CPT 71552Radiology

Mri chest w/o & w/dye

CPT code 71552 is for an MRI scan of the chest that is performed twice: once without contrast dye, then again after injecting contrast dye through an IV to get more detailed images of chest structures including the heart, lungs, and blood vessels.

Showing rates for

National Average

Base Medicare rate

$461.58

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

2.26

PE RVU (NF)

11.84

MP RVU

0.17

Total RVU

14.27

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

NCCI bundling edits

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Billing tips

Always obtain pre-authorization before scheduling; most payers require prior authorization for advanced imaging with contrast
Impact: Prevents denials that can delay payment 30-60 days and may result in 100% payment denial
Verify that documentation supports medical necessity for BOTH non-contrast and contrast phases; if only one is medically necessary, bill 71550 or 71551 instead
Impact: Prevents downcoding from 71552 ($461.58) to 71550 ($378.42), a loss of $83.16 per case
Ensure contrast type, dosage, and route are documented in radiology report; many payers audit contrast administration claims
Impact: Reduces audit recoupment risk; contrast documentation failures can trigger takebacks of 25-30% of payments
Do not bill 71552 with 71550 or 71551 on same date of service for same anatomic area; these are mutually exclusive
Impact: Prevents NCCI edits and automatic denials; attempting to bill both can flag practice for audit
Document patient screening for contraindications including renal function (eGFR) prior to gadolinium administration
Impact: Required for compliance; absence can trigger quality review and potential liability issues beyond just billing
For Medicare patients, ensure ordering physician has a valid NPI and order is in patient record before exam date
Impact: Medicare Appropriate Use Criteria requirement; missing order documentation causes automatic denials

Common denials

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Frequently asked questions

What is the Medicare reimbursement rate for CPT 71552 in 2025?

The 2025 Medicare national average payment rate for CPT 71552 is $461.58 for both facility and non-facility settings. This is based on 14.27 total RVUs multiplied by the 2025 conversion factor of 32.3465. Actual payment may vary by geographic locality.

What is the difference between CPT 71550, 71551, and 71552?

CPT 71550 is MRI chest without contrast, 71551 is with contrast only, and 71552 is without contrast followed by with contrast (both phases). Code 71552 is used when the clinical question requires comparison of pre- and post-contrast images, such as for vascular assessment or tumor characterization. These codes are mutually exclusive and cannot be billed together.

Does CPT 71552 require prior authorization?

Most commercial payers and Medicare Advantage plans require prior authorization for CPT 71552. Original Medicare does not require prior authorization but does require compliance with Appropriate Use Criteria (AUC) via CDSM consultation. Always verify specific payer requirements before scheduling.

How many RVUs is CPT code 71552 worth?

CPT 71552 has 14.27 total RVUs for 2025, consisting of 2.26 work RVUs, 11.84 practice expense RVUs (both facility and non-facility), and 0.17 malpractice RVUs. This makes it a moderately valued advanced imaging procedure.

Can you bill CPT 71552 and a cardiac MRI on the same day?

Yes, if medically necessary and the studies address different clinical questions with separate documentation. Use modifier 59 on the secondary procedure to indicate distinct services. However, ensure there is no anatomic overlap that would trigger NCCI edits, and be prepared to justify medical necessity for both studies during potential audit.

What diagnosis codes support medical necessity for CPT 71552?

Common supporting diagnoses include mediastinal mass (D15.2, D38.3), lung neoplasm (C34.x), cardiac tumor (D15.1), superior vena cava syndrome (I87.1), thoracic aortic aneurysm (I71.2), pleural effusion (J90-J94), and staging of malignancies. The diagnosis must justify the need for both non-contrast and contrast imaging phases.

What happens if the patient cannot complete the contrast portion of 71552?

If contrast cannot be administered due to patient reaction, contraindication discovered during exam, or patient refusal, bill CPT 71550 (without contrast) instead of 71552 with modifier 52. Document the reason contrast was not given. Do not bill the full 71552 code if only the non-contrast portion was completed.