CPT 75557 Cardiac MRI Reimbursement & Policy | OpenPayer

Summary & Overview

CPT 75557: Cardiac MRI for Structure and Function, No Contrast

CPT code 75557 represents a non-contrast cardiac magnetic resonance imaging (MRI) study used to evaluate cardiac morphology and function. As a non-contrast diagnostic cardiac imaging code, it is important nationally for characterization of ventricular size, wall motion, and structural heart disease when contrast is not used or is contraindicated. The code is relevant across hospital outpatient imaging centers and freestanding MRI facilities where advanced cardiac imaging is performed.

Key payers included in this analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a national overview of clinical context for non-contrast cardiac MRI, typical sites of service, and common billing considerations. The publication provides benchmarks and payment context where available, notes on coding relationships, and policy updates that affect utilization and coverage nationally. It also summarizes typical clinical indications and operational considerations that influence when CPT code 75557 is used versus contrast-enhanced cardiac MRI studies. Data not provided in the input are noted as such.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare75557CPTcardiac MRIdiagnostic imagingnon-contrast MRIcardiac morphologyventricular functionradiology coding

Billing Code Overview

CPT code 75557 describes a cardiac magnetic resonance imaging (MRI) exam focused on assessing the morphology and function of the heart without the use of intravenous contrast. The procedure evaluates cardiac chamber size, wall motion, ventricular function, and structural anatomy using MRI sequences performed without contrast enhancement.

Service type: Diagnostic imaging — non-contrast cardiac MRI
Typical site of service: Hospital outpatient imaging center or freestanding MRI facility

Clinical & Coding Specifications

Clinical Context

A 58-year-old patient with exertional dyspnea and known cardiomyopathy is referred for a non-contrast cardiac magnetic resonance (CMR) exam to evaluate cardiac morphology and ventricular function. The procedure is scheduled in an outpatient advanced imaging center where a cardiac MRI technologist performs the study under the supervision of a cardiologist or radiologist with cardiac imaging expertise. The workflow includes pre-procedure screening for MRI safety, review of prior echocardiography and ECG, patient positioning and ECG gating setup, acquisition of cine sequences (steady-state free precession) in standard planes (short axis, two-chamber, four-chamber) and flow quantification sequences if indicated, real-time monitoring for patient tolerance, and post-acquisition image reconstruction and interpretation. No gadolinium contrast is administered, so sequences focus on morphology and function rather than tissue characterization. A final report documents ventricular volumes, ejection fraction, wall motion abnormalities, chamber sizes, and any structural anomalies, and the interpreting physician signs the report for billing using CPT 75557 for the non-contrast cardiac MRI study.

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	When billing only the physician interpretation separate from facility technical component

CPT 75559: Cardiac MRI with Stress, Non-Contrast

CPT-75577-CORONARY-CTA-PLAQUE-QUANTIFICATION-POST-PROCESSING

CPT 75577: Coronary CTA Plaque Quantification and Post-Processing

CPT-75572-CARDIAC-CT-3D-POST-PROCESSING-FUNCTIONAL-ASSESSMENT

CPT 75572: Cardiac CT with 3D Post-Processing and Functional Assessment

CPT-75573-CARDIAC-CT-CONGENITAL-HEART-EVALUATION

CPT 75573: Cardiac CT for Congenital Heart Evaluation

CPT-75580-FFR-CT-FROM-CCTA-AUGMENTATION-SOFTWARE-REPORT

CPT 75580: FFR-CT from Coronary CT Angiography via Augmentative Software

CPT-75565-CARDIAC-MRI-VELOCITY-FLOW-MAPPING

CPT 75565: Cardiac MRI with Velocity Flow Mapping

CPT-75561-CARDIAC-MRI-WITH-AND-WITHOUT-CONTRAST

CPT 75561: Cardiac MRI Without and With Contrast

CPT-75571-CORONARY-CALCIUM-SCORING-CT-NON-CONTRAST

CPT 75571: Non-Contrast CT Coronary Calcium Scoring

CPT-75563-CARDIAC-MRI-STRESS-REST-WITH-AND-WITHOUT-CONTRAST

CPT 75563: Cardiac MRI Stress and Rest with and without Contrast

CPT-75574-CARDIAC-CT-WITH-CONTRAST-CORONARY-EVALUATION

CPT 75574: Cardiac CT With Contrast for Coronary Evaluation

Taxonomy Code	Specialty	Notes
207RC0000X	Cardiology	Noninvasive cardiologists interpret and order cardiac MRI for functional assessment
207RX0400X	Diagnostic Radiology	Radiologists with cardiac MRI expertise often perform and interpret studies
2084P0800X	Pediatric Cardiology	Pediatric cardiologists perform/interpret CMR in younger patients with congenital disease
207K00000X	Nuclear Cardiology	Cardiovascular imaging specialists involved in multimodality cardiac assessments
207L00000X	Cardiac Electrophysiology	EP specialists may order CMR for pre-procedural planning or device assessment

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`I50.9`	Heart failure, unspecified	CMR assesses ventricular size and function in suspected or known heart failure
`I42.9`	Cardiomyopathy, unspecified	Used to evaluate morphology and systolic function in cardiomyopathy workup
`I48.91`	Unspecified atrial fibrillation	CMR can assess structural substrates and atrial size for management planning
`I25.10`	Atherosclerotic heart disease of native coronary artery without angina pectoris	CMR functional assessment may be used when ischemic cardiomyopathy is suspected
`Q24.9`	Congenital anomaly of heart, unspecified	CMR is used for detailed structural assessment in congenital heart disease
`R07.9`	Chest pain, unspecified	When noninvasive imaging is needed to evaluate structural causes of chest pain
`I34.9`	Nonrheumatic mitral valve disorder, unspecified	CMR can quantify chamber volumes and ventricular function in valvular disease
`Z45.02`	Encounter for adjustment and management of cardiac pacemaker	CMR is typically avoided with non-MRI conditional devices but may be performed under controlled conditions or alternative imaging considered

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`75557`	Cardiac MRI for morphology and function without contrast	Primary procedure for non-contrast assessment of ventricular size, function, and morphology
`75561`	Cardiac MRI for morphology and function with contrast	Performed when tissue characterization or delayed enhancement is required after `CPT 75557` exam if contrast is later indicated
`75565`	Cardiac MRI for morphology and function with and without contrast	Combined protocol that includes both non-contrast and contrast sequences when both assessments are clinically necessary
`72156`	MRI thoracic spine without contrast	Performed in the same session for patients with suspected spinal pathology; coded separately if distinct from cardiac study
`93306`	Echocardiography, transthoracic, complete	Common complementary test for initial functional assessment; MRI often follows to provide more precise volumetric and tissue information
`93000`	Electrocardiogram, routine ECG with interpretation and report	Performed contemporaneously for gating and arrhythmia assessment prior to or during the CMR exam

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