| Category | Amount |
|---|---|
| Medicare Allowed Rate What Medicare approves for this service | $334.15 |
| Typical Billed Amount What providers commonly charge | $600 – $4000 |
| Potential Markup How much more you might pay vs. Medicare rate | 1097% above Medicare |
What CPT Code 70553 Means
When your doctor orders CPT code 70553, you'll be getting a comprehensive brain MRI that involves two sets of images. First, technicians will take pictures of your brain without any contrast dye. Then, they'll inject a special contrast material (usually gadolinium) into your bloodstream and take another set of images.
This two-part process gives doctors the most detailed view possible of your brain structures. The contrast dye helps highlight blood vessels, tumors, inflammation, or other abnormalities that might not show up clearly on regular MRI images. Doctors typically order this comprehensive scan when they need to investigate symptoms like persistent headaches, neurological problems, or when monitoring known brain conditions.
The entire procedure usually takes 45-90 minutes, with most of that time spent in the MRI machine. While it takes longer than a basic brain MRI, the additional information from the contrast images often provides crucial details for your diagnosis and treatment plan.
Understanding the Costs and Billing
CPT code 70553 typically appears on your medical bill as "MRI brain w/o & w contrast" or similar wording. The cost can vary significantly depending on where you have the scan done. You can expect charges ranging from $600 to $4,000, with hospital-based imaging centers usually charging more than independent radiology facilities.
If you have Medicare, the approved rate for this procedure is $334.15, though you may still owe coinsurance or deductible amounts depending on your coverage. Private insurance companies negotiate their own rates, which are often higher than Medicare but typically lower than the facility's standard charges.
Your bill should show one line item for CPT 70553. If you see separate charges for brain MRI without contrast (70551) and with contrast (70552), this might indicate an error, as 70553 already includes both components. The contrast material cost is included in the 70553 fee, so you shouldn't see a separate charge for the gadolinium injection.
How to Verify Your Bill Is Correct
Start by confirming that your medical records and the radiology report match what's on your bill. If your doctor ordered a brain MRI with and without contrast, and you received both types of images during your appointment, then CPT 70553 is the correct code. However, if you only received one type of scan, you should see either 70551 (without contrast) or 70552 (with contrast) instead.
Compare your charges to typical ranges for your area and insurance type. If your bill seems unusually high, contact your insurance company first to understand what they've approved and what you're responsible for paying. Many facilities offer payment plans or financial assistance programs if the cost is causing hardship.
If you believe there's an error, contact the billing department at the facility where you had your MRI. Have your medical records, insurance information, and the specific CPT codes ready when you call. Most billing errors can be resolved with a phone call, especially if you can clearly explain what procedure you actually received versus what appears on your bill.