Radiology CPT Reference

Radiology CPT Codes and Reimbursement Rates

Radiology billing encompasses a wide array of CPT codes for diagnostic imaging, interventional procedures, and radiation therapy services.

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Radiology CPT Codes and Reimbursement Rates
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Overview

The Complexity of Radiology billing

Radiology billing encompasses a wide array of CPT codes for diagnostic imaging, interventional procedures, and radiation therapy services. The technical and professional component split (modifier -TC and -26) is fundamental to radiology coding and directly affects how claims are submitted, processed, and reimbursed across different practice arrangements.

This reference covers the most frequently billed radiology CPT codes across modalities including X-ray, CT, MRI, ultrasound, and nuclear medicine studies. Each section includes component billing rules, common modifier combinations, and documentation standards for establishing medical necessity across imaging types.

The Complexity of Radiology billing
Challenges

Common Radiology billing Challenges We Solve

Every Radiology billing team deals with payer delays, coding nuance, and collection leakage.

Authorization Gaps

We identify missing authorizations and documentation gaps before they create denials.

Coding Drift

Procedure coding and modifier use stay aligned with payer rules.

Aging AR

We actively work unresolved balances so claims do not sit untouched.

Patient Collections

Clear statements and follow-up plans reduce missed payments.

Services

Complete Radiology billing Services

Support spans the full revenue cycle.

Eligibility verification and benefits checks

Specialty-specific coding review

Electronic claim submission within 24 hours

Denial management and appeals

Payment posting and reconciliation

Weekly reporting and revenue reviews

Coverage

Serving Radiology billing Teams Nationwide

We support independent practices and growing provider organizations.

Independent physician groups

Multi-location practices

Private equity backed platforms

Hospital-owned outpatient groups

Guide

The Complete Guide to Radiology billing

Radiology CPT Code Structure

Radiology billing is built around a fundamental distinction that does not exist in most medical specialties: the separation of professional and technical components. Every radiology service has a global fee that splits into the professional component (physician interpretation, coded with modifier 26) and the technical component (equipment, technician, facility, coded with modifier TC). How you bill depends on whether you own the equipment, employ the interpreting physician, or both. Getting this split wrong is the most expensive coding error in radiology.

Diagnostic Imaging Codes

X-ray codes (70000-73599) are the highest-volume radiology codes. Chest X-ray 2-view (71046) reimburses approximately $31 for the global service, splitting into roughly $10 professional and $21 technical. Extremity X-rays (73060-73130) range from $20 to $45 global. The technical component generates most of the revenue because it covers equipment and facility costs.

CT scan codes (70450-72133) reimburse significantly more: CT head without contrast (70450) reimburses approximately $120 global ($40 professional, $80 technical). CT abdomen/pelvis with contrast (74178) reimburses approximately $280 global. MRI codes (70551-73723) represent the highest-value diagnostic imaging: brain MRI without contrast (70551) reimburses approximately $260 global, and lumbar spine MRI (72148) reimburses approximately $280.

Professional vs. Technical Billing

The billing model depends on the practice arrangement. Hospital-based radiologists bill only the professional component (modifier 26) because the hospital bills the technical component. Freestanding imaging centers bill the global code because they own the equipment and employ or contract with the interpreting radiologist. Teleradiology groups bill modifier 26 only because they provide interpretation services remotely.

Billing the wrong component is a compliance issue. A radiologist who interprets from a remote location but bills the global code is claiming technical component reimbursement for equipment they do not own. Payers audit this aggressively, and overpayment recovery for technical component claims billed without equipment ownership can be substantial.

Interventional Radiology Codes

Interventional radiology (IR) procedures generate the highest per-case revenue in the specialty. Image-guided biopsies (77012 for CT guidance, 77021 for MRI guidance), vascular access procedures (36556-36573), and drainage procedures (49405-49407) combine imaging guidance codes with procedure codes. The imaging guidance code and the procedure code are billed together, each with its own professional and technical split.

Contrast Administration

Contrast-enhanced studies require additional codes for contrast administration. Oral contrast preparation is typically not separately billable. IV contrast injection may be billed using 96374 (IV push) when the radiologist or radiology staff performs the injection. The contrast material itself is billed using HCPCS codes (A9575 for iodinated contrast, A9576-A9579 for MRI contrast agents).

Screening and Preventive Imaging

Screening mammography (77067) and low-dose CT lung screening (G0297 for Medicare, 71271 for commercial) have specific billing requirements. Screening exams use different codes than diagnostic exams of the same body part. Billing a diagnostic mammography code (77066) for a screening study, or vice versa, results in denial. The distinction is clinical: screening is performed on asymptomatic patients, diagnostic on patients with symptoms or prior abnormal findings.

Common Questions

Frequently Asked Questions About Radiology billing

Answers to the questions practice owners ask most often.

Bill modifier 26 (professional only) when you provide the interpretation but do not own the imaging equipment. Bill modifier TC (technical only) when you own the equipment but a separate radiologist interprets. Bill the global code (no modifier) when you both own the equipment and provide the interpretation. The most common scenario for radiology groups is modifier 26 for hospital-based work and global for freestanding imaging center work.

Yes. The contrast agent is billed using HCPCS codes (A-codes) separately from the imaging procedure code. The imaging code with contrast (e.g., 74178 CT with contrast) includes the professional interpretation of the contrast-enhanced study but does not include the material cost. IV contrast administration may also be billable (96374) depending on who performs the injection and the payer policy.

Screening mammography (77067) is performed on asymptomatic women for early detection. Diagnostic mammography (77065 unilateral, 77066 bilateral) is performed on women with symptoms, prior abnormal findings, or a personal history of breast cancer. The reimbursement and patient cost-sharing differ: screening mammography is covered at 100% under ACA-compliant plans with no cost-sharing. Diagnostic mammography may have copays and deductibles.

IR procedures typically generate two claims: the imaging guidance code (77012 for CT, 77021 for MRI, 76942 for ultrasound) and the procedure code (biopsy, drainage, access). Each code has its own professional and technical split. Bill both codes on the same claim with the appropriate modifiers. Some procedure-guidance code combinations have CCI edits that require modifier 59 to unbundle.

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