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See a sample rate comparisonHealthcare 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 | 21 - Inpatient Hospital 22 - On Campus Outpatient Hospital |
| Common Modifiers | None 26 - Professional component 59 - Distinct Procedural Service |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 70558 |
| Medicaid Fee Schedule | View Medicaid rates for 70558 |
National average reimbursement for CPT 70558 by major payers:

$911.41

$478.04

$485.54

$1,494.61
Choose a payer to see a sample of rates for CPT 70558.
Northern Arizona Healthcare Corporation
Northern Arizona Healthcare Corporation
Northern Arizona Healthcare Corporation
Northern Arizona Healthcare Corporation
Northern Arizona Healthcare Corporation
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Rate Benchmarking
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See a sample payer proposalCPT 70558 vs. Other Diagnostic Radiology (Diagnostic Imaging) Procedures Codes
The CPT 70558 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 70558 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 | Mri Of Brain And Brainstem, An Mri (Magnetic Resonance Imaging) Uses A Strong Magnetic Field To View And Create Images Of The Brain And Brainstem. A Contrast Agent May Be Introduced To Highlight Areas. Multiple Images May Be Taken. |
| 70557-CPT | High | Mri Brain W O Dye, Magnetic Resonance Eg Proton Imaging Brain Including Brain Stem And Skull Base During Open Intracranial Procedure Eg To Assess For Residual Tumor Or Residual Vascular Malformation Without Contrast Material |
| 70558-CPT | Moderate | Advanced Imaging - Mr, Magnetic Resonance (Eg Proton) Imaging Brain (Including Brain Stem And Skull Base) During Open Intracranial Procedure (Eg To Assess For Residual Tumor Or Residual Vascular Malformation); With Contrast Material(S) |
| 70559-CPT | Moderate | Mri Brain W O W Dye, Magnetic Resonance Eg Proton Imaging Brain Including Brain Stem And Skull Base During Open Intracranial Procedure Eg To Assess For Residual Tumor Or Residual Vascular Malformation Without Contrast Material S Followed By Contrast Material S And Further Sequences |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 70558. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 70558 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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