CPT 70559 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 • GC - Service performed by resident under supervision |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 70559 |
National average reimbursement for CPT 70559 by major payers:
$899.09
$563.04
$468.81
$1,513.86
| 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 70559 | ||||||
United | 70559 | $739.46 | 1922291434 - GERALD ZENK | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | IL | Anesthesiology Physician (207L00000X) |
United | 70559 | $288.00 | 1083662449 - TRACY MACEACHERN | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | CO | Emergency Medicine Physician (207P00000X) |
United | 70559 | $288.00 | 1992117089 - ADNAN ZUBAIR | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | GA | Orthopaedic Surgery Physician (207X00000X) |
United | 70559 | $198.83 | 1851390637 - BAYCARE HOME CARE, INC. | 593582520 - (FL) BAYCARE HOME CARE INC | FL | Home Health Agency (251E00000X) |
United | 70559 | $451.47 | 1134575863 - SANYA KAYANI | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Hospitalist Physician (208M00000X) |
United | 70559 | $416.85 | 1164428249 - DOUGLAS WRIGHT | 751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PA | TX | Diagnostic Radiology Physician (2085R0202X) |
United | 70559 | $739.46 | 1023072857 - MARY ALLARE | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Neonatal-Perinatal Medicine Physician (2080N0001X) |
United | 70559 | $288.00 | 1720272693 - ADAM JOHNSON | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Anesthesiology Physician (207L00000X) |
United | 70559 | $288.00 | 1992003875 - DARLA TALBOTT | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | OH | Nurse Practitioner (363L00000X) |
United | 70559 | $154.91 | 1821182429 - ALLISON KIRSHNER | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Nurse Practitioner (363L00000X) |
United | 70559 | $143.25 | 1588661094 - JUAN ESCOBAR | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | FL | Interventional Cardiology Physician (207RI0011X) |
United | 70559 | $876.11 | 1073502985 - CHU CHEN | 42484572 - MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC. | MA | Pediatrics Physician (208000000X) |
United | 70559 | $288.00 | 1689023228 - HAMISH PATEL | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | TX | Internal Medicine Physician (207R00000X) |
United | 70559 | $288.00 | 1609919471 - JONATHAN MELLEN | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AK | Gastroenterology Physician (207RG0100X) |
United | 70559 | $298.17 | 1295977718 - CHRISTOPHER MUELLER | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Cardiovascular Disease Physician (207RC0000X) |
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 70559 vs. Other Diagnostic Radiology (Diagnostic Imaging) Procedures Codes
The CPT 70559 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 70559 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) |
| 70559-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); 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 70559. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 70559 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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