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CPT 70551: MRI Brain and Brain Stem, No Contrast
CPT code 70551 designates a non-contrast magnetic resonance imaging (MRI) exam of the brain and brain stem. This imaging service is widely used in neurologic evaluation for headache, seizures, vertigo, ischemic and other cerebrovascular conditions. As a commonly billed diagnostic radiology procedure, 70551 has national relevance for utilization, prior authorization workflows, and coding accuracy in both outpatient imaging centers and hospital radiology departments.
Key payers covered in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of the clinical context for 70551, comparisons to related imaging services, common billing modifiers, typical indications tied to ICD-10 diagnoses, and payer coverage considerations. The report also highlights adjacent codes relevant to brain MRI workflows, such as magnetic resonance angiography and available add-on automated analysis codes.
This publication aims to help coding managers, revenue cycle leaders, and clinical radiology staff understand where 70551 fits in diagnostic pathways, how payers commonly treat the service, and which clinical scenarios most frequently generate the code. Data-driven benchmarks and policy updates are summarized where available. Data not available in the input is noted explicitly.
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Billing Code Overview
CPT code 70551 describes a magnetic resonance imaging (MRI) exam of the brain and brain stem without contrast. The procedure uses MRI technology to capture diagnostic images of intracranial structures and the brainstem anatomy without administration of intravenous contrast agents.
Service Type: Diagnostic imaging — MRI, non-contrast brain and brain stem
Typical Site of Service: Outpatient imaging center or hospital radiology department
National Reimbursement Benchmarks
Commercial averages sit well above Medicare for CPT 70551: Blue Cross Blue Shield and BUCA (an aggregate commercial benchmark) each show mean rates far above Medicare’s mean of $135.40, with BUCA at $532.40 and Blue Cross Blue Shield at $754.10. This highlights a sizable commercial-to-Medicare gap in national mean reimbursements for this imaging code.
Dispersion varies notably across payers when comparing the interquartile ranges (P75–P25). Blue Cross Blue Shield’s IQR is $808.40 (877.30–606.90), the widest, reflecting substantial variability; UnitedHealth Group follows with an IQR of $218.90 (347.80–127.90). Cigna’s IQR is $240.50 (343.80–110.30). Aetna is comparatively tighter with an IQR of $193.60 (282.10–85.00). BUCA’s IQR is $271.40 (640.40–393.00), and Medicare’s IQR is $117.00 (188–71), the narrowest of the group.