How much does Medicare pay for CPT 70553?

Medicare allowed an average of $153.94 per service and paid $117.51 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $1117.93, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 70553?

Mri scan of brain before and after contrast. It was billed 1,028,334 times to 969,993 Medicare beneficiaries by 11,330 providers in 2024.

Does 70553 pay differently in an office than a hospital?

Yes. The allowed amount averaged $231.15 in an office setting and $105.66 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 70553 most?

Diagnostic Radiology, with 939,817 services from 10,007 clinicians. Next are Independent Diagnostic Testing Facility (IDTF), Interventional Radiology, Neurology.

CPT 70553

Mri scan of brain before and after contrast

$153.94Medicare-allowed amount per service, averaged across 1,028,334 services

Providers submitted

$1117.93

Asking price, not received

Medicare allowed

$153.94

The fee schedule figure

Medicare paid

$117.51

Balance is patient coinsurance

Providers submitted an average of $1117.93 for this code and Medicare allowed $153.94 — 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 $117.51 (76%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $231.15
Hospital / facility: $105.66

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. 395,605 services were billed in an office setting and 632,729 in a facility.

Services: 1,028,334
Beneficiaries: 969,993
Providers billing it: 11,330
Total allowed: $158,301,736

What Medicare pays for CPT 70553

Across 1,028,334 services billed by 11,330 providers to 969,993 beneficiaries, Medicare allowed an average of $153.94 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 70553

Specialty	Services	Beneficiaries	Avg allowed	Providers
Diagnostic Radiology	939,817	888,302	$146.74	10,007
Independent Diagnostic Testing Facility (IDTF)	51,674	47,230	$271.81	589
Interventional Radiology	14,826	14,273	$135.01	222
Neurology	7,011	6,775	$207.04	184
Hematology-Oncology	2,424	1,726	$206.44	55
Nuclear Medicine	2,001	1,912	$155.20	16
Radiation Oncology	1,716	1,510	$200.81	33
Neurosurgery	1,621	1,393	$221.16	45
Family Practice	1,370	1,282	$200.63	42
Internal Medicine	1,226	1,157	$194.94	29
Undefined Physician type	881	805	$143.58	6
Physician Assistant	872	840	$194.45	12
Nurse Practitioner	647	634	$173.66	17
Pediatric Medicine	421	406	$182.02	5
Medical Oncology	309	286	$203.67	12

70553 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	94,473	$190.31	$127.55	1,046
Texas	74,695	$156.17	$118.50	791
New York	70,074	$189.88	$128.01	596
Florida	62,618	$182.42	$138.92	737
Illinois	45,878	$131.50	$95.75	515
Massachusetts	45,439	$149.78	$103.54	338
Pennsylvania	42,921	$134.46	$97.99	479
North Carolina	35,521	$135.46	$105.40	358
Virginia	31,571	$149.36	$110.38	241
Minnesota	31,147	$165.99	$122.81	399
Ohio	29,414	$122.94	$92.52	315
Michigan	28,107	$120.36	$89.10	297
Missouri	26,538	$115.38	$88.21	271
New Jersey	26,235	$200.90	$138.03	274
Tennessee	26,159	$140.71	$113.10	297
Maryland	24,844	$205.54	$145.36	212
Georgia	24,683	$139.92	$106.83	324
Arizona	24,628	$170.17	$129.18	230
Washington	19,871	$157.57	$111.48	203
Wisconsin	19,251	$119.56	$89.80	239
South Carolina	19,003	$144.47	$114.76	226
Colorado	18,542	$155.67	$112.11	212
Alabama	15,685	$139.86	$113.23	252
Indiana	15,281	$122.23	$95.21	229
Connecticut	12,813	$144.40	$103.14	140
Kansas	12,147	$127.79	$100.65	137
Louisiana	11,234	$131.61	$103.77	189
Arkansas	10,315	$126.50	$103.66	140
Iowa	10,206	$124.44	$98.81	116
Kentucky	10,059	$125.81	$97.54	157
Oregon	9,721	$139.20	$102.49	122
Oklahoma	9,408	$124.04	$96.27	144
Mississippi	9,224	$120.54	$97.18	111
Nebraska	8,211	$118.34	$92.81	92
Nevada	7,952	$191.33	$145.77	98
Utah	7,461	$128.31	$98.02	104
New Hampshire	6,581	$117.89	$86.55	94
Delaware	5,312	$134.64	$99.24	35
District of Columbia	4,327	$176.62	$123.51	32
West Virginia	4,142	$118.87	$88.64	87
Montana	3,955	$129.20	$96.32	45
North Dakota	3,931	$109.66	$80.99	44
Idaho	3,867	$119.87	$91.10	43
Maine	3,683	$132.74	$96.70	47
New Mexico	3,661	$154.34	$114.69	50
Rhode Island	3,613	$155.19	$110.65	41
South Dakota	3,100	$122.49	$90.74	36
Alaska	2,853	$195.10	$119.02	31
Vermont	2,689	$116.21	$86.00	23
Hawaii	2,217	$176.83	$124.64	32
Wyoming	2,004	$157.69	$119.98	33
Puerto Rico	450	$230.97	$173.78	16
AA	167	$104.17	$75.24	2
ZZ	152	$142.19	$104.08	1
Guam	124	$309.40	$199.26	3
XX	122	$116.30	$84.87	2

Related codes

70551Mri scan of brain without contrast$94.16
70544Mri scan of blood vessels of head without contrast$93.59
70543Mri scan of bone of eye socket$189.65
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.