Billing code 70542: MRI with contrastMedicare rate & RVUs in Kentucky
Reports an MRI examination of the orbit, face, or neck performed with contrast, such as imaging to evaluate a mass or inflammatory process.
Medicare pays $242.91 for 70542 in the office in Kentucky (Kentucky). 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 70542 covers
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.
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 in Kentucky
| Payment locality | Office | Facility |
|---|---|---|
| Kentucky | $242.91 | Unavailable |
How the 70542 rate is calculated
Each of 70542’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 · 70542
RVUs × geographic indexes × conversion factor
Work1.58
1.58 RVUs× 1.000 GPCI
Practice expense6.29
6.29 RVUs× 1.000 GPCI
Malpractice0.11
0.11 RVUs× 1.000 GPCI
Adjusted RVUs
7.9800
Conversion factor
$33.4009
Medicare rate
$266.54
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 70542
The CMS indicators that decide how 70542 is paid alongside other services.
CMS payment indicators · 70542
MRI with contrast
| 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
70542 without 26 · national office
$266.54
MRI with contrast
70542-26 · Professional component
$74.48
Pays only the interpretation and report.
70542 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 70540MRI
- 70540 describes the same anatomic regions without contrast; 70542 is for an examination performed with contrast.
- 70543Regional MRI
- 70543 includes precontrast and postcontrast imaging, while 70542 is for imaging with contrast only.
- 70553Brain MRI
- 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.
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 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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