MRI With Contrast price: Medicare anchor and facility lever
Anchor for MRI With Contrast - CPT 70553
$312.34
Professional (26) $107.27 plus technical (TC) $205.07.
Hospital OPPS facility anchor, this code billed alone: $356.43 (APC 5572, Level 2 Imaging with Contrast; national unadjusted, before wage-index adjustment).
Composite APC 8008: $867.08 (multi-study only, national unadjusted).
CPT 70553 is a two-part study: the brain is scanned without contrast, the agent is given, and the scan is repeated. That single code covers both passes, which is why its anchors sit well above the plain study. The contrast agent itself and the hospital composite rules are where quotes for this code most often disagree.
CPT code
70553
Magnetic resonance imaging, brain (including brain stem); without contrast material, followed by contrast material(s) and further sequences
CPT 70553 is the brain MRI without and with contrast code used as the anchor example. Other body areas use paired codes (for example 72158 lumbar, 73723 joint) with different anchors.
The codes this visit can be billed under
| CPT | PFS office or global | PFS facility (professional) | Global period | Hospital single-service APC | Minimum Medicare copay at hospital |
|---|---|---|---|---|---|
| 70553 (this page) | $312.34 | $312.34 | not a surgical global | $356.43 (APC 5572) | $71.29 |
| 70552 | $264.39 | $264.39 | not a surgical global | $356.43 (APC 5572) | $71.29 |
| 70551 | $192.65 | $192.65 | not a surgical global | $243.77 (APC 5523) | $48.76 |
Billed alone in a hospital, 70553 maps to APC 5572 at $356.43 with a minimum unadjusted copayment of $71.29. That is the same single-service APC used for contrast-only brain MRI (70552) and for contrast CT of the abdomen and pelvis, so a hospital estimate for 70553 should not differ from those codes on the facility line unless a composite applies.
The professional side is larger here than for the plain study: the CY2026 professional component is $107.27 against $69.04 for 70551. A quote that lists only a facility price leaves out a reading fee that is meaningfully bigger than for the without-contrast scan.
Read the two hospital figures on this page carefully. The single-service APC for 70553 is $356.43, while the contrast MRI composite on record is higher and applies only when the composite rules are met. For a self-pay patient comparing a hospital quote with an imaging-center quote for 70553 alone, the single-service figure plus the $107.27 reading fee is the fairer Medicare comparison than the composite.
Inside and outside the 70553 anchor
Covered by the anchor
- Scanner time for pre- and post-contrast sequences
- Contrast material administration as part of the study
- Radiologist interpretation and written report (professional component)
Billed outside it
- Sedation or anesthesia, when used
- Lab work sometimes ordered before contrast
- The ordering visit and follow-up visit
- A separate body area billed under its own CPT code
Why prices vary for CPT 70553
Contrast adds scanner time and a contrast agent, so both the PFS global amount and the OPPS composite rate sit above the without-contrast study. The facility-type gap widens with contrast because the hospital OPPS composite for MRI with contrast is substantially higher than the without-contrast composite, while the imaging-center global payment rises by a smaller amount.
Confirm the exact CPT code (with contrast versus without and with) before you price-shop. A quote for 70551 will not match a bill for 70553.
Questions specific to MRI with contrast
- Is the contrast agent included in the quoted price, or will it appear as its own line?
- Is the quote for the full without-and-with study (70553), or for contrast only (70552)?
- Will a separate radiology group bill the interpretation, and what is its price for 70553?
- If kidney-function lab work is required before contrast, who bills it and is it in the price?
MRI With Contrast: billing questions
Is 70553 the same as an MRI with contrast?
Not exactly. 70553 is the study without contrast followed by with contrast. A study done only after contrast is 70552, which has a lower PFS global anchor. The order should name the code, and the quote should match it.
Why might the contrast agent show up as a separate charge?
Facilities bill supplies and drugs differently. Some fold the agent into the scan price and some list it on its own line. Ask whether the agent is inside the quoted total so the written number is the complete price for the visit.
Is the hospital facility amount for 70553 higher than for 70551?
Yes when each is billed alone. Under the CY2026 OPPS addenda, 70551 maps to APC 5523 and 70553 maps to APC 5572, which pays more. When composite rules apply, the hospital is paid the contrast MRI composite instead, which is the figure shown at the top of this page.
What would a Medicare patient's minimum hospital copayment be for 70553 alone?
In the CY2026 OPPS Addendum B, 70553 maps to APC 5572 with a minimum unadjusted copayment of $71.29, before wage-index adjustment. The radiologist's professional fee carries its own Part B coinsurance, so a hospital scan produces two cost-sharing amounts.