CPT 70553 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 • 11 - Office |
| Common Modifiers | • None • 26 - Professional component • TC - Technical component |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 70553 |
National average reimbursement for CPT 70553 by major payers:
$436.79
$612.71
$616.98
$689.43
| 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 70553 | ||||||
United | 70553 | $466.51 | 1366442170 - JULIE SLADE | 480805658 - (KS) UNIVERSITY OF KANSAS SCHOOL OF MEDICINE WICHITA MEDICAL PRACTICE ASSOC | KS | Medical Physician Assistant (363AM0700X) |
United | 70553 | $648.25 | 1346235801 - MICHAEL BREEN | 61793948 - (NJ) NBIMC DEPARTMENT OF RADIOLOGY | FL | Diagnostic Radiology Physician (2085R0202X) |
United | 70553 | $1018.29 | 1386674281 - DANIEL ZEE | 204820187 - (CA) LOS ALAMITOS RADIOLOGY GROUP, INC. | CA | Diagnostic Radiology Physician (2085R0202X) |
United | 70553 | $221.25 | 1073747259 - NATHANIEL MARGOLIS | 133625316 - (NY) HARTSDALE DIAGNOSTIC & WOMEN'S IMAGING SERVICES, PC | NY | Diagnostic Radiology Physician (2085R0202X) |
United | 70553 | $253.35 | 1922207372 - BINH TRAN | 952635165 - (CA) ARCADIA RADIOLOGY MEDICAL GROUP, A PROFESSIONAL CORPORATION | CA | Diagnostic Radiology Physician (2085R0202X) |
United | 70553 | $428.14 | 1407026495 - ANTHONY GILET | 264709927 - WESTCHESTER MEDICAL CENTER ADVANCED PHYSICIAN SERVICES, P.C | NY | Diagnostic Radiology Physician (2085R0202X) |
United | 70553 | $569.55 | 1134539927 - KRISTEN LAUNIER | 952321786 - CHILDRENS HOSPITAL OF ORANGE COUNTY | CA | Diagnostic Radiology Physician (2085R0202X) |
United | 70553 | $320.60 | 1700871266 - MICHAEL HOLT | 390806261 - THE MEDICAL COLLEGE OF WISCONSIN INC | WI | Diagnostic Radiology Physician (2085R0202X) |
United | 70553 | $466.51 | 1093780579 - RICKEY KELLERMAN | 480805658 - (KS) UNIVERSITY OF KANSAS SCHOOL OF MEDICINE WICHITA MEDICAL PRACTICE ASSOC | KS | Family Medicine Physician (207Q00000X) |
United | 70553 | $224.53 | 1962489104 - PETER MCGOWAN | 263792403 - PHOEBE PHYSICIAN GROUP INC | TX | Diagnostic Radiology Physician (2085R0202X) |
United | 70553 | $1098.69 | 1396734430 - ROLF VRLA | 250815795 - GUTHRIE MEDICAL GROUP PC | MN | Diagnostic Radiology Physician (2085R0202X) |
United | 70553 | $295.04 | 1902198682 - ARPIT GANDHI | 751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PA | TX | Diagnostic Radiology Physician (2085R0202X) |
United | 70553 | $466.51 | 1780625558 - WASSIM SHAHEEN | 480805658 - (KS) UNIVERSITY OF KANSAS SCHOOL OF MEDICINE WICHITA MEDICAL PRACTICE ASSOC | KS | Cardiovascular Disease Physician (207RC0000X) |
United | 70553 | $1030.55 | 1669504494 - ALEX SASSANI | 391678306 - AURORA MEDICAL GROUP INC | CA | Diagnostic Radiology Physician (2085R0202X) |
United | 70553 | $201.80 | 1811930910 - CAREN GREENSTEIN | 830535258 | NY | Diagnostic Radiology Physician (2085R0202X) |
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 70553 vs. Other Diagnostic Radiology (Diagnostic Imaging) Procedures Codes
The CPT 70553 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 70553 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 70553. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 70553 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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