CPT 70553
Global XXX ActiveMri brain stem w/o & w/dye
CPT 70553 Billing & Documentation Guide
CPT code 70553 (Mri brain stem w/o & w/dye) is classified under Radiology with a global period indicator of XXX. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 2.23, a non-facility practice expense RVU of 7.1, and a malpractice RVU of 0.16, a total non-facility RVU of 9.49 and facility RVU of 9.49. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $328.08, though rates vary from $280.94 to $427.51 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 70553, 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 70553 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 70553 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 70553
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 2.23 | 2.23 |
| Practice Expense RVU | 7.1 | 7.1 |
| Malpractice RVU | 0.16 | 0.16 |
| Total RVU | 9.49 | 9.49 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 70553
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 | $360.66 | $360.66 | $338.53 - $427.51 | 29 |
| Florida | $322.83 | $322.83 | $309.23 - $334.87 | 3 |
| Georgia | $307.23 | $307.23 | $292.39 - $322.07 | 2 |
| Illinois | $314.1 | $314.1 | $299.35 - $328.02 | 4 |
| Michigan | $304.68 | $304.68 | $297.03 - $312.34 | 2 |
| North Carolina | $299.16 | $299.16 | $299.16 - $299.16 | 1 |
| New York | $349.84 | $349.84 | $303.53 - $371.14 | 5 |
| Ohio | $296.39 | $296.39 | $296.39 - $296.39 | 1 |
| Pennsylvania | $313.15 | $313.15 | $297.23 - $329.07 | 2 |
| Texas | $313.33 | $313.33 | $295.25 - $330.27 | 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 70553
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 70553 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 |
| 0708T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0709T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0865T | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 36000 | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 36005 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 36011 | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 36406 | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 36410 | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 36591 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
Frequently Asked Questions, CPT 70553
What does CPT code 70553 mean? +
CPT code 70553 represents: Mri brain stem w/o & w/dye. It's in the Radiology category with a global period of XXX.
What is the Medicare reimbursement for CPT 70553? +
The 2026 Medicare national average non-facility payment for CPT 70553 is $328.08. Rates range from $280.94 to $427.51 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 70553? +
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 70553? +
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 June 1, 2026.
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