Magnetic resonance angiography of the neck vessels done without contrast and then with contrast, showing the carotid and vertebral arteries.
- Medicare
- $343.36
- Work RVU
- 1.76
- Global, days
- Region
- Spine
Documentation requirements
What must appear in the operative or office note to support the claim.
Source · Editorial brief grounded in 3 cited references ↓
- Order stating the vascular question, such as vertebral artery injury or pre-op mapping
- Cervical fracture pattern or planned procedure that creates the risk
- Gadolinium agent and dose
- Report describing both the non-contrast and contrast sequences
- MRI safety screening for hardware and implants
Applicable modifiers
Modifiers commonly billed with this code.
Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual
What this code covers
Source · Editorial summary grounded in 3 cited references ↓
70549 is an MR angiogram of the neck with both non-contrast and contrast images. It shows the carotid and vertebral arteries without a catheter.
Spine surgeons care about this code. The vertebral arteries run through the transverse foramina of the cervical spine. Before C1-C2 fusion or posterior cervical screw placement, some surgeons want the vertebral artery course mapped, especially when anatomy looks anomalous on CT. After cervical spine trauma with fractures through the transverse foramen or facet dislocation, vertebral artery injury is a real concern, and MRA or CTA is used to screen for it.
On the billing side, Medicare limits MRA to the indications listed in its national coverage determination for magnetic resonance angiography. Check that the diagnosis fits one of them. Commercial plans usually require authorization. The diagnosis should name the vascular concern or the cervical fracture pattern that creates the risk. Neck MRA without contrast is 70547 and with contrast only is 70548, so match the code to what the report describes.
RVU & reimbursement
Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.
Source · CMS Physician Fee Schedule, RVU26A · January 2026
Work RVU vs. total RVU
The work RVU (1.76) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (10.28) adds practice overhead and malpractice, and is what drives the Medicare payment below.
| Work RVU | 1.76 |
| Practice expense RVU | 8.39 |
| Malpractice RVU | 0.13 |
| Total RVU | 10.28 |
| Medicare national rate | $343.36 |
| Global period | days |
Payment by site of service
Medicare pays different rates by setting. HOPD typically pays substantially more than ASC for the same procedure.
Source · CMS OPPS Addendum B·ASC HCPCS payment rates·2026
| Setting | Medicare rate (national) |
|---|---|
Office (PFS non-facility) Procedure performed in physician's office | $343.36 |
HOPD (APC 5572) Hospital outpatient department | $356.43 |
Common denial reasons
The recurring reasons claims for CPT 70549 get rejected.
Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓
- Indication not covered under the Medicare MRA coverage policy
- Only one phase performed, so 70547 or 70548 applies
- No prior authorization for a commercial plan
- Diagnosis lists neck pain without a vascular concern
- Billed with a cervical spine MRI without separate orders
Frequently asked questions
Source · Generated from the editorial pipeline, verified against 3 cited references ↓
01Why would a spine surgeon order a neck MRA?
02Does Medicare cover CPT 70549?
03What is the difference between 70547, 70548, and 70549?
04Can 70549 be billed with a cervical spine MRI?
Sources & references
Editorial content was developed using the following public sources.
- 01CMS Physician Fee Schedule 2026
- 02cms.govhttps://www.cms.gov/medicare/payment/fee-schedules/physician
- 03Medicare National Coverage Determination 220.3, Magnetic Resonance Angiography
Mira Scribe
Mira Scribe captures the fracture pattern and the surgeon's concern about the vertebral artery in the trauma or pre-op note, which is the medical necessity a neck MRA needs.
See how Mira captures CPT 70549 documentation