Billing code 76016: MR safety reviewMedicare rate & RVUs in Maine
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.
Medicare pays $67.15–$70.74 for 76016 in the office in Maine, from Rest Of Maine to Southern Maine. 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 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.
Where 76016 pays more and less in Maine
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Maine | $67.15 | Unavailable |
| Southern Maine | $70.74 | Unavailable |
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.
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
| 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
76016-26 · Professional component
$27.72
Pays only the interpretation and report.
76016 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 76014MRI safety assessment
- Choose 76014 for the clinical-staff implant or foreign-body assessment; choose 76016 when a physician or QHP makes the individualized safety determination.
- 76015MR safety assessment
- 76015 reports additional clinical-staff assessment time. It is not the physician or QHP determination represented by 76016.
- 76017MR safety
- 76017 is a customized medical physics examination. 76016 is the physician or QHP’s clinical MR safety determination.
- 76018MRI implant preparation
- 76018 addresses electrical preparation of an implanted device; 76016 reports the broader physician or QHP safety decision.
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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