CPT 70552 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 | • 22 - On Campus Outpatient Hospital • 21 - Inpatient Hospital |
| Common Modifiers | • None • 26 - Professional component • 52 - Reduced Services |
| Complexity Level | Moderate |
National average reimbursement for CPT 70552 by major payers:
$366.48
$466.34
$523.88
$536.95
| 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 70552 | ||||||
United | 70552 | $229.16 | 1093775512 - ROBERT SANCHEZ | 751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PA | TX | Diagnostic Radiology Physician (2085R0202X) |
United | 70552 | $266.57 | 1689023228 - HAMISH PATEL | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | FL | Internal Medicine Physician (207R00000X) |
United | 70552 | $77.62 | 1700182714 - AARON SCHNELL | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Hospitalist Physician (208M00000X) |
United | 70552 | $151.21 | 1649351222 - RAVINDRA GUDAVALLI | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | IA | Pulmonary Disease Physician (207RP1001X) |
United | 70552 | $300.52 | 1700885035 - THOMAS FLEETER | 541383504 - TOWN CENTER ORTHOPAEDIC ASSOCIATES, P.C. | VA | Orthopaedic Surgery Physician (207X00000X) |
United | 70552 | $90.73 | 1760849426 - JENNIFER GOBENCION | 221487330 - (NJ) SAINT PETERS UNIVERSITY HOSPITAL | NJ | Advanced Practice Midwife (367A00000X) |
United | 70552 | $370.72 | 1235746082 - JESSICA YUEN | 541383504 - TOWN CENTER ORTHOPAEDIC ASSOCIATES, P.C. | VA | Physical Therapist (225100000X) |
United | 70552 | $97.08 | 1003882606 - ROSE MEROLA | 221487330 - (NJ) SAINT PETERS UNIVERSITY HOSPITAL | NJ | Pediatric Neurodevelopmental Disabilities Physician (2080P0008X) |
United | 70552 | $111.66 | 1982135778 - AUON HAMADANI | 221487330 - (NJ) SAINT PETERS UNIVERSITY HOSPITAL | NJ | Internal Medicine Physician (207R00000X) |
United | 70552 | $966.86 | 1811000177 - CHARLESTON RADIOLOGISTS PA | 570634747 - CHARLESTON RADIOLOGISTS, P.A. | SC | Single Specialty Group (193400000X) |
United | 70552 | $260.41 | 1811558026 - ROBERT VAGUEIRO | 221487330 - (NJ) SAINT PETERS UNIVERSITY HOSPITAL | NJ | Physician Assistant (363A00000X) |
United | 70552 | $452.08 | 1255478004 - CHRISTOPHER RAIO | 111635088 - MERCY MEDICAL CENTER | NY | Emergency Medicine Physician (207P00000X) |
United | 70552 | $109.40 | 1811484009 - RUWAA SAMARRAI | 221487330 - (NJ) SAINT PETERS UNIVERSITY HOSPITAL | NJ | Pediatric Otolaryngology Physician (207YP0228X) |
United | 70552 | $135.26 | 1164776688 - NICOLE SCHWAB | 362925195 - ALLERGY & ASTHMA OF DUPAGE, S.C. | IL | Family Nurse Practitioner (363LF0000X) |
United | 70552 | $274.10 | 1598089195 - SABAH KALYOUSSEF | 221487330 - (NJ) SAINT PETERS UNIVERSITY HOSPITAL | NJ | Pediatric Infectious Diseases Physician (2080P0208X) |
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 70552 vs. Other Diagnostic Radiology (Diagnostic Imaging) Procedures Codes
The CPT 70552 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 70552 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 70552. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 70552 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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