Chest MRI performed in one session with non-contrast sequences first and then repeat sequences after gadolinium contrast.
- Medicare
- $465.94
- Work RVU
- 2.2
- 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 mass characterization
- Mass location, size, and history
- Gadolinium agent, dose, and timing
- Report describing both phases
- Authorization for the two-phase code
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 ↓
71552 is a chest MRI with sequences before and after contrast. It is the standard protocol for characterizing a chest wall or mediastinal mass, since contrast enhancement helps separate tumor from other tissue.
Orthopedic oncology uses it for chest wall and periscapular soft tissue sarcomas and for bone tumors of the ribs, sternum, or scapula when the soft tissue extent matters. A surgeon planning a resection wants to see how far the mass reaches.
Coding points: do not bill 71550 with 71551 for one session. Report 71552 once. If the contrast phase was cancelled, the code is 71550. Commercial authorization is almost always needed, and approvals for a non-contrast study do not cover the two-phase code. Brachial plexus and shoulder girdle studies may be coded differently by different facilities, so confirm the code before the auth goes in.
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 (2.2) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (13.95) adds practice overhead and malpractice, and is what drives the Medicare payment below.
| Work RVU | 2.2 |
| Practice expense RVU | 11.58 |
| Malpractice RVU | 0.17 |
| Total RVU | 13.95 |
| Medicare national rate | $465.94 |
| 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 | $465.94 |
HOPD (APC 5572) Hospital outpatient department | $356.43 |
Common denial reasons
The recurring reasons claims for CPT 71552 get rejected.
Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓
- 71550 and 71551 billed for the same session
- Contrast phase not done but 71552 billed
- Authorization for a single-phase code
- Diagnosis does not support contrast
- Region billed does not match the authorized region
Frequently asked questions
Source · Generated from the editorial pipeline, verified against 3 cited references ↓
01Can 71550 and 71551 be billed together?
02Why would an orthopedic oncologist order 71552?
03Does an auth for 71550 cover 71552?
Sources & references
Editorial content was developed using the following public sources.
Mira Scribe
Mira Scribe captures the mass history, exam findings, and surgical plan in the oncology visit note, which supports the contrast MRI before resection.
See how Mira captures CPT 71552 documentation