Magnetic resonance (eg, proton) imaging, brain (including brain stem); with contrast material(s)
Relative Value Units (RVUs)
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Clinical Information
When to Use
For MRI brain with contrast
Common Scenarios
Documentation Requirements
- Indication for MRI brain
- With contrast
- Contrast type and amount
- Findings and interpretation
- Report documentation
Coding Guidelines
Common Modifiers
Bundling Rules
- Includes MRI brain with contrast
- Includes interpretation and report
- Without contrast coded separately
- With and without contrast coded separately
- CT brain coded separately
Exclusions
- 70551 (MRI brain without contrast)
- 70553 (MRI brain without contrast followed by contrast)
- 70460 (CT head or brain with contrast)
- 70540 (MRI orbit, face, and/or neck without contrast)
Coding Notes
Clinical scenarios
- Indication for MRI brain
- With contrast
- Contrast type and amount
- Indication for MRI brain
- With contrast
- Contrast type and amount
- Indication for MRI brain
- With contrast
- Contrast type and amount
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Code Details
Medicare Pricing
PFSRVU Breakdown
OPPS Details
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Ask a QuestionFrequently Asked Questions
CPT 70552 is the billing code for "Magnetic resonance (eg, proton) imaging, brain (including brain stem); with contrast material(s)". For MRI brain with contrast
Medicare pays approximately $266.54 for CPT 70552 (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 70552 has a total RVU of 15.48, broken down as: Work RVU 1.80, Practice Expense RVU 13.50, and Malpractice RVU 0.18. RVUs (Relative Value Units) determine Medicare reimbursement rates.
Key documentation requirements for CPT 70552 include: Indication for MRI brain; With contrast; Contrast type and amount; Findings and interpretation. Missing or incomplete documentation is a leading cause of claim denials for this code.
Bundling considerations for CPT 70552: Includes MRI brain with contrast. Includes interpretation and report Use an NCCI bundling checker to verify specific code combinations before billing.
Common modifiers for CPT 70552 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 70552 is 40-55 minutes typical procedure time. Time-based codes require documentation of the actual time spent providing the service.