CPT 71551Radiology

Mri chest w/dye

CPT code 71551 is used when a patient receives an MRI scan of the chest using contrast dye (a special substance injected to make internal structures show up more clearly on the images).

Showing rates for

National Average

Base Medicare rate

$367.13

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

1.73

PE RVU (NF)

9.51

MP RVU

0.11

Total RVU

11.35

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

NCCI bundling edits

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Billing tips

Verify contrast administration is documented in both technologist notes and radiologist report
Impact: Prevents downcoding to 71550 (without contrast), which would reduce reimbursement by approximately $50-80 depending on payer
Ensure medical necessity documentation specifies why contrast enhancement was required (not just 'per protocol')
Impact: Reduces denial rate by 30-40% and prevents post-payment audits that can recoup the full $367.13
Bill globally (no modifier) when facility owns equipment and employs interpreting radiologist to capture full $367.13
Impact: Maximizes reimbursement versus splitting 26/TC between separate entities
Document type and amount of contrast agent used, including lot number for quality assurance
Impact: Protects against audits and supports medical necessity; prevents denials worth $367.13 per study
Never bundle with 71550 (MRI chest without contrast) on same date of service unless performing true pre- and post-contrast sequences
Impact: CCI edits will deny one code; proper coding is 71550 + 71551 only when both are separately performed for specific clinical indication
Check for prior authorization requirements before scheduling; most commercial payers require pre-auth for MRI procedures
Impact: Prevents 100% denial ($367.13 loss) due to lack of authorization; authorization approval increases clean claim rate to 95%+

Common denials

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Frequently asked questions

What is the Medicare reimbursement rate for CPT 71551 in 2025?

The 2025 Medicare national average reimbursement rate for CPT 71551 is $367.13 for both facility and non-facility settings. This rate is based on 11.35 total RVUs (1.73 work RVU + 9.51 PE RVU + 0.11 MP RVU) multiplied by the 2025 conversion factor of 32.3465.

What is the difference between CPT 71550 and 71551?

CPT 71550 is MRI chest without contrast material, while CPT 71551 is MRI chest with contrast material. The key difference is the administration of intravenous contrast agent in 71551, which enhances visualization of vascular structures, tumors, and inflammatory processes. Code 71551 reimburses at a higher rate due to the additional contrast administration and interpretation complexity.

Can you bill CPT 71551 and 71550 together on the same date of service?

Generally, no. These codes are considered mutually exclusive for the same anatomic area on the same date. If both pre-contrast and post-contrast imaging are performed in the same session, the appropriate code is typically 71552 (MRI chest without contrast followed by with contrast). Billing both 71550 and 71551 will likely result in denial unless there is distinct clinical justification for separate studies at different times.

Does CPT 71551 require prior authorization?

Most commercial insurance plans and Medicare Advantage plans require prior authorization for CPT 71551 through radiology benefit management (RBM) programs. Traditional Medicare does not require prior authorization but does require medical necessity. Always verify authorization requirements with the specific payer before scheduling to avoid claim denials.

What diagnosis codes support medical necessity for CPT 71551?

Common supporting diagnoses include lung masses or nodules (R91.8), malignant neoplasms of lung or bronchus (C34.x), mediastinal masses (D15.2, D38.3), chest pain requiring cardiovascular evaluation (R07.x), suspected vascular abnormalities (I28.x, I77.x), and staging of known malignancies. The diagnosis must justify why contrast-enhanced imaging is necessary rather than non-contrast or alternative modalities.

How many RVUs is CPT code 71551 worth in 2025?

CPT 71551 has a total of 11.35 RVUs in 2025, consisting of 1.73 work RVUs, 9.51 practice expense RVUs (both facility and non-facility), and 0.11 malpractice RVUs. This relatively high RVU value reflects the technical complexity and professional interpretation involved in contrast-enhanced chest MRI.

What modifiers are commonly used with CPT 71551?

Common modifiers include 26 (professional component only, for interpretation without equipment ownership), TC (technical component only, for equipment and staff without interpretation), 59 (distinct procedural service when performed with other imaging), and 76 (repeat procedure by same physician). The modifier used depends on the billing arrangement and clinical circumstances of the examination.