Diagnostic Radiology CPT Code Framework
Diagnostic radiology billing revolves around the professional component (reading and interpretation) of imaging studies. The CPT code range 70010 through 76499 covers diagnostic radiology procedures, and each code can be billed as a global service (both technical and professional components), technical component only (modifier TC), or professional component only (modifier 26). For radiologists in private practice or hospital-employed reading groups, the professional component represents the core revenue stream, and accurate code selection determines whether the interpretation is reimbursed at the correct rate.
The distinction between professional and technical component billing is fundamental. A hospital or imaging center bills the technical component (equipment, technologist, supplies) with modifier TC. The radiologist bills the professional component (interpretation, report) with modifier 26. If the radiologist owns the equipment and employs the technologist, they bill the global code without a modifier. Most diagnostic radiologists bill modifier 26 exclusively because they are interpreting studies performed at facilities they do not own.
CT Scan Interpretation Codes
CT scan interpretation codes follow an anatomical organization. Head CT without contrast (70450, professional component approximately $45) is the highest-volume CT interpretation for most radiology groups. Head CT with contrast (70460, approximately $55) and head CT without then with contrast (70470, approximately $65) are billed based on the protocol ordered. Chest CT without contrast (71250, approximately $55) is the standard lung screening and pulmonary evaluation study. Chest CT with contrast (71260, approximately $65) applies to vascular and mediastinal evaluations. Abdomen and pelvis CT with contrast (74178, approximately $95) is the highest-revenue single CT interpretation because it covers the combined abdomen-pelvis study.
MRI Interpretation Codes
MRI interpretation reimburses at higher rates than CT due to the greater complexity of multiplanar image review. Brain MRI without contrast (70551, professional component approximately $65) is the baseline neuroimaging code. Brain MRI without then with contrast (70553, approximately $95) is used for tumor evaluation, infection, and vascular anomalies. Lumbar spine MRI without contrast (72148, approximately $55) is the highest-volume spine study. Knee MRI without contrast (73721, approximately $55) leads the musculoskeletal MRI category. Breast MRI (77046 without contrast, approximately $65; 77047 with contrast, approximately $85) is separately coded from the standard body MRI range.
Mammography Codes (77065-77067)
Mammography has its own code series. Screening mammography bilateral (77067, approximately $60 professional component) is the highest-volume mammography code, performed on asymptomatic patients per USPSTF guidelines. Diagnostic mammography unilateral (77065, approximately $50) applies when a specific breast concern is being evaluated. Diagnostic mammography bilateral (77066, approximately $60) applies when both breasts require diagnostic evaluation. Computer-aided detection (77061-77062 for digital breast tomosynthesis, approximately $25 add-on) is billed when 3D mammography technology is used alongside the standard mammography code.
Bone Density (DEXA) Codes
Bone density measurement by dual-energy X-ray absorptiometry (DEXA) uses code 77080 (axial skeleton DEXA, approximately $25 professional component) for the standard hip and spine measurement. Code 77081 (appendicular skeleton DEXA, approximately $18) covers peripheral measurements. DEXA is typically billed as a global service when the radiology group owns the equipment. Medicare covers screening DEXA every 24 months for women age 65+ and men age 70+, or more frequently if clinically indicated. The low per-study reimbursement means DEXA profitability depends on volume and efficient scheduling.
Fluoroscopy and Special Procedures
Fluoroscopy codes cover real-time imaging guidance. Code 76000 (fluoroscopy, up to 1 hour, approximately $30) is the basic fluoroscopic guidance code used during procedures performed by other physicians. Code 76001 (fluoroscopy by radiologist during a procedure performed by another physician, approximately $45) applies when the radiologist provides dedicated fluoroscopic guidance. Barium swallow (74220, approximately $40), upper GI series (74240, approximately $50), and barium enema (74270, approximately $55) are diagnostic fluoroscopy studies interpreted by the radiologist. These studies have declined in volume as CT and endoscopy have replaced many fluoroscopic evaluations.