CPT 73225Radiology

Mr angio upr extr w/o&w/dye

CPT 73225 covers magnetic resonance angiography (MRA) of the upper extremity (arm, forearm, or hand) performed both without and with contrast dye. This advanced imaging test visualizes blood vessels to detect blockages, aneurysms, or vascular abnormalities.

Showing rates for

National Average

Base Medicare rate

$320.55

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)

8.06

MP RVU

0.12

Total RVU

9.91

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

NCCI bundling edits

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Billing tips

Verify the complete without-and-with contrast protocol was performed before using 73225; if only one phase completed, use 73218 (without contrast) or 73223 (with contrast) instead
Impact: Prevents downcoding from $320.55 to approximately $240-280 for single-phase codes and avoids fraud allegations
Document medical necessity clearly indicating why both non-contrast and contrast phases were required, particularly for Medicare patients where contrast use must be justified
Impact: Reduces denial rate by 30-40%; lack of justification is the leading cause of medical necessity denials for this code
Ensure radiology report explicitly states both phases were performed and interpreted; template reports sometimes omit protocol details
Impact: Prevents audit recoupments averaging $320.55 per study when documentation does not support code billed
Bill with appropriate ICD-10 codes that support vascular pathology (not musculoskeletal complaints alone); codes like I74.2, I77.1, or I67.1 provide stronger justification
Impact: Improves first-pass approval rate by 25-35% and reduces medical necessity denials
Verify contrast dose, type, and radiologist supervision are documented in the medical record; this is an audit target for high-RVU imaging codes
Impact: Protects against OIG audit recoupments and ensures compliance with safety regulations
For Medicare patients, confirm the ordering physician's NPI is included and that the order is within the medical record before the exam date
Impact: Prevents automatic denial under Medicare's ordering documentation requirements; saves $320.55 per compliant claim

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Frequently asked questions

What is the Medicare reimbursement rate for CPT 73225 in 2025?

The 2025 Medicare national average payment for CPT 73225 is $320.55 for both facility and non-facility settings. This is based on 9.91 total RVUs multiplied by the 2025 conversion factor of 32.3465. Actual payment may vary by geographic locality based on the GPCI adjustments for your region.

What is the difference between CPT 73225 and 73223?

CPT 73225 includes MR angiography performed both without and with contrast (dual-phase protocol), while 73223 is for MRA with contrast only. Code 73225 has higher reimbursement ($320.55 vs approximately $280) but requires documentation of both imaging phases. You cannot bill both codes together for the same exam.

How many RVUs is CPT code 73225 worth?

CPT 73225 has 9.91 total RVUs in 2025, consisting of 1.73 work RVUs, 8.06 practice expense RVUs (both facility and non-facility), and 0.12 malpractice RVUs. This makes it a moderately valued radiology procedure code.

Can you bill CPT 73225 with modifier 26?

Yes, modifier 26 (professional component) can be appended to 73225 when the radiologist interprets the study but does not own the MRI equipment. This splits the payment between the professional and technical components, with the physician receiving approximately 40-50% of the total $320.55 fee for interpretation only.

What diagnosis codes support medical necessity for CPT 73225?

Common supporting ICD-10 codes include I74.2 (arterial embolism/thrombosis of upper extremity), I77.1 (stricture of artery), I77.0 (arteriovenous fistula), I72.1 (aneurysm of upper extremity artery), S45.0-S45.9 (injury of blood vessels at shoulder/upper arm), and G54.0 (brachial plexus disorders). The diagnosis must justify why both non-contrast and contrast phases are medically necessary.

Is prior authorization required for CPT 73225?

Most commercial payers and Medicare Advantage plans require prior authorization for CPT 73225 as it is an advanced imaging procedure. Traditional Medicare does not require prior authorization but does require a valid order from the treating physician. Check specific payer policies as requirements vary, and lack of authorization will result in claim denial.

Can CPT 73225 be billed bilaterally?

CPT 73225 is a unilateral code describing one upper extremity. For bilateral MRA, you should bill 73225 twice with RT and LT modifiers, though many payers will apply a bilateral reduction (typically paying 150% of the single code rather than 200%). Some payers may require modifier 50 instead. Verify payer-specific bilateral imaging policies before billing.