CPT 71550Radiology

Mri chest w/o dye

CPT code 71550 covers an MRI scan of the chest performed without contrast dye (injected material that makes certain tissues show up more clearly). This imaging test helps doctors examine the lungs, heart, blood vessels, and chest wall structures.

Showing rates for

National Average

Base Medicare rate

$329.61

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

1.46

PE RVU (NF)

8.63

MP RVU

0.1

Total RVU

10.19

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

NCCI bundling edits

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Billing tips

Verify medical necessity documentation includes specific clinical indication before billing 71550
Impact: Prevents 30-40% of denials related to lack of medical necessity; documentation must justify why MRI is needed over CT or X-ray
Never bill 71550 with 71551 or 71552 on the same date of service for the same anatomical area
Impact: Billing multiple chest MRI codes together will result in automatic denial; choose the code that most accurately represents the complete service performed
Ensure prior authorization is obtained before scheduling when required by commercial payers
Impact: Lack of prior authorization is the #1 cause of complete claim denial for MRI services, resulting in $329.61 loss per study
Bill the complete study code (71550) rather than splitting into 26/TC when performing both components in same facility
Impact: Billing global code streamlines processing and prevents coordination errors; modifier splits only when different entities provide components
Document any patient safety screening for MRI contraindications (pacemakers, implants, metal fragments) in the record
Impact: Required for compliance and reduces liability risk; incomplete safety screening can invalidate medical necessity and result in full denial
For Medicare patients, verify the ordering physician's NPI is documented and that the order meets current appropriateness criteria
Impact: Missing or invalid ordering physician information causes 15-20% of MRI claim denials; CMS requires specific order documentation

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Frequently asked questions

What is the Medicare reimbursement rate for CPT 71550 in 2025?

The 2025 Medicare national average reimbursement rate for CPT 71550 is $329.61 for both facility and non-facility settings. This rate is based on 10.19 total RVUs multiplied by the 2025 conversion factor of 32.3465. Actual payments may vary based on geographic location and MAC adjustments.

What is the difference between CPT 71550 and 71552?

CPT 71550 is an MRI chest without contrast dye, while 71552 is an MRI chest with contrast followed by further sequences. Code 71552 involves intravenous injection of gadolinium contrast agent and additional imaging, resulting in higher reimbursement. The two codes cannot be billed together for the same session.

Does CPT 71550 require prior authorization for Medicare patients?

Traditional Medicare does not typically require prior authorization for 71550, but Medicare Advantage plans often do require it. Additionally, many commercial payers mandate prior authorization for all MRI services. Always verify authorization requirements with the specific payer before scheduling to avoid claim denial.

How many RVUs is CPT code 71550 worth?

CPT 71550 has a total RVU value of 10.19 for 2025, consisting of 1.46 work RVUs, 8.63 practice expense RVUs, and 0.10 malpractice RVUs. These values are the same for both facility and non-facility settings for this particular code.

Can you bill 71550 and 71046 together on the same day?

Yes, CPT 71550 (MRI chest without contrast) and 71046 (CT chest without contrast) can be billed together if medically necessary and documented, though this combination is unusual. You should append modifier 59 to indicate distinct procedural services and provide clear documentation explaining why both modalities were required on the same day to prevent bundling denials.

What diagnosis codes support medical necessity for CPT 71550?

Common supporting ICD-10 codes include lung mass or nodule (R91.8), mediastinal mass (R59.0), chest pain (R07.9), suspected pulmonary embolism when contrast contraindicated (I26.99), chest wall lesion (D49.2), and follow-up of malignancy (Z08). The diagnosis must justify why MRI specifically is needed rather than less expensive imaging alternatives.

Who can bill CPT 71550 - the radiologist or the ordering physician?

Only the radiologist or the facility performing and interpreting the MRI can bill CPT 71550. The ordering physician (such as a pulmonologist or oncologist) cannot bill for the MRI service itself, though they bill separately for their evaluation and management services. The radiologist bills with modifier 26 for professional component interpretation only, or the facility bills the complete code.