CPT 70551 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | • Radiology Procedures • Diagnostic Radiology (Diagnostic Imaging) Procedures |
| Common Place of Service | • 11 - Office • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • 26 - Professional component • TC - Technical component |
| Complexity Level | Moderate |
National average reimbursement for CPT 70551 by major payers:
$264.69
$370.39
$451.33
$418.68
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 70551 | ||||||
United | 70551 | $192.63 | 1689671828 - ANNE GLASER | 853238714 - (CA) VESTA TELEMEDICINE SOLUTIONS PC | CA | Diagnostic Radiology Physician (2085R0202X) |
United | 70551 | $361.73 | 1528396231 - ANOBEL ODISHO | 943281657 | CA | Urology Physician (208800000X) |
United | 70551 | $263.04 | 1184910986 - BIFTU MENGESHA | 943281657 | IL | Obstetrics & Gynecology Physician (207V00000X) |
United | 70551 | $993.76 | 1659304400 - WILLIAM ALAGO | 593801080 | NY | Diagnostic Radiology Physician (2085R0202X) |
United | 70551 | $2716.87 | 1831248756 - LAWRENCE HAMMER | 943281657 | CA | Pediatrics Physician (208000000X) |
United | 70551 | $233.02 | 1164484721 - JOHN BOARDMAN | 540549603 - (VA) CARILION GILES COMMUNITY HOSPITAL | WI | Diagnostic Radiology Physician (2085R0202X) |
United | 70551 | $401.94 | 1568880607 - JENNIFER WOODBURY | 943281657 | CA | Anesthesiology Physician (207L00000X) |
United | 70551 | $901.79 | 1649226804 - ADAM GREEN | 591943602 - (FL) GASTROENTEROLOGY ASSOCIATES OF PENSACOLA, PA | MN | Diagnostic Radiology Physician (2085R0202X) |
United | 70551 | $334.14 | 1861547317 - GREGORY THALKEN | 260894006 - (CA) SILICON VALLEY DIAGNOSTIC IMAGING, INC. | NJ | Diagnostic Radiology Physician (2085R0202X) |
United | 70551 | $361.73 | 1992179162 - CODY FRIEBEN | 943281660 | FL | Nurse Practitioner (363L00000X) |
United | 70551 | $314.26 | 1508814286 - COLLEEN BONKOWSKI | 391696443 - LAKESHORE MEDICAL CLINIC, LTD. | WI | Diagnostic Radiology Physician (2085R0202X) |
United | 70551 | $3018.79 | 1285618330 - TRICIA WRIGHT | 943281657 | HI | Obstetrics & Gynecology Physician (207V00000X) |
United | 70551 | $519.69 | 1295053775 - KATHLEEN SENEBOUTTARATH | 391696443 - LAKESHORE MEDICAL CLINIC, LTD. | WI | Diagnostic Radiology Physician (2085R0202X) |
United | 70551 | $1019.66 | 1306817952 - MARK BLUTH | 300937486 | NY | Diagnostic Radiology Physician (2085R0202X) |
United | 70551 | $3018.79 | 1225441371 - BRIEZE BELL | 943281657 | CA | Internal Medicine Physician (207R00000X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 70551 vs. Other Diagnostic Radiology (Diagnostic Imaging) Procedures Codes
The CPT 70551 code is part of the Radiology Procedures services used for Diagnostic Radiology (Diagnostic Imaging) Procedures. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 70551 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 70551-CPT | Moderate | Magnetic Resonance Imag,Brain;W/O Contra |
| 70552-CPT | Moderate | Magnetic Resonance (Eg, Proton) Imaging, Brain (Including Brain Stem); With Contrast Material(S) |
| 70553-CPT | Moderate | Magnetic Resonance (Eg, Proton) Imaging, Brain (Including Brain Stem); Without Contrast Material, Followed By Contrast Material(S) And Further Sequences |
| 70554-CPT | Moderate | Magnetic Resonance Imaging Brain Functional Mri; Including Test Selection And Administration Of Repetitive Body Part Movement And/Or Visual Stimulation Not Requiring Physician Or Phsychologist Administration |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 70551. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 70551 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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