Every MRI and MRA code by body area, plus the joint, contrast and implant rules that decide what you bill
MRI claims fail for reasons CT claims rarely do. A knee gets coded as a thigh. A pacemaker patient gets billed without the device diagnosis. Two MRA codes go out when 2027 gives you one combined code. This guide covers the full MRI code set and the MRI-only rules behind those denials.
Looking for CT, X-ray, ultrasound or another modality? Start with our radiology CPT codes cheat sheet, which covers every imaging modality in one place.
MRI CPT codes are the AMA codes for magnetic resonance imaging and MR angiography, spread through the 70000 series by body area. Most regions have three codes: without contrast, with contrast, and without followed by with. The extremities add a second split that CT doesn’t have: joint versus non-joint.
Descriptions below are written in our own words. Confirm the official AMA descriptor in your 2027 CPT manual or encoder before you code.
Read across the row to match the contrast phases in the report. Gadolinium has to actually go in during the session for a “with” code.
| Body Area | Without Contrast | With Contrast | Without, Then With |
|---|---|---|---|
| Brain (includes IAC and pituitary protocols) | 70551 | 70552 | 70553 |
| Orbit, face and/or neck | 70540 | 70542 | 70543 |
There’s no separate pituitary or internal auditory canal code. Those protocols bill with the brain family. Orbits, face and soft-tissue neck share 70540–70543, and the TMJ is a single code, 70336, with no contrast split.
| Body Area | Without Contrast | With Contrast | Without, Then With |
|---|---|---|---|
| Cervical spine | 72141 | 72142 | 72156 |
| Thoracic spine | 72146 | 72147 | 72157 |
| Lumbar spine | 72148 | 72149 | 72158 |
A “total spine” order is three codes, one per region. Each region is its own study, with its own line and its own auth.
| Body Area | Without Contrast | With Contrast | Without, Then With |
|---|---|---|---|
| Chest | 71550 | 71551 | 71552 |
| Abdomen | 74181 | 74182 | 74183 |
| Pelvis | 72195 | 72196 | 72197 |
MRCP has no code of its own. It’s reported with the abdomen family, usually 74181, or 74183 when contrast is given. Prostate MRI is almost always 72197.
| Body Area | Without Contrast | With Contrast | Without, Then With |
|---|---|---|---|
| Upper extremity, non-joint | 73218 | 73219 | 73220 |
| Upper extremity, joint | 73221 | 73222 | 73223 |
| Lower extremity, non-joint | 73718 | 73719 | 73720 |
| Lower extremity, joint | 73721 | 73722 | 73723 |
Joint codes cover the shoulder, elbow, wrist, hip, knee and ankle. Non-joint codes cover the long bones and soft tissue between them, plus the hand and foot in most payer policies. Every extremity code is per side.
| Body Area | CPT Code(s) | Contrast |
|---|---|---|
| Head | 70544 / 70545 / 70546 | Without / with / without, then with |
| Neck | 70547 / 70548 / 70549 | Without / with / without, then with |
| Chest | 71555 | With or without |
| Spinal canal | 72159 | With or without |
| Abdomen | 74185 | With or without |
| Pelvis | 72198 | With or without |
| Upper extremity | 73225 | With or without |
| Lower extremity | 73725 | With or without |
Outside the head and neck, each MRA region is a single code that covers any contrast pattern. MR venography uses the same MRA codes. There’s no separate MRV code.
| CPT Code | Study |
|---|---|
| 77046 / 77047 | Breast MRI without contrast, one breast / both breasts |
| 77048 / 77049 | Breast MRI without, then with contrast, including CAD, one breast / both breasts |
| 75557 | Cardiac MRI, morphology and function, without contrast |
| 75559 | Cardiac MRI without contrast, with stress imaging |
| 75561 | Cardiac MRI without, then with contrast |
| 75563 | Cardiac MRI without, then with contrast, with stress imaging |
| 75565 | Cardiac MRI velocity flow mapping (add-on) |
| 74712 / 74713 | Fetal MRI, first gestation / each additional gestation (add-on) |
| 77084 | Bone marrow blood supply MRI |
| 70554 / 70555 | Functional brain MRI, without / with physician or psychologist test administration |
| 76390 | MR spectroscopy |
| 77021 | MR guidance for needle placement |
| 77022 | MR guidance and monitoring for tissue ablation |
| 76498 | Unlisted MRI procedure |
Starting January 1, 2027, head and neck MRA done together gets its own codes. Until now, a head and neck MRA in one session went out as two lines, typically 70544 plus 70547. That combination got reported so often that the AMA’s review workgroup flagged it, and the CPT Editorial Panel approved a restructured family in September 2025.
Two billing consequences follow. First, stop billing a head code plus a neck code for the same session in 2027. Use the combined code. Second, because postprocessing is now in every MRA head and neck descriptor, adding 76376 or 76377 for 3D rendering is a bundling denial waiting to happen. The new combined codes carry placeholder numbers in the published proposals, so pull the final numbers from your 2027 CPT book or encoder before you update the charge master.
Source: American Society of Neuroradiology, advocacy activities
The code follows the field of view in the report. A thigh MRI for a hamstring tear is 73718 even if the referral mentions knee pain. A knee MRI that captures the distal femur is still 73721. When the order says “left leg MRI,” query the ordering provider before the auth is requested, because the auth has to name the same code you bill.
Bilateral hips are the other trap. Two unilateral hip codes (73721-RT and 73721-LT) and one pelvis code (72195) are both seen in the field, and payers disagree on which they want. Check the payer’s policy and the auth, then code to match.
CT has 74176–74178 for abdomen and pelvis together. MRI doesn’t. An MRI abdomen and pelvis with and without contrast is two lines: 74183 and 72197. Coders who move between modalities sometimes look for a combined MRI code that doesn’t exist. If you need the CT rules, see our guide to CT scan CPT codes.
A cervical, thoracic and lumbar MRI in one session is 72141, 72146 and 72148. Medicare’s multiple procedure payment reduction then pays the technical component of the second and third studies at 50% and the professional component at 95%. That’s a payment rule, not an error, so don’t appeal it.
“With contrast” means gadolinium was given and post-contrast sequences were acquired. If the IV failed or the patient refused the injection, code the non-contrast study, whatever the order said. Intra-articular gadolinium for an MR arthrogram also counts as “with contrast,” which is why arthrograms use 73222 or 73722.
CT has 76380 for a limited study. MRI has nothing like it. A fast brain MRI for shunt checks or a single-sequence follow-up is usually billed with the full code plus modifier 52 for reduced services. Some payers want 76498 instead. Pick one approach per payer and document why the study was reduced.
Medicare has covered MRI for patients with implanted pacemakers, ICDs and CRT devices since April 10, 2018, under National Coverage Determination 220.2. The billing requirement is narrow and easy to miss: the MRI line must carry one of two diagnosis codes.
Leave them off and the claim denies with CARC 146 (diagnosis invalid for the date of service). The old Q0 and KX modifiers are no longer required.
For devices without MR-conditional FDA labeling, coverage also depends on the facility following the NCD’s conditions: a 1.5 Tesla scanner in normal operating mode, no fractured, epicardial or abandoned leads, device interrogation and programming before and after the scan, direct supervision by a qualified practitioner, and an ACLS-trained provider present throughout. The cardiology team bills its device check separately, with 93286 for a pacemaker or 93287 for an ICD, once before and once after the scan.
Source: CMS MLN Matters MM10877, MRI coverage for implanted devices
MRI denials cluster around the auth, the anatomy and the diagnosis. The read itself is rarely the problem.
| Denial | What Happened | Fix |
|---|---|---|
| CPT doesn't match auth | Auth for 72148, radiologist added contrast and it became 72158 | Update the auth with the payer or RBM within its window, usually 1–2 business days after the scan |
| Medical necessity, lumbar spine | Low back pain without red flags and no documented conservative treatment | Document the duration and type of conservative care (most RBM guidelines look for about six weeks) or the red flag that justifies imaging sooner |
| Wrong extremity family | Auth for 73721, report describes the thigh (73718) | Match the order, auth and report on joint vs non-joint before the scan |
| Missing laterality | Extremity or breast MRI without RT or LT | Make RT/LT required for 732xx, 737xx and unilateral breast codes |
| Invalid diagnosis, device patient | Pacemaker patient billed without Z95.0 or Z95.810 (CARC 146) | Add the device code to the MRI line |
| Bundling, MRA | 3D rendering (76376/76377) billed with an MRA code, or head and neck MRA billed as two codes in 2027 | Drop the 3D code and use the combined 2027 code |
| Contrast billed, not given | Gadolinium HCPCS billed when the report shows no post-contrast sequences | Code from the report's sequence list, not the protocol name |
Gadolinium is billed per unit, and several agents are priced per 0.1 mL rather than per mL. Unit errors on contrast are covered in our cheat sheet, but they show up on MRI claims more than anywhere else.
| Modifier | When to Use It on MRI |
|---|---|
| RT / LT | Every extremity MRI and unilateral breast MRI, one line per side |
| 52 | Abbreviated protocol with significantly fewer sequences, where the payer accepts it |
| 26 / TC | Radiologist read only, or scan only, when two entities split the service |
| 59 / XU | Two separate MRI sessions on the same day, documented as separate encounters |
| 76 / 77 | Repeat of the same MRI the same day by the same (76) or a different (77) radiologist |
Most commercial and Medicare Advantage plans require prior auth for outpatient MRI and MRA, usually through a radiology benefit manager such as eviCore or Carelon. Two MRI-specific habits save the most rework: request auth for each region and each MRA separately, and request the “without, then with” code whenever the protocol might add contrast. Traditional Medicare doesn’t require prior auth for diagnostic MRI.
MRI pays more per claim than almost any other outpatient imaging study, which is why a single auth mismatch or missing device code hurts. If your MRI denials keep tracing back to the same few problems, our MRI billing services team checks every claim against the report, the auth and current payer policy before it goes out.
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