MRI of the brain and brainstem done without any contrast agent, often the first advanced study when symptoms point to a central nervous system cause.
- Medicare
- $195.40
- Work RVU
- 1.44
- Global, days
- Region
- Other
Documentation requirements
What must appear in the operative or office note to support the claim.
Source · Editorial brief grounded in 3 cited references ↓
- Neurologic exam findings, such as hyperreflexia, gait change, or upper motor neuron signs
- Reason the cervical findings do not fully explain symptoms
- MRI safety screening for implants and hardware
- Prior authorization number when required
- Signed radiology report
Applicable modifiers
Modifiers commonly billed with this code.
Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual
What this code covers
Source · Editorial summary grounded in 3 cited references ↓
70551 is a non-contrast brain MRI. It is used for stroke, demyelinating disease, dementia workups, and many other neurologic questions.
Spine practices order it more than people expect. A patient with hand clumsiness, gait trouble, and hyperreflexia may have cervical myelopathy, but multiple sclerosis or a brain lesion can look the same. When the cervical MRI does not explain the findings, the surgeon or a neurologist orders a brain MRI. It also comes up when a patient's symptoms do not follow a dermatome.
Billing: medical necessity rests on the neurologic findings, so the order should list them, not just "neck pain." Commercial plans usually need prior authorization. If the brain and cervical spine are scanned in the same session, each region is billed separately, and both need their own reason. A brain MRI with contrast only is 70552, and without then with is 70553.
RVU & reimbursement
Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.
Source · CMS Physician Fee Schedule, RVU26A · January 2026
Work RVU vs. total RVU
The work RVU (1.44) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (5.85) adds practice overhead and malpractice, and is what drives the Medicare payment below.
| Work RVU | 1.44 |
| Practice expense RVU | 4.31 |
| Malpractice RVU | 0.1 |
| Total RVU | 5.85 |
| Medicare national rate | $195.40 |
| Global period | days |
Payment by site of service
Medicare pays different rates by setting. HOPD typically pays substantially more than ASC for the same procedure.
Source · CMS OPPS Addendum B·ASC HCPCS payment rates·2026
| Setting | Medicare rate (national) |
|---|---|
Office (PFS non-facility) Procedure performed in physician's office | $195.40 |
HOPD (APC 5523) Hospital outpatient department | $243.77 |
Common denial reasons
The recurring reasons claims for CPT 70551 get rejected.
Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓
- Diagnosis limited to neck pain without neurologic signs
- Authorization obtained only for the cervical spine study
- Wrong contrast code compared to the report
- Billed by the ordering surgeon without owning the equipment
- Repeat study within a short window without a new indication
Frequently asked questions
Source · Generated from the editorial pipeline, verified against 3 cited references ↓
01Why would a spine surgeon order a brain MRI?
02Can a brain MRI and cervical spine MRI be billed the same day?
03What diagnosis supports 70551?
Sources & references
Editorial content was developed using the following public sources.
Mira Scribe
Mira Scribe records the full neurologic exam, including reflexes and gait, so a brain MRI ordered to rule out a central cause has the findings behind it.
See how Mira captures CPT 70551 documentation