CPT 70551
Global XXX ActiveMri brain stem w/o dye
CPT 70551 Billing & Documentation Guide
CPT code 70551 (Mri brain stem w/o dye) is classified under Radiology with a global period indicator of XXX. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 1.44, a non-facility practice expense RVU of 4.31, and a malpractice RVU of 0.1, a total non-facility RVU of 5.85 and facility RVU of 5.85. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $202.18, though rates vary from $173.48 to $262.77 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 70551, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 70551 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
No global period (E/M and other non-procedural services)
MUE Limit (Medically Unlikely Edits)
Submitting more than 2 units of 70551 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 70551
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 1.44 | 1.44 |
| Practice Expense RVU | 4.31 | 4.31 |
| Malpractice RVU | 0.1 | 0.1 |
| Total RVU | 5.85 | 5.85 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 70551
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $221.97 | $221.97 | $208.48 - $262.77 | 29 |
| Florida | $199.04 | $199.04 | $190.74 - $206.4 | 3 |
| Georgia | $189.5 | $189.5 | $180.49 - $198.51 | 2 |
| Illinois | $193.75 | $193.75 | $184.75 - $202.2 | 4 |
| Michigan | $187.98 | $187.98 | $183.3 - $192.65 | 2 |
| North Carolina | $184.54 | $184.54 | $184.54 - $184.54 | 1 |
| New York | $215.52 | $215.52 | $187.21 - $228.54 | 5 |
| Ohio | $182.9 | $182.9 | $182.9 - $182.9 | 1 |
| Pennsylvania | $193.11 | $193.11 | $183.41 - $202.81 | 2 |
| Texas | $193.19 | $193.19 | $182.2 - $203.46 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 70551
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 70551 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 01922 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 0865T | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 36591 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 36592 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 61715 | Column 1 (primary), can be billed with modifier | Yes | CPT Manual or CMS manual coding instruction |
| 70544 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 70545 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 70555 | Column 1 (primary), can be billed with modifier | Yes | CPT Manual or CMS manual coding instruction |
| 70557 | Column 1 (primary), can be billed with modifier | Yes | Mutually exclusive procedures |
| 76350 | Column 1 (primary), can be billed with modifier | No | Misuse of Column Two code with Column One code |
Frequently Asked Questions, CPT 70551
What does CPT code 70551 mean? +
CPT code 70551 represents: Mri brain stem w/o dye. It's in the Radiology category with a global period of XXX.
What is the Medicare reimbursement for CPT 70551? +
The 2026 Medicare national average non-facility payment for CPT 70551 is $202.18. Rates range from $173.48 to $262.77 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 70551? +
Radiology codes rely heavily on the professional/technical split: modifier 26 (professional component only) and TC (technical component only). Also common: 50 (bilateral imaging), 76 (repeat by same physician), 77 (repeat by different physician), and LT/RT for laterality.
What bundling edits apply to CPT 70551? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on May 31, 2026.
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