MRI Procedure codes list - MRA

Procedure code and description


70540 - Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s) -average fee amount- $360 - $370

70542 - Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; with contrast material(s)


70543 - Magnetic resonance (eg, proton) imaging, orbit, face, and/or neck; without contrast material(s), followed by contrast material(s) and further sequences

MRI and MRA's	Procedure code
MRI spine screening to include 3 separate codes	72146, 74141 72148
MRA abdomen; with or w/o contrast	74185
MRA carotid w/o contrast	70547
MRA carotid with contrast	70548
MRA chest; with or w/o contrast	71555
MRA head; w/o contrast	70544
MRA head; w/o contrast followed by contrast	70546
MRA head; with contrast	70545
MRA pelvis; with or w/o contrast	72198
MRA peripheral runoff	73725, 72198 74185
MRA spinal canal & contents; with or w/o contrast	72159
MRA upper extremity; with or w/o contrast	73225
MRI abdomen; w/o contrast	74181
MRI abdomen; w/o contrast followed by with contrast	74183
MRI abdomen; with contrast	74182
MRI brain; w/o contrast	70551
MRI brain; w/o contrast followed by contrast	70553
MRI brain; with contrast	70552
MRI breast; bilateral	77059
MRI breast; unilateral	77058
MRI cardiac for morphology and function w/o contrast	75557
MRI cardiac for morphology and function w/o contrast and with contrast	75561
MRI cardiac velocity flow map	75565
MRI cervical spine; w/o contrast	72141
MRI cervical spine; w/o contrast followed by contrast	72156
MRI cervical spine; with contrast	72142
MRI chest; w/o contrast	71550
MRI chest; w/o contrast followed by with contrast	71552
MRI chest; with contrast	71551
MRI Etris DVT Research scan; scan involves both CPT codes	73718, 72198
MRI fetal	76498
MRI lower extremity, any joint w/o contrast	73721
MRI lower extremity, any joint w/o contrast followed by with contrast	73723
MRI lower extremity, any joint with contrast	73722
MRI lower extremity, other than joint w/o contrast	73720
MRI lower extremity, other than joint with contrast	73719
MRI lower extremity, other than joint/o contrast	73718
MRI lumbar spine; w/o contrast	72148
MRI lumbar spine; w/o contrast followed by contrast	72158
MRI lumbar spine; with contrast	72149
MRI orbit, face and neck; w/o contrast	70540
MRI orbit, face and neck; w/o contrast followed by with contrast	70543
MRI orbit, face and neck; with contrast	70542
MRI pelvis; w/o contrast	72195
MRI pelvis; w/o contrast followed by contrast	72197
MRI pelvis; with contrast	72196
MRI temporomandibular joint(s)	70336
MRI thoracic spine w/o contrast followed by contrast	72157
MRI thoracic spine; w/o contrast	72146
MRI thoracic spine; with contrast	72147
MRI upper extremity, any joint w/o contrast	73221
MRI upper extremity, any joint w/o contrast followed by with contrast	73223
MRI upper extremity, any joint with contrast	73222
MRI upper extremity, other than joint w/o contrast	73218
MRI upper extremity, other than joint w/o contrast followed by with contrast	73220
MRI upper extremity, other than joint with contrast	73219
MRI pelvis; w/o contrast	72195
MRI pelvis; w/o contrast followed by contrast	72197
MRI pelvis; with contrast	72196
MRI temporomandibular joint(s)	70336
MRI thoracic spine w/o contrast followed by contrast	72157
Infant upper extremity minimum 2 views	73092

Medicare coverage and limitation

Magnetic Resonance Imaging (MRI) is a noninvasive diagnostic imaging modality used to diagnose a variety of central nervous system disorders. MRI provides superior tissue contrast when compared to CT, is able to image in multiple planes, is not affected by bone artifact, provides vascular imaging capability, and makes use of safer contrast media (gadolinium chelate agents). Its major disadvantage over CT is the longer scanning time required for study, making it less useful for emergency evaluations. Contraindications include patients with cardiac pacemakers, implanted neurostimulators, cochlear implants, metal in the eye and older ferromagnetic intracranial aneurysm clips. All of these may be potentially displaced when exposed to the powerful magnetic fields used in MRI.

MRI of the Orbit, Face, and/or Neck will be considered medically reasonable and necessary when used to diagnose and characterize pathology of the nasopharynx, oropharynx, and neck including tumors, infection, soft tissue pathologies, and congenital abnormalities.

The MRI is not covered when the following patient-specific contraindications are present:

•MRI is not covered for patients with cardiac pacemakers or with metallic clips on vascular aneurysms unless the Medicare beneficiary meets the provisions of the following exceptions:

Effective for claims with dates of service on or after July 7, 2011, the contraindications will not apply to pacemakers when used according to the FDA-approved labeling in an MRI environment, or effective for claims with dates of service on or after February 24, 2011, CMS believes that the evidence is promising although not yet convincing that MRI will improve patient health outcomes if certain safeguards are in place to ensure that the exposure of the device to an MRI environment adversely affects neither the interpretation of the MRI result nor the proper functioning of the implanted device itself. We believe that specific precautions (as listed below) could maximize benefits of MRI exposure for beneficiaries enrolled in clinical trials designed to assess the utility and safety of MRI exposure. Therefore, CMS determines that MRI will be covered by Medicare when provided in a clinical study under section 1862(a)(1)(E) (consistent with section 1142 of the Act) through the Coverage with Study Participation (CSP) form of Coverage with Evidence Development (CED) if the study meets the criteria in each of the three paragraphs in CMS Pub 100-03, CMS National Coverage Determination Manual, Chapter 1, Section 220.2.C.1

•MRI during a viable pregnancy is also contraindicated at this time.

•The danger inherent in bringing ferromagnetic materials within range of MRI units generally constrains the use of MRI on acutely ill patients requiring life support systems and monitoring devices that employ ferromagnetic materials.

•In addition, the long imaging time and the enclosed position of the patient may result in claustrophobia, making patients who have a history of claustrophobia unsuitable candidates for MRI procedures.

Nationally Non-Covered Indications:

CMS has determined that MRI of cortical bone and calcifications, and procedures involving spatial resolution of bone and calcifications, are not considered reasonable and necessary indications within the meaning of section 1862(a)(1)(A) of the Act, and are therefore non-covered.

When Magnetic Resonance Imaging is used for an investigational purpose, an acceptable advance notice of denial of payment must be given to the patient when the provider does not want to accept financial responsibility for the service.

In some instances, MRI of the brain, as well as MRI of the orbit, face, and/or neck may be medically necessary on the same day. The medical record should document the medical necessity for these two procedures being performed on the same day.


Initial imaging of the thyroid should be done with ultrasound or nuclear medicine, unless there is a known carcinoma present.


This policy addresses standard CT and MR imaging. Magnetic Resonance Angiography (MRA) is not addressed in this policy.

Computerized Tomography (CT)

Computerized tomography (CT scanning) uses the attenuation of an x-ray beam by an object in its path to create cross-sectional images. As x-rays pass through planes of the body, the photons are detected and recorded as they exit from different angles. Computers process the signals to produce a cross-sectional view of the body. The signal data may be subjected to a variety of post-acquisitional processing algorithms to obtain a multiplanar view of the anatomy.

Magnetic Resonance Imaging (MRI)

Magnetic Resonance Imaging (MRI) is a non-invasive diagnostic scanning technique that employs a powerful and highly uniform static magnetic field, rather than ionizing radiation, to produce images. Fluctuations in the strength of the magnetic field alter the motion and relaxation times of hydrogen molecules, which are related to the density of molecules and reflect the physicochemical properties of the tissues. Reconstructed images can be displayed in multiple planes to facilitate analysis. See national non-coverage in CMS section above.

Coverage is limited to those CT and MRI machines that have received pre-market approval by the FDA. Such units must be operated within the parameters specified by the approval.

Medicare coverage for CT scans is allowed provided the service is medically reasonable and necessary.

Inconclusive findings on a CT scan may warrant a MRI study and, conversely, findings of a MRI study may be further clarified (under certain circumstances) with a subsequent CT scan. The information provided by the two modalities may be complementary.

Cancer Staging. Clinicians commonly use CT and MRI of the brain when metastatic involvement is suspected.

Non-covered indications: esophagus, oropharynx, and prostate, and non-melanoma skin cancer in the absence of symptoms of brain involvement. “Certain tumors almost never metastasize to the brain parenchyma. These include carcinomas of the esophagus, oropharynx, and prostate, and non-melanoma skin cancers.” (DeVita, Chapter 52.1) Accordingly, the related diagnoses found in the following diagnosis code list do not justify brain scans for “staging” purposes unless a patient has signs or symptoms suggesting brain involvement. Covered: In contrast, for those malignancies that commonly metastasize to the brain, staging in the absence of neurological findings may be appropriate.

Payment will be allowed for reasonable and necessary scans of different areas of the body that are performed on the same day.