CPT code 70547 – MRA of the neck without contrast

Key takeaways

CPT code 70547 covers MRA of the neck without contrast only, not a with-and-without sequence.

70547, 70548, and 70549 are mutually exclusive: Only one neck MRA code may be billed per session.

Modifier 26 is required when the radiologist bills the professional component separately from a facility.

In 2026, Medicare pays about $215 nationally for the global 70547 service, before locality adjustment.

Pabau’s claims management software runs validation checks before each claim is sent, so missing insurer details are caught before submission.

CPT code 70547: Official descriptor and clinical scope

CPT code 70547 is the procedure code for Magnetic resonance angiography, neck; without contrast material(s), as defined by the American Medical Association’s CPT code set. The study images the neck’s extracranial vessels with time-of-flight (TOF) or phase-contrast (PC) MRA, without gadolinium or any other contrast agent. It captures the carotid arteries (common, internal, and external) and the vertebral arteries from their origin to the skull base.

This is the first study in the neck MRA family. It fits a clinical question such as carotid stenosis screening or pre-surgical mapping where contrast is best avoided. With no gadolinium, there is no contrast injection, no contrast timing sequence, and no post-contrast acquisition.

Billing 70547 for a study that included gadolinium is miscoding. Under Article A56775 (LCD L34424), which applies in some MAC regions, such a claim may be denied or audited.

“Neck” in CPT means the extracranial cervical vessels, not the intracranial circle of Willis. Intracranial MRA belongs to the head MRA family, where 70544 is the non-contrast equivalent. Mixing head and neck sites within one code is a common coder error, particularly when the requisition reads “MRA head and neck”.

CPT code 70547 vs 70548 vs 70549: Choosing the right code

The three neck MRA codes share the same anatomy and technique and differ only by contrast sequence. All three image the same cervical vessels. The billing question is whether gadolinium was given, and if so, when.

A protocol that acquires a non-contrast TOF run and a gadolinium-enhanced sequence in the same session is billed as 70549, not as 70547 plus 70548. Billing both separately is an NCCI violation. The scan log or MRI protocol sheet must state which sequences were performed before the claim goes out.

The flow below takes a 70547 study from that protocol sheet to the claim line, with the modifier and its 2026 national rate.

Procedure and documentation requirements

A billable 70547 claim needs documentation at the ordering level and at the interpretation level. Missing either can trigger a CO-16 (missing information) or CO-50 denial.

Ordering documentation must include:

• The ordering physician’s name and NPI
• A clinical indication sufficient to establish medical necessity (e.g. “symptomatic carotid stenosis, duplex-confirmed 60% narrowing right ICA”)
• The specific study requested (MRA neck without contrast), not just “MRA neck”
• Signature date

Radiology report must include:

• Technique: TOF or PC MRA, field strength, plane of acquisition
• Confirmation that no contrast was administered
• Vessels evaluated (carotid bifurcation, ICA, ECA, vertebral arteries)
• Supervising radiologist’s interpretation and signature
• Date of service matching the claim

Where Billing and Coding Article A56805 (LCD L34865) applies, covered 70547 claims typically carry one of these ICD-10 codes:

• I65.21 (occlusion and stenosis of right carotid artery)
• I65.22 (occlusion and stenosis of left carotid artery)
• I65.29 (occlusion and stenosis of unspecified carotid artery)
• G45.9 (transient cerebral ischemic attack, unspecified)
• The I63.x series (cerebral infarction)

Pairing 70547 with a non-covered ICD-10 diagnosis is a frequent denial reason for this code.

Modifiers for CPT code 70547

Modifier selection for CPT code 70547 depends on where the service is performed and whether the radiologist bills globally or separately from the facility.

LT and RT modifiers (left and right) are not typically applied to MRA neck codes. The study evaluates both sides of the neck in one session. If a payer requests laterality, document that both sides were assessed and clarify it in an appeal.

Medicare reimbursement and fee schedule for CPT code 70547

Medicare payment rates for CPT code 70547 are published annually in the Medicare Physician Fee Schedule (MPFS) final rule. The CMS Physician Fee Schedule lookup tool gives the current year’s national unadjusted rates by modifier and place of service.

The global figure is 6.43 total RVUs multiplied by the 2026 conversion factor of $33.4009, which comes to $214.77. These are national amounts. Allowed amounts vary by Medicare Administrative Contractor (MAC) locality and the Geographic Practice Cost Index (GPCI) adjustment.

Use the FastRVU RVU lookup tool to find locality-adjusted rates for your practice’s ZIP code. Hospital outpatient departments billing under OPPS are paid under an APC grouping rather than the MPFS rates above.

Private payer contracted rates for 70547 depend on each payer contract and often differ from Medicare. To check payment accuracy, compare your electronic remittance advice against the allowed amount for the claim’s locality. A payment well below the expected MPFS rate often points to a modifier error or a payer-specific payment policy.

Medicare and payer coverage criteria for CPT code 70547

Medicare coverage for neck MRA is set by Local Coverage Determinations (LCDs), and the one that applies depends on your MAC region. In some regions, Billing and Coding Article A56805 (LCD L34865) governs covered indications. In others, Article A56775 (LCD L34424) applies.

Both are revised from time to time. Check the active version as part of your medical billing compliance routine before finalizing a denial appeal.

Covered indications under Article A56805 (representative, not exhaustive):

• Evaluation of known or suspected carotid stenosis (ICD-10: I65.21, I65.22, I65.23)
• Workup of transient ischemic attack (G45.9) or ischemic stroke (I63.x)
• Pre-surgical planning prior to carotid endarterectomy or stenting
• Evaluation of vertebral artery stenosis (I65.0x) or dissection (I77.74)
• Surveillance of known vascular anomaly where contrast is contraindicated

Non-covered uses include routine screening without documented symptoms or risk factors, and studies ordered without a supervising physician’s signature. Many commercial payers use Medicare LCD criteria as a baseline and add prior authorization on top. Confirm payer-specific coverage before you schedule the study.

Prior authorization requirements

Medicare fee-for-service does not require prior authorization for CPT code 70547. The CMS Appropriate Use Criteria program is currently paused. CMS rescinded its regulations in the CY2024 Physician Fee Schedule final rule, so it is not an active requirement.

The following payer classes typically require prior authorization for 70547:

• Medicare Advantage plans: Most MA plans require auth, even for indications covered under Medicare FFS. Auth requirements vary by plan and locality.
• Commercial/PPO plans: The majority of commercial plans require auth for outpatient MRA studies. Auth requests should include the ordering clinical note, any prior duplex ultrasound findings, and the specific ICD-10 diagnosis.
• Medicaid managed care: State-administered Medicaid managed care organizations frequently require auth. Requirements differ by state and MCO.

Before submitting an auth request, confirm coverage with insurance eligibility verification for the specific date of service. An auth obtained for the wrong date or under the wrong NPI is treated as no auth at all at adjudication.

NCCI edits and bundling rules

National Correct Coding Initiative (NCCI) edits for CPT code 70547 set which procedures cannot be billed together, and which pairs a modifier can separate. CMS updates the edit table quarterly. Confirm any bundling guidance here against the current quarter’s table, through the AAPC Codify platform or the CMS NCCI edit files.

Mutual exclusivity within the neck MRA family: 70547, 70548, and 70549 are mutually exclusive per session. Only one neck MRA code may appear on a claim for a given date of service. Billing 70547 and 70549 together is always an NCCI violation, and the second code is denied whichever modifier is appended.

Use CrossCoder’s procedure-to-diagnosis crosswalk tool to confirm active NCCI edits before billing 70547 alongside adjacent codes. Key bundling scenarios to verify:

• 70547 + 70544 (MRA head without contrast): Head and neck MRA are different anatomical sites. Both may be billed on the same date when each is separately indicated and documented. No NCCI conflict in most quarters, but confirm the current edit status.
• 70547 + 70551/70553 (brain MRI): MRI brain and MRA neck are distinct studies. Both may be billed when separately ordered and documented. Not typically bundled.
• 70547 + 72141 (cervical spine MRI): Cervical MRI and cervical MRA are separate procedures with different clinical purposes. They may be billed together with modifier 59 when the radiology report documents a distinct indication for each. Verify the current NCCI edit status before applying the modifier.
• 70547 + 70548 or 70547 + 70549: Absolute bundle. No modifier breaks this edit. One code per session.

Common claim denial reasons and how to avoid them

Most 70547 denials fall into six categories, and each is preventable with the right pre-submission workflow. The table pairs each one with its usual claim adjustment reason code (CARC), and our guide to medical billing denial codes explains the rest.

A pre-bill audit step built on clean claim submission principles catches most of these before the claim reaches the payer. A denial management workflow for radiology billing should include a weekly review of CO-50 and CO-167 denials. Both trace back to the diagnosis and documentation on the claim.

How claims management software prevents 70547 denials

Without a check before submission, a 70547 error usually surfaces in the remittance, after the payer has denied the line. Fixing it then means a corrected claim, a resubmission, and another payment cycle.

Pabau, the practice management platform we build, includes claims software for practices that bill insurance. Pabau’s claims management software runs validation checks before each claim is sent, so missing insurer details are caught before submission. A missing membership number or authorization code gets fixed while the claim is still on your screen.

Claims then go out through Pabau’s Claim.MD clearinghouse integration, which reaches thousands of US payers. It supports real-time eligibility checks (270/271), CMS-1500 claim submission, and ERA matching, so payments post against the right claim line. Your billing team spends less time reworking neck MRA denials.

Reduce claim denials for radiology codes

Pabau’s claims management software runs validation checks before each claim is sent, then submits clean claims to thousands of US payers through the Claim.MD integration. See how it works for your billing team.

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Conclusion

CPT code 70547 is simple in clinical terms, yet each claim turns on three billing-layer decisions: Choosing the code, the modifier, and the diagnosis. Settle the protocol sheet, the 26/TC arrangement, and the ICD-10 pairing before submission, and the denials in the table above become avoidable. A few minutes of pre-bill review costs far less than weeks spent on an appeal.

Pabau’s claims management software runs validation checks before each claim is sent, so missing insurer details are caught before submission. Book a demo to see how that check fits your radiology billing workflow.

Continue your research

Need to understand how clearinghouse submissions work end to end? Medical claims clearinghouse guide explains how claims move from practice to payer and where edits are applied.

Dealing with 835 remittance files after payment? Claim.MD clearinghouse overview covers ERA parsing, CARC codes, and automated payment posting.

Want to understand the superbill behind the claim? Superbill billing guide walks through how the superbill feeds CPT and ICD-10 codes into the claim submission workflow.

Billing a brain MRI in the same session? CPT code 70553 covers MRI of the brain with and without contrast, which may be billed alongside 70547 when separately ordered.

Imaging the neck vessels with CT instead? CPT code 70498 explains how CT angiography of the neck is coded and billed.

Frequently asked questions