Brain and brainstem MRI acquired only after a gadolinium contrast injection, with no non-contrast sequences in the same session.
- Medicare
- $268.88
- Work RVU
- 1.74
- Global, days
- Region
- Other
Documentation requirements
What must appear in the operative or office note to support the claim.
Source · Editorial brief grounded in 3 cited references ↓
- Order with the reason for contrast, such as metastasis staging
- Gadolinium agent and dose
- Report confirming contrast-only sequences
- Kidney function screening per facility protocol
- Prior authorization for commercial plans
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 ↓
70552 is a brain MRI with contrast only. It is uncommon because most brain protocols include non-contrast sequences first, which makes the study 70553.
In an orthopedic or spine setting, contrast brain imaging shows up in metastatic disease. A patient with a pathologic fracture or spinal metastasis from a known primary may need brain staging. Infection workups are another case.
The main audit risk is code-to-report mismatch. Read the protocol. If the report lists pre-contrast T1 or any non-contrast sequences, the code is 70553. Billing 70552 when 70553 was performed underpays the claim, and billing 70553 when only contrast images were acquired overbills it.
Prior authorization is usually required for outpatient brain MRI on commercial plans, and the approved code has to match what was performed. Gadolinium screening, including kidney function when the facility requires it, belongs in the technologist record.
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 (1.74) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (8.05) adds practice overhead and malpractice, and is what drives the Medicare payment below.
| Work RVU | 1.74 |
| Practice expense RVU | 6.19 |
| Malpractice RVU | 0.12 |
| Total RVU | 8.05 |
| Medicare national rate | $268.88 |
| 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 | $268.88 |
HOPD (APC 5572) Hospital outpatient department | $356.43 |
Common denial reasons
The recurring reasons claims for CPT 70552 get rejected.
Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓
- Report shows non-contrast sequences, so 70553 was correct
- Authorization was for a different brain MRI code
- Diagnosis does not support contrast
- Global billed in a facility setting
- No signed report
Frequently asked questions
Source · Generated from the editorial pipeline, verified against 3 cited references ↓
01When is 70552 used instead of 70553?
02Does a pathologic fracture justify a brain MRI?
03Is prior authorization needed for 70552?
Sources & references
Editorial content was developed using the following public sources.
Mira Scribe
For a patient with a pathologic fracture, Mira Scribe records the known cancer history and the staging plan, which supports any brain imaging that follows.
See how Mira captures CPT 70552 documentation