CPT 70549Radiology

Mr angiograph neck w/o&w/dye

CPT code 70549 covers an MRI scan of the blood vessels in the neck performed twice—once without contrast dye and again with contrast dye injected into a vein to highlight the arteries and veins.

Showing rates for

National Average

Base Medicare rate

$340.29

This calculator gives a typical-case estimate using standard Medicare modifier rules. Actual payment depends on payer policies, documentation, code-specific CMS status indicators, and locality. Verify before billing.

RVU breakdown

Work RVU

1.8

PE RVU (NF)

8.6

MP RVU

0.12

Total RVU

10.52

Conversion factor: 32.3465 · Source: CMS MPFS RVU25A · Confidence: High

NCCI bundling edits

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Billing tips

Ensure documentation explicitly states both pre-contrast and post-contrast sequences were performed and interpreted separately, with clear medical necessity for the dual-phase protocol
Impact: Prevents downcoding to 70548 (without contrast) or 70547 (without dye followed by with dye), which could reduce reimbursement by $50-150
Verify contrast administration is documented with type, dose, route, and time of injection in the medical record, as missing contrast documentation is the #1 reason for audit recoupment
Impact: Protects against post-payment audits that could recoup the entire $340.29 payment plus potential penalties
Code 70549 requires BOTH without and with contrast—if only post-contrast imaging was performed, use 70548 instead to avoid upcoding allegations
Impact: Prevents compliance violations and potential False Claims Act exposure; incorrect coding could trigger RAC audits
When billing split/shared with modifier 26 or TC, ensure facility has accurate contractual arrangements and that both components are billed with correct TIN and place of service
Impact: Prevents payment denials due to duplicate billing or incorrect claim submission; ensures proper payment split between facility and physician
Document medical necessity with specific clinical indication beyond screening—Medicare and most payers require symptomatology or abnormal prior test results
Impact: Reduces denial rate by 30-40% for medical necessity; appeals without clinical correlation result in sustained denials
Check NCCI edits before billing 70549 with same-day brain MRI/MRA codes (70551-70553) as these may require modifier 59 and separate documentation of distinct anatomic areas

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Frequently asked questions

What is the difference between CPT 70549 and 70547?

CPT 70549 is MR angiography of the neck performed both without contrast AND with contrast, followed by further sequences. CPT 70547 is performed without contrast followed by with contrast (standard dual-phase). Code 70549 specifically requires additional sequences after contrast administration, making it a more comprehensive study. The reimbursement and clinical applications differ based on protocol complexity.

How much does Medicare pay for CPT 70549 in 2025?

Medicare pays $340.29 for CPT 70549 in 2025 based on the national average non-facility rate. This amount is the same for both facility and non-facility settings. The payment is based on 10.52 total RVUs multiplied by the 2025 conversion factor of 32.3465. Local Medicare Administrative Contractors may have slight geographic variations.

Does CPT 70549 require prior authorization?

Prior authorization requirements for CPT 70549 vary by payer and state. Most Medicare Advantage plans, Medicaid programs, and commercial insurers require prior authorization for MRA studies. Traditional Medicare typically does not require prior auth but does require medical necessity. Always verify authorization requirements with the specific payer before scheduling to avoid denial.

Can you bill CPT 70549 with a brain MRI on the same day?

Yes, but you must use modifier 59 on CPT 70549 to indicate it is a distinct procedural service from brain MRI codes (70551-70553). Documentation must clearly show separate medical necessity for both the brain and neck vascular studies, and the radiology report should address each anatomic area separately. NCCI edits may bundle these without proper modifier use.

What diagnosis codes support medical necessity for CPT 70549?

Commonly accepted ICD-10 codes include I63.x (cerebral infarction), I65.x (occlusion of precerebral arteries), I67.x (cerebrovascular diseases), G45.x (TIA), R55 (syncope), R42 (dizziness), I77.71-I77.74 (arterial dissection), and D18.x (vascular malformations). The diagnosis must correlate with symptoms or clinical findings documented in the medical record to establish medical necessity.

What is the RVU value for CPT code 70549?

CPT 70549 has a total RVU of 10.52 for 2025, consisting of 1.8 work RVUs, 8.6 practice expense RVUs, and 0.12 malpractice RVUs. This is a relatively high RVU value reflecting the technical complexity and professional expertise required for dual-phase MR angiography with contrast administration and specialized interpretation.

How do you bill CPT 70549 when only the professional or technical component is provided?

Use modifier 26 for professional component only (physician interpretation) or modifier TC for technical component only (equipment, technologist, supplies). The professional component represents approximately 40% of the total payment ($136.12) and the technical component approximately 60% ($204.17). Each component must be billed by the appropriate entity with correct tax identification numbers.