CPT 70557 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address high-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 | • 21 - Inpatient Hospital • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • 26 - Professional component • TC - Technical component |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 70557 |
National average reimbursement for CPT 70557 by major payers:
$1,007.04
$617.80
$587.12
$1,563.97
| 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 70557 | ||||||
United | 70557 | $375.35 | 1124029764 - STEVEN HOLMAN | 751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PA | TX | Diagnostic Radiology Physician (2085R0202X) |
United | 70557 | $409.22 | 1427051705 - MOHAMMAD KHEDR | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | TX | Critical Care Medicine (Internal Medicine) Physician (207RC0200X) |
United | 70557 | $611.07 | 1184042095 - EMILY COURTNEY | 541383504 - TOWN CENTER ORTHOPAEDIC ASSOCIATES, P.C. | VA | Occupational Therapist (225X00000X) |
United | 70557 | $549.71 | 1689023228 - HAMISH PATEL | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | TX | Internal Medicine Physician (207R00000X) |
United | 70557 | $409.22 | 1346668225 - STEPHANIE RICE | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | WI | Radiation Oncology Physician (2085R0001X) |
United | 70557 | $623.15 | 1396278669 - JENNIFER DAVIS | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Anesthesiology Physician (207L00000X) |
United | 70557 | $235.86 | 1548645021 - JELISA VICK | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | NM | Acute Care Nurse Practitioner (363LA2100X) |
United | 70557 | $1062.89 | 1992766083 - STEPHEN ARMSTRONG | 751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PA | TX | Diagnostic Radiology Physician (2085R0202X) |
United | 70557 | $120.51 | 1134689938 - JAMES ESTIPONA | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Family Medicine Physician (207Q00000X) |
United | 70557 | $258.86 | 1447317110 - BAPTIST HEALTH CARE, INC., BAPTIST HOME HEALT CARE AND MEDICAL EQUIPMENT | 590657322 - BAPTIST HEALTH CARE INC | FL | Home Health Agency (251E00000X) |
United | 70557 | $235.86 | 1841586906 - MUHAMMAD SHAHID | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | FL | Hospitalist Physician (208M00000X) |
United | 70557 | $623.15 | 1063417756 - TIMOTHY FITCH | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Physician Assistant (363A00000X) |
United | 70557 | $140.50 | 1205013919 - PATRICK MARTIN | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | FL | Critical Care Medicine (Internal Medicine) Physician (207RC0200X) |
United | 70557 | $409.22 | 1134132772 - VIRGINIA ROWLAND | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Pulmonary Disease Physician (207RP1001X) |
United | 70557 | $623.15 | 1497997977 - AMANBIR DHADE | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | CO | Anesthesiology Physician (207L00000X) |
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 70557 vs. Other Diagnostic Radiology (Diagnostic Imaging) Procedures Codes
The CPT 70557 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 70557 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) |
| 70555-CPT | Moderate | Magnetic Resonance Imaging, Brain, Functional Mri; Requiring Physician Or Psychologist Administration Of Entire Neurofunctional Testing |
| 70557-CPT | High | Magnetic Resonance (Eg Proton) Imaging Brain (Including Brain Stem And Skull Base) During Open Intracranial Procedure (Eg Toaccess For Residual Tumor Or Residural Vascular Malformation); Without Contrast Material |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 70557. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 70557 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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