CPT 70558 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 | • 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 |
National average reimbursement for CPT 70558 by major payers:
$911.41
$478.04
$485.54
$1,550.38
| 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 70558 | ||||||
United | 70558 | $735.07 | 1780947937 - GURJEET SINGH | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | WA | Neurology Physician (2084N0400X) |
United | 70558 | $735.07 | 1033564026 - AYSHA AGARWAL | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Critical Care Medicine (Internal Medicine) Physician (207RC0200X) |
United | 70558 | $154.91 | 1992117089 - ADNAN ZUBAIR | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | GA | Orthopaedic Surgery Physician (207X00000X) |
United | 70558 | $275.91 | 1669764924 - DAVID DELMAN | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | WA | Neurology Physician (2084N0400X) |
United | 70558 | $215.87 | 1033587365 - GABRIELLE PHAM-CHE | 541383504 - TOWN CENTER ORTHOPAEDIC ASSOCIATES, P.C. | VA | Orthopedic Physical Therapist (2251X0800X) |
United | 70558 | $154.91 | 1609950500 - MICHAEL REIDY | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | ID | Pulmonary Disease Physician (207RP1001X) |
United | 70558 | $154.91 | 1942763156 - HANNAH FOX | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Emergency Medicine Physician (207P00000X) |
United | 70558 | $275.91 | 1114307741 - AMBER SHILL | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Physical Therapist (225100000X) |
United | 70558 | $154.91 | 1568428282 - MAZHAR ALI | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | NC | Certified Registered Nurse Anesthetist (367500000X) |
United | 70558 | $275.91 | 1275920928 - JUNLI GALLAGHER | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Speech-Language Pathologist (235Z00000X) |
United | 70558 | $735.07 | 1083662449 - TRACY MACEACHERN | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | CO | Emergency Medicine Physician (207P00000X) |
United | 70558 | $459.16 | 1427051705 - MOHAMMAD KHEDR | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | TX | Critical Care Medicine (Internal Medicine) Physician (207RC0200X) |
United | 70558 | $375.57 | 1205187051 - MELISSA SCOTT | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Nurse Practitioner (363L00000X) |
United | 70558 | $275.91 | 1093945081 - GINA BADESCU | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | ME | Anesthesiology Physician (207L00000X) |
United | 70558 | $275.91 | 1659516169 - JESSICA COURTNEY | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | MI | Certified Registered Nurse Anesthetist (367500000X) |
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 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 |
|---|---|---|
| 70546-CPT | Moderate | Magnetic Resonance Angiography, Head; Without Contrast Material(S), Followed By Contrast Material(S) And Further Sequences |
| 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) |
| 70558-CPT | Moderate | Magnetic Resonance (Eg Proton) Imaging Brain (Including Brain Stem And Skull Base) During Open Intracranial Procedure (Eg To Access For Residual Tumor Or Residural Vascular Malformation); With 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 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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