CPT 75559
Global XXX ActiveCardiac mri w/stress img
CPT 75559 Billing & Documentation Guide
CPT code 75559 (Cardiac mri w/stress img) is classified under Radiology with a global period indicator of XXX. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 2.88, a non-facility practice expense RVU of 8.39, and a malpractice RVU of 0.11, a total non-facility RVU of 11.38 and facility RVU of 11.38. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $393.77, though rates vary from $338.81 to $512.84 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 75559, 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 75559 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 1 units of 75559 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 75559
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 2.88 | 2.88 |
| Practice Expense RVU | 8.39 | 8.39 |
| Malpractice RVU | 0.11 | 0.11 |
| Total RVU | 11.38 | 11.38 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 75559
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 | $433.23 | $433.23 | $406.94 - $512.84 | 29 |
| Florida | $384.51 | $384.51 | $369.62 - $397.21 | 3 |
| Georgia | $368.08 | $368.08 | $350.54 - $385.61 | 2 |
| Illinois | $374.33 | $374.33 | $357.79 - $391.18 | 4 |
| Michigan | $364.51 | $364.51 | $356.2 - $372.81 | 2 |
| North Carolina | $360 | $360 | $360 - $360 | 1 |
| New York | $418.38 | $418.38 | $365 - $442.37 | 5 |
| Ohio | $355.75 | $355.75 | $355.75 - $355.75 | 1 |
| Pennsylvania | $375.48 | $375.48 | $356.92 - $394.03 | 2 |
| Texas | $376.03 | $376.03 | $354.62 - $396.13 | 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 75559
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 75559 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 0694T | Column 1 (primary), can be billed with modifier | Yes | 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 |
| 75557 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 76376 | Column 1 (primary), can be billed with modifier | Yes | CPT Manual or CMS manual coding instruction |
| 76377 | Column 1 (primary), can be billed with modifier | Yes | CPT Manual or CMS manual coding instruction |
| 96523 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 0648T | Column 2 (secondary), bundled into primary | Yes | CPT Manual or CMS manual coding instruction |
| 75561 | Column 2 (secondary), bundled into primary | No | CPT Manual or CMS manual coding instruction |
| 75563 | Column 2 (secondary), bundled into primary | No | CPT Manual or CMS manual coding instruction |
Frequently Asked Questions, CPT 75559
What does CPT code 75559 mean? +
CPT code 75559 represents: Cardiac mri w/stress img. It's in the Radiology category with a global period of XXX.
What is the Medicare reimbursement for CPT 75559? +
The 2026 Medicare national average non-facility payment for CPT 75559 is $393.77. Rates range from $338.81 to $512.84 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 75559? +
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 75559? +
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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