Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s)

CPT 70540 is the billing code for "Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s)". For MRI orbit, face, and/or neck without contrast

Medicare pays approximately $222.22 for CPT 70540 (national average). Actual payment varies by geographic location due to GPCI adjustments. Hospital and commercial insurance rates are typically 2-4x higher than Medicare rates.

CPT 70540 has a total RVU of 13.65, broken down as: Work RVU 1.50, Practice Expense RVU 12.00, and Malpractice RVU 0.15. RVUs (Relative Value Units) determine Medicare reimbursement rates.

Key documentation requirements for CPT 70540 include: Indication for MRI; Area(s) imaged; Without contrast; Findings and interpretation. Missing or incomplete documentation is a leading cause of claim denials for this code.

Bundling considerations for CPT 70540: Includes MRI orbit/face/neck without contrast. Includes interpretation and report Use an NCCI bundling checker to verify specific code combinations before billing.

Common modifiers for CPT 70540 include: 26 (Professional component only (interpretation)), TC (Technical component only (equipment/staff)), 59 (Distinct procedural service if performed separately). Modifiers indicate special circumstances and can affect reimbursement or prevent claim denials.

The typical time requirement for CPT 70540 is 30-45 minutes typical procedure time. Time-based codes require documentation of the actual time spent providing the service.