both the professional and technical components of 75561.
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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