CPT 70553: MRI Brain with and without Contrast

Medicare pays $220 and commercial payers pay $844 on average nationally for this procedure.

CPT code 70553 describes a magnetic resonance imaging (MRI) study of the brain including the brain stem performed first without intravenous contrast and then repeated with contrast, constituting a combined non-contrast and contrast-enhanced brain MRI; service type: diagnostic MRI of the brain; typical site of service: hospital outpatient department or freestanding imaging center.

For related coverage guidance, see recent payer policy updates: Lumbar Microdiscectomy, Artificial Cervical Intervertebral Disc, Lumbar Decompression.

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National Reimbursement Benchmarks

Medicare’s mean rate of $219.8 for CPT 70553 sits well below BUCA’s average commercial mean of $843.8, indicating a substantial gap between public and the BUCA commercial benchmark. That gap of $624.0 highlights how much higher commercial reimbursements can be versus Medicare for this service, with Medicare also showing a median local payment of $216 which is close to its mean, suggesting national Medicare locality payments cluster near that level. Rate dispersion (P75 minus P25) varies notably across payers. Blue Cross Blue Shield shows a tight spread of $396.1 (P75 $1,377.20 minus P25 $981.10) relative to its higher central tendency, while Aetna’s spread is $177.3 and Cigna’s is $384.8. UnitedHealth Group’s dispersion is $428.0. BUCA’s interquartile spread is $365.0. The widest IQR among listed payers is UnitedHealth Group at $428.0 and the tightest is Aetna at $177.3, reflecting meaningful differences in within-payer variability.

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CPT 70553: MRI Brain with and without Contrast

Medicare pays $220 and commercial payers pay $844 on average nationally for this procedure.

For related coverage guidance, see recent payer policy updates: Lumbar Microdiscectomy, Artificial Cervical Intervertebral Disc, Lumbar Decompression.

Customize your policy alerts

Sign up for cpt 70553 policy alerts

Get alerted when payer policies referencing 70553 are released or updated.

Monitor payer policy activity

Receive email alerts as soon as relevant payer policies are published or updated.

National Reimbursement Benchmarks

National Payer Mean Reimbursement Rates

Clinical & Coding Specifications

Clinical Context

A 52-year-old patient presents to the outpatient radiology clinic with a 3-week history of progressive, unexplained headaches and new intermittent episodes of dizziness. The referring neurologist documents focal neurologic symptoms on exam and requests neuroimaging to evaluate for structural brain disease, mass lesion, demyelination, or vascular abnormality. The MRI brain study is performed in two phases: an initial non-contrast MRI of the brain including the brain stem to evaluate baseline signal characteristics and identify acute hemorrhage or calcification, followed by administration of gadolinium-based contrast and additional post-contrast sequences to assess enhancement patterns (tumor, infection, inflammatory lesions, breakdown of the blood–brain barrier). The typical workflow includes patient registration, screening for MRI safety and contrast allergy/renal function, intravenous access placement, acquisition of non-contrast sequences (T1, T2, FLAIR, DWI, SWI), contrast injection, and acquisition of post-contrast T1-weighted sequences. Typical site of service is an outpatient radiology department or hospital-based imaging suite; inpatient or emergency department settings are also common when indicated. The encounter is billed using 70553 to reflect both non-contrast and contrast-enhanced brain MRI performed in the same session involving the brain and brain stem.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`70551`	Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material	Alternative when only non-contrast MRI is performed; precedes contrast sequences when study is limited to non-contrast imaging.
`70552`	Magnetic resonance (eg, proton) imaging, brain (including brain stem); without and with contrast material, or with and without contrast material	Closely related; codes ordered by payer rules to reflect sequence of non-contrast and contrast imaging — `70553` is used when the provider performs non-contrast then contrast in the same session (provider interpretation emphasis).
`70540-70543`	Magnetic resonance imaging of the orbit, face, and/or neck (MRI study of the orbit)	Performed when additional imaging of contiguous anatomic regions (orbits/face/neck) is clinically indicated in the same encounter; may be billed separately if distinct and not bundled.
`70545`	Magnetic resonance angiography, head	Performed when vascular evaluation is required; may be added to an MRI brain study to assess intracranial vessels and flow characteristics.

Related Modifiers

9 rows

Modifier	Description	When to Use
26	Modifier 26 (Professional Component) identifies and bills only the professional portion of a split service — the physician’s interpretation, report, and medical judgment — when the technical…	- Use CPT Modifier -26 when you are billing only the professional component (PC) of a split‑bill eligible service—i.e., you performed the physician interpretation, medical judgment and prepared a…
50	Modifier –50 (Bilateral Procedure) is appended to a CPT code when an identical procedure is performed on paired anatomical structures during the same operative session. The AMA states to add…	- Use modifier -50 when the same CPT surgical, diagnostic, or radiology procedure is performed on paired anatomical structures (both sides of the body) during the same operative/session by the same…
52	Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…	- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
53	Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…	- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
59	Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…	- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…
62	Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…	- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
76	Modifier -76, Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional, is appended when the same provider performs an identical, medically necessary procedure or…	- Use modifier -76 when the same physician or other qualified health care professional performs an identical procedure or service a second (or subsequent) time on the same date of service and the…
77	Modifier 77 indicates that a previously performed procedure or service was legitimately repeated by a different physician or other qualified health care professional. The AMA’s CPT definition…	- Use modifier 77 when a basic procedure or service already performed is repeated by a different physician or other qualified health care professional (for example, a second provider independently…
91	Modifier 91 — “Repeat Clinical Diagnostic Laboratory Test” — is appended when the exact same CPT laboratory test is performed more than once for the same patient on the same day because serial,…	- Use modifier 91 when the exact same CPT laboratory test is performed more than once on the same patient on the same date because serial or repeated testing is medically necessary to monitor…

Related Provider Taxonomies

8 rows

Taxonomy Code	Specialty	Notes
2085R0202X	Diagnostic Radiology Physician	A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
207PE0005X	Undersea and Hyperbaric Medicine (Emergency Medicine) Physician	A specialist who treats decompression illness and diving accident cases and uses hyperbaric oxygen therapy to treat such conditions as carbon monoxide…
261QM1101X	Military and U.S. Coast Guard Ambulatory Procedure Clinic/Center	That part of a "fixed" (non-temporary, non-deployed) DoD or Coast Guard entity furnishing surgical procedures requiring medically supervised recovery.…
2080S0010X	Pediatric Sports Medicine Physician	A pediatrician who is responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also fo…
163WU0100X	Urology Registered Nurse	Nursing Service Providers · Registered Nurse
204F00000X	Transplant Surgery Physician	A surgeon who specializes in transplant surgery.
122400000X	Denturist	A denturist is a licensed professional that serves patients with removable dental prosthetic oral health needs. A licensed denturist is trained in rem…
2080I0007X	Pediatric Clinical & Laboratory Immunology Physician	A pediatrician who specializes in clinical and laboratory immunology disease management.

Related Payer Policy Updates

Specialty: Neurology/Neurosurgery1 / 3

10 rows

Policy	Payer	Effective Date
Lumbar Microdiscectomy	univerahealthcare	2026-10-15
Artificial Cervical Intervertebral Disc	univerahealthcare	2026-10-15
Lumbar Decompression	univerahealthcare	2026-10-15
Nerve Fiber Density Testing (IENFD/ENFD) Coverage Criteria	Oscar Health	2026-10-01
Biomarker Testing for Multiple Sclerosis and Related Neurologic Diseases	Oscar Health	2026-10-01
Biochemical Markers of Alzheimer Disease and Dementia	Oscar Health	2026-10-01
Serum Testing For Evidence of Mild Traumatic Brain Injury	Oscar Health	2026-10-01
Evaluation of Cerebrospinal Fluid, Urine and Plasma for Alzheimer Disease	Bluecross Idaho	2026-09-01
Prior Authorization of Spinal Procedures	Blue Cross Blue Shield - Rhode Island	2026-09-01
Alzheimer's Disease - Amyloid Beta- Directed Antibodies - Kisunla	Cigna	2026-08-15

CPT 70010: CT Posterior Cranial Fossa With Contrast

CPT-70015-BASAL-CISTERN-BRAIN-IMAGING-SUPERVISION-INTERPRETATION

CPT 70015: Basal Cistern Brain Imaging, Supervision and Interpretation

CPT-70030-EYE-XRAY-FOREIGN-BODY-EVALUATION

CPT 70030: Orbital X‑ray for Foreign Body Evaluation

CPT-70100-MANDIBLE-X-RAY-ONE-TO-THREE-VIEWS

CPT 70100: Mandible X‑ray, 1–3 Views

CPT-70110-MANDIBLE-X-RAY-4-OR-MORE-VIEWS

CPT 70110: Mandible X‑ray, Four or More Views

CPT-70120-MASTOID-X-RAY-FEWER-THAN-3-VIEWS

CPT 70120: Mastoid X‑ray, Limited (fewer than 3 views per side)

CPT-70130-MASTOID-X-RAY-SERIES-MASTOIDITIS-VESTIBULAR-EVALUATION

CPT 70130: Mastoid X‑ray, Minimum Three Views Per Side

CPT-70134-INTERNAL-AUDITORY-CANAL-RADIOGRAPHY

CPT 70134: X‑ray of Internal Auditory Canals and Temporal Bone

CPT-70140-FACIAL-BONES-XRAY-FEWER-THAN-THREE-VIEWS

CPT 70140: Facial Bones X‑Ray, Fewer Than Three Views

CPT-70150-FACIAL-BONES-XRAY-THREE-VIEWS

CPT 70150: Facial Bones X‑ray, Three Views

Showing 1–10 of 66

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

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Clinical & Coding Specifications

Clinical Context

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`70551`	Magnetic resonance (eg, proton) imaging, brain (including brain stem); without contrast material	Alternative when only non-contrast MRI is performed; precedes contrast sequences when study is limited to non-contrast imaging.
`70552`	Magnetic resonance (eg, proton) imaging, brain (including brain stem); without and with contrast material, or with and without contrast material	Closely related; codes ordered by payer rules to reflect sequence of non-contrast and contrast imaging — `70553` is used when the provider performs non-contrast then contrast in the same session (provider interpretation emphasis).
`70540-70543`	Magnetic resonance imaging of the orbit, face, and/or neck (MRI study of the orbit)	Performed when additional imaging of contiguous anatomic regions (orbits/face/neck) is clinically indicated in the same encounter; may be billed separately if distinct and not bundled.
`70545`	Magnetic resonance angiography, head	Performed when vascular evaluation is required; may be added to an MRI brain study to assess intracranial vessels and flow characteristics.

Related Modifiers

9 rows

Modifier	Description	When to Use
26	Modifier 26 (Professional Component) identifies and bills only the professional portion of a split service — the physician’s interpretation, report, and medical judgment — when the technical…	- Use CPT Modifier -26 when you are billing only the professional component (PC) of a split‑bill eligible service—i.e., you performed the physician interpretation, medical judgment and prepared a…
50	Modifier –50 (Bilateral Procedure) is appended to a CPT code when an identical procedure is performed on paired anatomical structures during the same operative session. The AMA states to add…	- Use modifier -50 when the same CPT surgical, diagnostic, or radiology procedure is performed on paired anatomical structures (both sides of the body) during the same operative/session by the same…
52	Modifier ‑52 (Reduced Services) indicates that a service or procedure was partially reduced or omitted at the provider’s discretion, allowing reporting of the basic procedure number with a qualifier…	- Use modifier -52 when a physician or qualified health professional electively reduces or omits part of a procedure or service (for example, performing fewer required views or omitting a portion of…
53	Modifier 53 (Discontinued Procedure) signals that a surgical or diagnostic service was begun by the physician but terminated because of extenuating circumstances that threatened the patient’s…	- Use modifier -53 when a physician/qualified healthcare professional has started a surgical or diagnostic procedure (e.g., anesthesia administered, incision or scope insertion) and then discontinues…
59	Modifier 59 indicates a distinct procedural service when two procedures that are not normally billed together are clinically and procedurally separate. The CPT definition (as reiterated by CMS)…	- Use modifier -59 to report a distinct procedural service when documentation supports that the procedure reported is not normally billed together with another service on the same day because of a…
62	Modifier 62 indicates that two surgeons function as co‑surgeons, each performing distinct parts of the same primary surgical procedure. It is appended to the primary procedure code (and any…	- Use modifier -62 when two surgeons act as co‑surgeons (both primary surgeons) on a single definitive primary procedure, each performing distinct parts of the same surgical procedure (append -62 to…
76	Modifier -76, Repeat Procedure or Service by Same Physician or Other Qualified Health Care Professional, is appended when the same provider performs an identical, medically necessary procedure or…	- Use modifier -76 when the same physician or other qualified health care professional performs an identical procedure or service a second (or subsequent) time on the same date of service and the…
77	Modifier 77 indicates that a previously performed procedure or service was legitimately repeated by a different physician or other qualified health care professional. The AMA’s CPT definition…	- Use modifier 77 when a basic procedure or service already performed is repeated by a different physician or other qualified health care professional (for example, a second provider independently…
91	Modifier 91 — “Repeat Clinical Diagnostic Laboratory Test” — is appended when the exact same CPT laboratory test is performed more than once for the same patient on the same day because serial,…	- Use modifier 91 when the exact same CPT laboratory test is performed more than once on the same patient on the same date because serial or repeated testing is medically necessary to monitor…

Related Provider Taxonomies

8 rows

Taxonomy Code	Specialty	Notes
2085R0202X	Diagnostic Radiology Physician	A radiologist who utilizes x-ray, radionuclides, ultrasound and electromagnetic radiation to diagnose and treat disease.
207PE0005X	Undersea and Hyperbaric Medicine (Emergency Medicine) Physician	A specialist who treats decompression illness and diving accident cases and uses hyperbaric oxygen therapy to treat such conditions as carbon monoxide…
261QM1101X	Military and U.S. Coast Guard Ambulatory Procedure Clinic/Center	That part of a "fixed" (non-temporary, non-deployed) DoD or Coast Guard entity furnishing surgical procedures requiring medically supervised recovery.…
2080S0010X	Pediatric Sports Medicine Physician	A pediatrician who is responsible for continuous care in the field of sports medicine, not only for the enhancement of health and fitness, but also fo…
163WU0100X	Urology Registered Nurse	Nursing Service Providers · Registered Nurse
204F00000X	Transplant Surgery Physician	A surgeon who specializes in transplant surgery.
122400000X	Denturist	A denturist is a licensed professional that serves patients with removable dental prosthetic oral health needs. A licensed denturist is trained in rem…
2080I0007X	Pediatric Clinical & Laboratory Immunology Physician	A pediatrician who specializes in clinical and laboratory immunology disease management.

Related Payer Policy Updates

Specialty: Neurology/Neurosurgery1 / 3

10 rows

Policy	Payer	Effective Date
Lumbar Microdiscectomy	univerahealthcare	2026-10-15
Artificial Cervical Intervertebral Disc	univerahealthcare	2026-10-15
Lumbar Decompression	univerahealthcare	2026-10-15
Nerve Fiber Density Testing (IENFD/ENFD) Coverage Criteria	Oscar Health	2026-10-01
Biomarker Testing for Multiple Sclerosis and Related Neurologic Diseases	Oscar Health	2026-10-01
Biochemical Markers of Alzheimer Disease and Dementia	Oscar Health	2026-10-01
Serum Testing For Evidence of Mild Traumatic Brain Injury	Oscar Health	2026-10-01
Evaluation of Cerebrospinal Fluid, Urine and Plasma for Alzheimer Disease	Bluecross Idaho	2026-09-01
Prior Authorization of Spinal Procedures	Blue Cross Blue Shield - Rhode Island	2026-09-01
Alzheimer's Disease - Amyloid Beta- Directed Antibodies - Kisunla	Cigna	2026-08-15

CPT 70010: CT Posterior Cranial Fossa With Contrast

CPT-70015-BASAL-CISTERN-BRAIN-IMAGING-SUPERVISION-INTERPRETATION

CPT 70015: Basal Cistern Brain Imaging, Supervision and Interpretation

CPT-70030-EYE-XRAY-FOREIGN-BODY-EVALUATION

CPT 70030: Orbital X‑ray for Foreign Body Evaluation

CPT-70100-MANDIBLE-X-RAY-ONE-TO-THREE-VIEWS

CPT 70100: Mandible X‑ray, 1–3 Views

CPT-70110-MANDIBLE-X-RAY-4-OR-MORE-VIEWS

CPT 70110: Mandible X‑ray, Four or More Views

CPT-70120-MASTOID-X-RAY-FEWER-THAN-3-VIEWS

CPT 70120: Mastoid X‑ray, Limited (fewer than 3 views per side)

CPT-70130-MASTOID-X-RAY-SERIES-MASTOIDITIS-VESTIBULAR-EVALUATION

CPT 70130: Mastoid X‑ray, Minimum Three Views Per Side

CPT-70134-INTERNAL-AUDITORY-CANAL-RADIOGRAPHY

CPT 70134: X‑ray of Internal Auditory Canals and Temporal Bone

CPT-70140-FACIAL-BONES-XRAY-FEWER-THAN-THREE-VIEWS

CPT 70140: Facial Bones X‑Ray, Fewer Than Three Views

CPT-70150-FACIAL-BONES-XRAY-THREE-VIEWS

CPT 70150: Facial Bones X‑ray, Three Views

Showing 1–10 of 66

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Aug 11, 2026.Maintains the CPT code set's official descriptions and guidelines, licensed from the American Medical Association, used as the definitional source for CPT codes on this page.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's quarterly release of HCPCS Level II codes and short/long descriptors, the source for HCPCS code definitions and update history.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Aug 11, 2026.CMS's complete ICD-10-CM diagnosis code list, used to cross-reference diagnosis codes associated with this procedure or service.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

OpenPayer

CPT 70553: MRI Brain with and without Contrast

Sign up for cpt 70553 policy alerts

National Reimbursement Benchmarks

OpenPayer

CPT 70553: MRI Brain with and without Contrast

Sign up for cpt 70553 policy alerts

National Reimbursement Benchmarks

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related Payer Policy Updates

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related Payer Policy Updates

Related Codes

References

CPT 70553: MRI Brain with and without Contrast

Sign up for cpt 70553 policy alerts

National Reimbursement Benchmarks

CPT 70553: MRI Brain with and without Contrast

Sign up for cpt 70553 policy alerts

National Reimbursement Benchmarks

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related Payer Policy Updates

Related Codes

What does CPT 70553 represent and when is it typically used?

Where is 70553 usually performed and what is the typical workflow?

Which CPT modifiers are commonly relevant when billing 70553?

What reimbursement benchmarks and payer variation are reported for 70553?

How does 70553 relate to other brain MRI CPT codes like 70551 and 70552?

References

Clinical & Coding Specifications

Clinical Context

Related CPT Codes

Related Modifiers

Related Provider Taxonomies

Related Payer Policy Updates

Related Codes

What does CPT 70553 represent and when is it typically used?

Where is 70553 usually performed and what is the typical workflow?

Which CPT modifiers are commonly relevant when billing 70553?

What reimbursement benchmarks and payer variation are reported for 70553?

How does 70553 relate to other brain MRI CPT codes like 70551 and 70552?

References