How much does Medicare pay for CPT 70543?

Medicare allowed an average of $189.65 per service and paid $146.53 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $1393.18, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 70543?

Mri scan of bone of eye socket, face, and/or neck before and after contrast. It was billed 42,334 times to 39,400 Medicare beneficiaries by 1,635 providers in 2024.

Does 70543 pay differently in an office than a hospital?

Yes. The allowed amount averaged $265.77 in an office setting and $100.00 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 70543 most?

Diagnostic Radiology, with 38,990 services from 1,487 clinicians. Next are Independent Diagnostic Testing Facility (IDTF), Interventional Radiology, Nuclear Medicine.

CPT 70543

Mri scan of bone of eye socket, face, and/or neck before and after contrast

$189.65Medicare-allowed amount per service, averaged across 42,334 services

Providers submitted

$1393.18

Asking price, not received

Medicare allowed

$189.65

The fee schedule figure

Medicare paid

$146.53

Balance is patient coinsurance

Providers submitted an average of $1393.18 for this code and Medicare allowed $189.65 — 7.3× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $146.53 (77%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $265.77
Hospital / facility: $100.00

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 22,894 services were billed in an office setting and 19,440 in a facility.

Services: 42,334
Beneficiaries: 39,400
Providers billing it: 1,635
Total allowed: $8,028,643

What Medicare pays for CPT 70543

Across 42,334 services billed by 1,635 providers to 39,400 beneficiaries, Medicare allowed an average of $189.65 per service. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 70543

Specialty	Services	Beneficiaries	Avg allowed	Providers
Diagnostic Radiology	38,990	36,302	$182.65	1,487
Independent Diagnostic Testing Facility (IDTF)	2,482	2,283	$303.84	115
Interventional Radiology	377	369	$147.30	14
Nuclear Medicine	121	119	$211.57	6
Physician Assistant	113	111	$229.37	1
Radiation Oncology	104	99	$140.33	4
Hematology-Oncology	36	14	$162.55	1
Internal Medicine	33	32	$164.02	2
Nurse Practitioner	22	21	$225.49	1
Undefined Physician type	19	16	$322.74	1
Family Practice	13	11	$260.85	1
Pediatric Medicine	12	11	$220.51	1
Sports Medicine	12	12	$235.68	1

70543 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
California	6,323	$218.02	$143.93	207
New York	5,400	$233.38	$155.38	147
Texas	3,949	$163.89	$124.28	136
Florida	2,857	$205.58	$157.70	101
Massachusetts	2,509	$161.07	$111.23	75
Pennsylvania	2,156	$152.15	$108.28	80
Maryland	1,803	$254.35	$180.82	54
Illinois	1,775	$141.22	$100.64	78
Arizona	1,482	$184.79	$142.17	53
New Jersey	1,182	$276.19	$191.22	54
Virginia	964	$188.62	$136.30	44
Colorado	823	$166.19	$118.78	31
Minnesota	795	$256.72	$190.26	47
Ohio	768	$120.84	$91.70	42
Washington	684	$163.37	$116.82	29
North Carolina	635	$173.82	$136.24	38
Georgia	591	$195.43	$151.76	29
Michigan	572	$119.43	$88.66	36
Missouri	550	$115.60	$88.61	34
Tennessee	511	$172.31	$141.42	27
Wisconsin	479	$113.58	$86.91	23
Connecticut	408	$153.34	$112.79	19
Oregon	371	$127.71	$95.52	15
South Carolina	364	$180.36	$150.25	19
Indiana	345	$135.20	$106.88	17
Alabama	332	$152.96	$124.65	15
Delaware	314	$131.02	$98.30	15
District of Columbia	294	$232.48	$159.95	12
Nevada	275	$259.30	$199.57	12
Arkansas	258	$95.32	$77.71	7
Kansas	202	$148.60	$119.75	13
New Hampshire	201	$96.97	$71.88	11
Iowa	199	$137.25	$106.67	10
Utah	197	$108.82	$80.49	10
Oklahoma	167	$145.49	$111.15	11
Kentucky	161	$240.62	$204.33	7
New Mexico	157	$243.62	$190.78	7
Montana	152	$152.29	$116.82	9
Louisiana	148	$164.52	$134.57	9
Maine	142	$168.99	$119.54	2
Mississippi	119	$141.15	$115.61	8
Nebraska	117	$132.83	$109.54	8
Alaska	106	$228.98	$152.12	4
Vermont	103	$120.94	$89.46	6
West Virginia	75	$259.59	$199.16	3
Hawaii	74	$188.92	$132.28	4
South Dakota	60	$94.40	$70.95	4
Rhode Island	53	$149.21	$106.25	4
Idaho	53	$95.57	$72.54	4
North Dakota	49	$95.10	$64.35	3
Guam	17	$375.71	$245.93	1
Wyoming	13	$339.50	$252.70	1

Related codes

70551Mri scan of brain without contrast$94.16
70553Mri scan of brain before and after contrast$153.94
70544Mri scan of blood vessels of head without contrast$93.59
70547Mri scan of blood vessels of neck without contrast$100.53
70549Mri scan of blood vessels of neck before and after contrast$145.19
70546Mri scan of blood vessels of head before and after contrast$164.09
70548Mri scan of blood vessels of neck$83.23
70552Mri scan of brain$109.43
70540Mri scan of bone of eye socket$143.49

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.