Billing code 70543: Regional MRIMedicare rate & RVUs in Missouri
MRI of the orbits, face, or neck with imaging before and after contrast, reported when the examination covers these structures and includes both phases.
Medicare pays $300.75–$324.46 for 70543 in the office in Missouri, from Rest Of Missouri to Metropolitan St. Louis. 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 70543 covers
This examination images the orbits, facial structures, or neck using MRI sequences obtained before and after contrast administration. Radiologists interpret these studies for questions such as an orbital or facial mass, suspected inflammation, or a neck soft-tissue abnormality. The imaging may be performed in a hospital or outpatient imaging center, or in an office with MRI equipment.
Report 70543 when the documented examination includes the relevant orbit, face, or neck anatomy and both pre-contrast and post-contrast imaging. The report should support the body region examined, use of contrast, and the interpreting findings. Billing without a component modifier represents the global service; modifier 26 identifies the professional interpretation, and modifier TC identifies the technical service, including equipment and staff. CMS multiple-procedure reduction applies to both the technical and professional components when multiple diagnostic imaging procedures are reported.
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 70543 pays more and less in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
3 payment localities
$300.75 to $324.46
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City | $320.93 | Unavailable |
| Metropolitan St. Louis | $324.46 | Unavailable |
| Rest Of Missouri | $300.75 | Unavailable |
How the 70543 rate is calculated
Each of 70543’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 · 70543
RVUs × geographic indexes × conversion factor
Work2.10
2.10 RVUs× 1.000 GPCI
Practice expense7.84
7.84 RVUs× 1.000 GPCI
Malpractice0.15
0.15 RVUs× 1.000 GPCI
Adjusted RVUs
10.0900
Conversion factor
$33.4009
Medicare rate
$337.02
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 70543
The CMS indicators that decide how 70543 is paid alongside other services.
CMS payment indicators · 70543
Regional 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
70543 without 26 · national office
$337.02
Regional MRI
70543-26 · Professional component
$98.87
Pays only the interpretation and report.
70543 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 70540MRI
- 70540 is for the same regional anatomy imaged without contrast; 70543 includes imaging before and after contrast.
- 70542MRI with contrast
- 70542 covers the same regional anatomy with contrast only. Choose 70543 when the examination includes both pre-contrast and post-contrast imaging.
- 70549Neck MRA
- 70549 is an MRA of the neck performed before and after contrast to evaluate vessels; 70543 images orbit, face, or neck structures rather than serving as a neck angiogram.
70543 billing questions
When should 70543 be chosen instead of 70540 or 70542?
Use 70543 when the examination includes imaging both before and after contrast. Use 70540 for imaging without contrast and 70542 for imaging with contrast only.
Can the professional interpretation and technical service be billed separately?
Yes. Modifier 26 identifies the professional interpretation, and modifier TC identifies the technical service. Billing without either modifier represents the global service.
Does the multiple-procedure reduction affect this MRI?
CMS applies diagnostic imaging multiple-procedure reduction to both the technical and professional components when multiple diagnostic imaging procedures are reported.
What documentation supports reporting 70543?
Document the orbit, face, or neck anatomy examined, that imaging was performed before and after contrast, and the interpretation findings.
Is 70543 the same as an MRA of the neck?
No. 70543 is an MRI examination of orbit, face, or neck structures; an MRA of the neck evaluates blood vessels.
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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