MRI CPT Codes: Complete Guide to MRI and CT Procedure Billing Codes
Advanced imaging is one of the most valuable — and most scrutinized — services in modern healthcare.
Every MRI or CT scan performed in a hospital, imaging center, or physician practice must be translated
into a precise billing code before it can be reimbursed. That is where MRI CPT codes come in.
MRI CPT codes are standardized five-digit Current Procedural Terminology (CPT®) codes that describe
exactly which magnetic resonance imaging study was performed, which body region was scanned, and
whether contrast material was used. CT codes follow the same logic for computed tomography.
Accurate coding matters for everyone involved
- Providers and facilities depend on correct codes for timely, full reimbursement.
- Medical billing specialists and coders must avoid denials, audits, and compliance risk.
- Patients benefit from accurate cost estimates, prior authorizations, and clean claims that don’t lead
to surprise bills.
Note: CPT® is a registered trademark of the American Medical Association (AMA). Codes are
updated annually. Always verify codes against the current-year AMA CPT codebook and your payer’s
policies before submitting claims.
What Are MRI CPT Codes?
CPT codes are maintained by the American Medical Association and form the national language used to
report medical, surgical, and diagnostic services to Medicare, Medicaid, and commercial insurers.
Diagnostic radiology codes fall within the 70010–79999 range of the CPT Category I code set.
MRI CPT codes are a subset of these radiology codes. Each MRI code tells the payer three key things:
1. Anatomic region — for example, brain, cervical spine, lumbar spine, pelvis, or a lower-extremity
joint.
2. Contrast status — without contrast, with contrast, or without contrast followed by contrast.
3. Type of study — standard MRI, MR angiography (MRA), or specialized studies such as cardiac or
breast MRI
The Role of MRI CPT Codes in Medical Billing
- On a claim, the CPT code describes what was done, while the ICD-10-CM diagnosis code explains why it
was done. Payers compare the two to determine medical necessity. If a lumbar spine MRI is billed with a
diagnosis that doesn’t support it, the claim may be denied even if the CPT code itself is correct.
MRI and CT codes are also commonly split into two components: - Professional component (modifier 26): the radiologist’s interpretation and written report.
- Technical component (modifier TC): the equipment, technologist, supplies, and facility costs.
When a single entity performs both, the “global” code is reported with no modifier
How Contrast Changes the Code
Most MRI and CT families use a three-code structure
| Code Position | Meaning |
|---|---|
| First code | Without contrast material |
| Second code | With contrast material |
| Third code | Without contrast, followed by contrast and additional sequences |
Under CPT guidelines, “with contrast” refers to contrast administered intravascularly, intra-articularly, or
intrathecally. Oral or rectal contrast alone does not qualify a study as “with contrast.” The contrast
agent itself is typically reported separately with a HCPCS Level II code (for example, gadolinium-based
agents in the A9575–A9585 range for MRI, or low-osmolar iodinated contrast Q9965–Q9967 for CT),
depending on payer and site of service.
MRI CPT Codes List and Common MRI Procedures
| Body Region | Without Contrast |
With Contrast |
Without & With Contrast |
|---|---|---|---|
| Brain (including brain stem) | 70551 | 70552 | 70553 |
| Orbit, face, and/or neck | 70540 | 70542 | 70543 |
| Cervical spine | 72141 | 72142 | 72156 |
| Thoracic spine | 72146 | 72147 | 72157 |
| Lumbar spine | 72148 | 72149 | 72158 |
| Chest | 71550 | 71551 | 71552 |
| Abdomen | 74181 | 74182 | 74183 |
| Pelvis | 72195 | 72196 | 72197 |
| Upper extremity joint (e.g., shoulder, elbow, wrist) | 73221 | 73222 | 73223 |
| Lower extremity joint (e.g., knee, hip, ankle) | 73721 | 73722 | 73723 |
| Upper extremity, other than joint | 73218 | 73219 | 73220 |
| Lower extremity, other than joint | 73718 | 73719 | 73720 |
Other Common MRI and MRA Codes
- 70544 / 70545 / 70546 — MRA head, without / with / without and with contrast
- 70547 / 70548 / 70549 — MRA neck, without / with / without and with contrast
- 77046–77049 — Breast MRI, unilateral or bilateral, with or without contrast (the with-contrast
codes include computer-aided detection when performed) - 75557–75563 — Cardiac MRI for morphology and function, with variations for stress imaging and
contras
Key Coding Tips for MRI Procedures
- Joint vs. non-joint: Extremity MRI codes differ depending on whether the study focuses on a joint
(73221, 73721) or on soft tissue/bone away from the joint (73218, 73718). - Laterality: Bilateral extremity studies are generally reported as two units or with modifiers (RT/LT or
50) depending on payer rules. - Separate regions: Cervical, thoracic, and lumbar spine MRIs are separate codes — a “whole spine”
MRI is usually reported as three distinct codes
MRI Brain CPT Code
| CPT Code |
Description |
|---|---|
| 70551 | MRI brain (including brain stem); without contrast material |
| 70552 | MRI brain (including brain stem); with contrast material(s) |
| 70553 | MRI brain (including brain stem); without contrast material, followed by contrast material(s) and further sequences |
Common Indications for Brain MRI
- Headaches with red-flag features or neurological deficits
- Suspected stroke or transient ischemic attack (TIA)
- Multiple sclerosis diagnosis and monitoring
- Brain tumors and metastatic disease evaluation
- Seizure disorders
- Dementia and cognitive decline workups
- Post-operative surveillance
Factors That Affect MRI Brain Code Selection
1. Contrast protocol. 70553 is the correct code when pre-contrast and post-contrast sequences are
performed in the same session — a common protocol for tumors and MS. Do not report 70551 and 70552
together for the same session.
2. Combined studies. If an MRA of the head (70544–70546) is performed along with a brain MRI, both
may be reported because they are distinct procedures, as long as each is documented and medically
necessary.
3. Specialized techniques. Functional MRI (70554–70555) and MR spectroscopy (76390) have their own
codes and should not be bundled into the standard brain MRI codes.
4. Orbit and internal auditory canal (IAC) studies. Dedicated orbit, face, or neck imaging is reported
with 70540–70543. Many payers expect IAC imaging to be reported under the brain codes, so check
payer-specific guidance
MRI Lumbar Spine W O Contrast CPT Code
| CPT Code |
Description |
|---|---|
| 72148 | MRI, spinal canal and contents, lumbar; without contrast material |
| 72149 | MRI, spinal canal and contents, lumbar; with contrast material(s) |
| 72158 | MRI, spinal canal and contents, lumbar; without contrast material, followed by contrast material(s) and further sequences |
When Is Lumbar MRI Without Contrast Used?
A non-contrast lumbar MRI (72148) is the standard study for:
- Lumbar disc herniation and radiculopathy
- Spinal stenosis
- Degenerative disc disease
- Persistent low back pain unresponsive to conservative therapy
- Suspected cauda equina syndrome (urgent)
When Is Contrast Added?
Contrast-enhanced lumbar studies (72149 or 72158) are typically ordered for:
- Post-surgical spine — distinguishing scar tissue from recurrent disc herniation
- Infection — discitis, osteomyelitis, or epidural abscess
- Tumors — primary or metastatic spinal lesions
- Inflammatory conditions such as arachnoiditis
Billing Considerations for Lumbar Spine MRI
- Prior authorization: Many commercial payers and Medicare Advantage plans require prior
authorization for 72148, often after documenting a period of conservative care (e.g., physical
therapy or medication) unless red flags are present. - Medical necessity: Link the claim to specific ICD-10-CM codes such as radiculopathy or stenosis
rather than nonspecific low back pain when the documentation supports it. - Order vs. performed: If a non-contrast study was ordered but the radiologist added contrast, the
documentation must justify the change, and authorization may need to be updated before billing
72158
Billing Considerations for Lumbar Spine MRI
Computed tomography uses X-rays and computer processing to create cross-sectional images. CT is faster
than MRI, widely available, and excellent for trauma, lung disease, bleeding, kidney stones, and abdominal
emergencies.
CT coding follows the same general structure as MRI coding:
- Anatomic region drives code selection.
- Contrast status (without, with, or without followed by with) determines which code in the family is
used. - CT angiography (CTA) has its own codes that include image post-processing.
- 3D rendering (76376/76377) is reported separately only when it is not already included in the
primary code, such as with CTA.
As with MRI, CT codes can be split into professional (26) and technical (TC) components, and contrast
agents are often reported separately using HCPCS Level II codes
CT CPT Codes
Below are the most common CT CPT codes used in radiology billing
| Body Region | Without Contrast | With Contrast | Without & With Contrast |
|---|---|---|---|
| Head/brain | 70450 | 70460 | 70470 |
| Orbit, sella, or ear | 70480 | 70481 | 70482 |
| Maxillofacial/sinuses | 70486 | 70487 | 70488 |
| Soft tissue neck | 70490 | 70491 | 70492 |
| Chest (thorax) | 71250 | 71260 | 71270 |
| Cervical spine | 72125 | 72126 | 72127 |
| Thoracic spine | 72128 | 72129 | 72130 |
| Lumbar spine | 72131 | 72132 | 72133 |
| Pelvis | 72192 | 72193 | 72194 |
| Abdomen | 74150 | 74160 | 74170 |
| Abdomen and pelvis (combined) | 74176 | 74177 | 74178 |
Other Important CT Codes
- 71271 — Low-dose CT for lung cancer screening
- 71275 — CTA chest (non-coronary)
- 74174 — CTA abdomen and pelvis
- 70496 / 70498 — CTA head / CTA neck
- 74261–74263 — CT colonography (diagnostic and screening)
Why CT CPT Codes Matter
Because CT is used heavily in emergency departments, coding errors can multiply quickly. Common issues
include billing separate abdomen and pelvis codes instead of the combined code, choosing the wrong
contrast code, and failing to support urgent studies with adequate diagnosis documentation
CT Chest CPT Code
The CT chest CPT code family covers diagnostic CT of the thorax, including the lungs, mediastinum,
pleura, and chest wall.
| CPT Code | Description |
|---|---|
| 71250 | CT thorax, diagnostic; without contrast material |
| 71260 | CT thorax, diagnostic; with contrast material(s) |
| 71270 | CT thorax, diagnostic; without contrast material, followed by contrast material(s) and further sections |
| 71271 | CT thorax, low dose for lung cancer screening, without contrast material(s) |
| 71275 | CTA chest (non-coronary), without contrast followed by contrast, including image post-processing |
Contrast Usage in Chest CT
- Without contrast (71250): Lung nodule follow-up, interstitial lung disease, emphysema, and high
resolution CT (HRCT) protocols. - With contrast (71260): Cancer staging, mediastinal masses, lymphadenopathy, empyema, and
complex infections. - CTA chest (71275): Suspected pulmonary embolism or aortic dissection. Do not report 71260 for a
PE study — the CTA code is correct when angiographic technique and post-processing are
performed and documented.
Common Indications
- Persistent cough, hemoptysis, or abnormal chest X-ray
- Pulmonary nodule evaluation and surveillance
- Lung cancer diagnosis and staging
- Chest trauma
- Pneumonia complications
Lung Cancer Screening vs. Diagnostic CT
Low-dose CT for lung cancer screening (71271) is distinct from diagnostic chest CT. Payers such as
Medicare cover screening only when specific eligibility criteria are met (age, smoking history, and a
documented shared decision-making visit for the initial screen). If the patient has symptoms, a diagnostic
code (71250) is generally more appropriate.
CT Abd Pelvis With Contrast CPT
| CPT Code |
Description |
|---|---|
| 74176 | CT abdomen and pelvis; without contrast material |
| 74177 | CT abdomen and pelvis; with contrast material(s) |
| 74178 | CT abdomen and pelvis; without contrast material in one or both body regions, followed by contrast material(s) and further sections in one or both body regions |
When to Use the Combined Code
Since 2011, CPT requires that when CT of the abdomen and pelvis are performed in the same session,
the combined codes (74176–74178) must be used. Coders should not report separate abdomen (74150
74170) and pelvis (72192–72194) codes together for the same encounter.
Choosing Between 74177 and 74178
- 74177 — Both regions scanned only after IV contrast administration (the most common protocol,
such as for appendicitis or abdominal pain). - 74178 — At least one region is scanned without contrast and then with contrast, such as
multiphase protocols for renal masses, liver lesions, or hematuria (CT urography)
Oral Contrast Reminder
Oral contrast alone does not make a study “with contrast.” If a patient receives only oral contrast, 74176 is
the correct code. The study must include IV contrast to qualify for 74177
Common Indications for CT Abdomen and Pelvis With Contrast
- Acute abdominal pain (appendicitis, diverticulitis, bowel obstruction)
- Cancer staging and follow-up
- Abdominal abscess or infection
- Inflammatory bowel disease complications
- Blunt abdominal trauma
MRI vs. CT Procedure Comparison Table
| Procedure | Imaging Type |
Common CPT Code Category |
When It Is Used |
|---|---|---|---|
| Brain MRI | MRI | 70551–70553 | Stroke, MS, tumors, seizures, neurological symptoms |
| Lumbar spine MRI | MRI | 72148–72158 | Disc herniation, stenosis, radiculopathy, post-op spine |
| Cervical spine MRI | MRI | 72141, 72142, 72156 | Neck pain with radiculopathy, myelopathy |
| Knee/joint MRI | MRI | 73721–73723 | Ligament tears, meniscal injury, cartilage damage |
| Head CT | CT | 70450–70470 | Head trauma, acute stroke, intracranial bleed |
| Chest CT | CT | 71250–71271 | Lung nodules, cancer staging, infection, screening |
| CTA chest | CT | 71275 | Pulmonary embolism, aortic dissection |
| Abdomen & pelvis CT | CT | 74176–74178 | Abdominal pain, appendicitis, cancer staging, trauma |
Common Mistakes When Using MRI and CT CPT Codes
Even experienced coders can run into trouble with radiology codes. These are the errors that most often
lead to denials, recoupments, or audit findings:
1. Selecting the wrong contrast code. Reporting “with contrast” when only a non-contrast study was
performed — or when only oral contrast was given — is a frequent and costly error.
2. Unbundling abdomen and pelvis CT. Billing 74160 + 72193 instead of 74177 violates CPT
guidelines and NCCI edits.
3. Reporting two codes for a combined contrast study. For example, billing 70551 + 70552 instead
of 70553.
4. Mismatched diagnosis codes. CPT codes not supported by ICD-10-CM codes that establish
medical necessity are a leading cause of denials.
5. Missing prior authorization. Advanced imaging often requires authorization; a changed protocol
(e.g., contrast added) may require an updated authorization.
6. Incorrect modifier use. Omitting modifier 26 or TC in split-billing arrangements, or misusing
laterality modifiers on extremity studies.
7. Confusing CTA with contrast CT. Billing 71260 for a pulmonary embolism protocol rather than
71275, or the reverse, when documentation doesn’t support angiographic imaging.
8. Coding from the order rather than the report. Always code from the final signed radiology
report — what was actually performed — not just what was ordered
9. Using outdated codes. CPT codes are revised every January; for example, breast MRI codes were
replaced in 2019 and lung screening moved to 71271 in 2021
What is the CPT code for MRI brain without contrast?
The MRI brain CPT code without contrast is 70551. Use 70552 for MRI with contrast only, and 70553 when the study is performed without contrast followed by contrast
What is the MRI lumbar spine w/o contrast CPT code?
The CPT code for MRI of the lumbar spine without contrast is 72148. With contrast it is 72149, and without followed by with contrast is 72158.
What is the CT abd pelvis with contrast CPT code?
The CT abdomen and pelvis with contrast CPT code is 74177. Use 74176 for non-contrast studies and 74178 for studies performed without and then with contrast.
