Key Takeaways
- Radiology CPT codes run from 70010 to 79999 and split into seven subsections maintained by the American Medical Association.
- Two code ranges published widely online are outdated. Radiologic guidance ends at 77022, not 77032, and nuclear medicine starts at 78012, not 78000.
- Contrast status and view count drive code selection, and the radiologist’s report controls both. The order doesn’t.
- Modifier 26 reports the interpretation and modifier TC reports the equipment side. Neither belongs on a claim when one entity bills both.
- CPT 2026 delivered 418 changes. Radiology gained 70471 for combined CTA of the head and neck, plus 70472 and 70473 for CT cerebral perfusion.
- CPT deleted the entire 37220 to 37235 revascularization family on January 1, 2026 and replaced it with 46 territory-based codes, 37254 through 37299.
- CMS applied a 2.5% efficiency adjustment to work RVUs on non-time-based codes for CY 2026, and radiology sits inside that group.
What This Guide Covers
- What Are Radiology CPT Codes?
- Radiology CPT Code Ranges: The Corrected 2026 List
- The Five Variables That Determine Every Radiology CPT Code
- Radiology CPT Codes Cheat Sheet 2026: Full List by Modality
- Contrast Rules in Radiology Coding: With, Without, and Without and With
- Modifier 26 vs Modifier TC: Component Billing in Radiology
- Radiology Modifiers Beyond 26 and TC
- Is a CPT Code a Radiology Code? How to Tell
- NCCI Edits, MUEs, and Bundling Rules in Radiology
- Medical Necessity and ICD-10 Pairing for Radiology Claims
- Prior Authorization for Radiology: What Requires It and Who Decides
- What Changed in Radiology CPT Codes for 2026
- Radiology CPT Codes Deleted for 2026: Do Not Bill These
- Category III Codes and AI in Radiology
- 2026 Radiology Reimbursement: MPFS, RVUs, and the Efficiency Adjustment
- Why Radiology Claims Get Denied and How to Fix Each One
- Download the 2026 Radiology CPT Codes Cheat Sheet
- Radiology Billing and Coding Services From MedSole RCM
- Radiology CPT Codes: Frequently Asked Questions
- Radiology CPT Coding in 2026: What Actually Keeps Claims Paid
What Are Radiology CPT Codes?
Radiology CPT codes are five-digit procedure codes maintained by the American Medical Association that report diagnostic imaging, image-guided procedures, and radiation therapy on insurance claims. They occupy the 70010 to 79999 range of the CPT code set. The code tells a payer which imaging service happened and how it was performed.
Two code sets have to agree on every radiology claim. ICD-10-CM explains why the patient needed imaging. CPT explains what the radiologist did. Both codes ride on the same claim, and a payer that can’t reconcile them denies it.
Radiology groups and freestanding imaging centers bill these codes daily. So do hospital outpatient departments, and so does every ordering specialty running imaging in-house: cardiology, orthopedics, oncology, urology, and emergency medicine. If your practice reads its own films, you’re billing from this range.
Pull any radiology AR report and the pattern shows up fast. The aged claims aren’t exotic procedures. They’re chest X-rays billed for two views when the report documents three, and CT scans coded with contrast when the tech withheld it.
Radiology CPT Code Ranges: The Corrected 2026 List
The CPT radiology section divides into seven subsections between 70010 and 79999. Each subsection groups codes by modality or service type: diagnostic radiology, diagnostic ultrasound, radiologic guidance, breast and mammography, bone and joint studies, radiation oncology, and nuclear medicine.
The ranges below match what AAPC publishes for the radiology code range as of 2026. Two of them differ from ranges you’ll find on widely cited coding pages.
Radiology CPT Code Ranges (2026)
|
Range |
Subsection |
What It Covers |
|---|---|---|
|
70010 to 76499 |
Diagnostic Radiology |
X-ray, CT, MRI, fluoroscopy, angiography |
|
76506 to 76999 |
Diagnostic Ultrasound |
Abdominal, pelvic, vascular, obstetric, breast |
|
77001 to 77022 |
Radiologic Guidance |
Needle placement, catheter and device guidance |
|
77046 to 77067 |
Breast and Mammography |
Screening and diagnostic breast imaging, breast MRI |
|
77071 to 77092 |
Bone and Joint Studies |
DXA, bone age, bone length, vertebral fracture assessment |
|
77261 to 77799 |
Radiation Oncology |
Planning, simulation, delivery, brachytherapy |
|
78012 to 79999 |
Nuclear Medicine |
PET, SPECT, bone scans, thyroid uptake, therapy |
Two Outdated Radiology Code Ranges Still Circulating Online
77001 to 77032 appears across published coding references. Codes 77031 and 77032, which reported stereotactic and mammographic guidance for breast procedures, were deleted effective January 1, 2014.
CPT folded that guidance into the combination biopsy codes 19081 through 19086 and the localization codes 19281 through 19288. Radiologic guidance ends at 77022, and it hasn’t reached past that in over a decade.
78000 to 79999 circulates just as widely. Codes 78000, 78001, 78003, 78006, 78007, 78010, and 78011 were deleted effective January 1, 2013 and consolidated into 78012, 78013, and 78014. Nuclear medicine begins at 78012, and it hasn’t started at 78000 since 2013.
You’ve probably inherited one of these ranges from a cheat sheet somebody saved years ago and nobody revisited. It passes an internal audit without complaint. It stops passing the quarter a payer runs its own edit against the current code set.
The Five Variables That Determine Every Radiology CPT Code
Radiology code selection comes down to five documented variables: modality, body region, contrast status, number of views, and guidance method. Together they decide which code applies. Most coding denials in radiology trace back to one of the five being wrong, missing, or contradicted by the radiologist’s report.
- Modality. X-ray, CT, MRI, ultrasound, nuclear medicine, and fluoroscopy each carry separate code families.
- Body region. Head, neck, chest, spine, abdomen, pelvis, and extremity carry distinct codes inside a single modality.
- Contrast status. Most CT and MRI studies split into three codes: without contrast, with contrast, and without followed by with.
- Number of views. Plain film codes change with view count, and the report has to document every view billed.
- Guidance method. Fluoroscopic, CT, MRI, and ultrasound guidance carry different codes, and many bundle into the primary procedure.
The report governs, not the order. When the order says non-contrast and the radiologist documents contrast administration, the report wins and the code changes with it. A coder working from the order alone can’t see the conflict, and bills the wrong code the moment the two disagree.
Radiology CPT Codes Cheat Sheet 2026: Full List by Modality
The tables below list the highest-volume radiology CPT codes by modality, checked against the 2026 code set. Every table carries a 2026 Status column, so you can see which codes stayed current, which ones CPT revised, and which ones deny on submission. Coders search this as a cheat sheet, so that’s the label it gets.
X-Ray CPT Codes
Plain film coding turns on view count. Bill 71046 for a two-view chest and the report documents three, and you’ve undercoded a study you already performed. Unilateral extremity studies also need LT or RT, and Medicare plus most commercial payers reject them without one.
Common X-Ray CPT Codes (2026)
|
Code |
Study |
2026 Status |
|---|---|---|
|
71045 |
Chest, single view |
Current |
|
71046 |
Chest, 2 views |
Current |
|
71047 |
Chest, 3 views |
Current |
|
71048 |
Chest, 4 or more views |
Current |
|
72040 |
Cervical spine, 2 or 3 views |
Current |
|
72100 |
Lumbar spine, 2 or 3 views |
Current |
|
72110 |
Lumbar spine, 4 or more views |
Current |
|
73030 |
Shoulder, complete, minimum 2 views |
Current |
|
73130 |
Hand, minimum 3 views |
Current |
|
73562 |
Knee, 3 views |
Current |
|
73630 |
Foot, complete, minimum 3 views |
Current |
|
74019 |
Abdomen, 2 views |
Current |
CT Scan CPT Codes
CT codes come in contrast triads. Abdomen and pelvis runs 74176 without, 74177 with, and 74178 without followed by with, which our CPT 74177 billing guide breaks down claim by claim. Two 2026 additions sit in this family, and they weren’t there last year.
CT CPT Codes by Contrast Status (2026)
|
Body Region |
Without |
With |
Without and With |
2026 Status |
|---|---|---|---|---|
|
Head or brain |
70450 |
70460 |
70470 |
Current |
|
Soft tissue neck |
70490 |
70491 |
70492 |
Current |
|
Chest |
71250 |
71260 |
71270 |
Current |
|
Cervical spine |
72125 |
72126 |
72127 |
Current |
|
Lumbar spine |
72131 |
72132 |
72133 |
Current |
|
Abdomen and pelvis |
74176 |
74177 |
74178 |
Current |
|
CTA head and neck, combined |
n/a |
70471 |
n/a |
New 2026 |
|
CT cerebral perfusion, with CT or CTA |
n/a |
70472 |
n/a |
New 2026 |
|
CT cerebral perfusion, standalone |
n/a |
70473 |
n/a |
New 2026 |
Denial trigger: contrast means intravenous contrast. Oral and rectal contrast don’t qualify a study for a with-contrast code, and billing 74177 on an oral-only study is one of the most common upcoding findings in imaging audits.
MRI CPT Codes
MRI follows the same three-tier contrast structure as CT, and the codes sit in different numeric neighborhoods by body part. Spine MRI carries the extra trap: the without-and-with code for each spinal region lives well outside the sequence you’d expect.
MRI CPT Codes by Contrast Status (2026)
|
Body Region |
Without |
With |
Without and With |
2026 Status |
|---|---|---|---|---|
|
Brain |
70551 |
70552 |
70553 |
Current |
|
Cervical spine |
72141 |
72142 |
72156 |
Current |
|
Thoracic spine |
72146 |
72147 |
72157 |
Current |
|
Lumbar spine |
72148 |
72149 |
72158 |
Current |
|
Pelvis |
72195 |
72196 |
72197 |
Current |
|
Upper extremity joint |
73221 |
73222 |
73223 |
Current |
|
Lower extremity joint |
73721 |
73722 |
73723 |
Current |
|
Abdomen |
74181 |
74182 |
74183 |
Current |
|
Breast, unilateral |
77046 |
n/a |
77048 |
Current |
|
Breast, bilateral |
77047 |
n/a |
77049 |
Current |
One correction worth flagging: 74181 is MRI of the abdomen without contrast, and 74183 is MRI of the abdomen without followed by with contrast. Neither one is a CT of the abdomen and pelvis. Confusing 74183 with the CT codes in the 74176 series is a recurring error, and the two families don’t pay the same.
Ultrasound CPT Codes
Ultrasound coding splits on complete versus limited, and the definition of complete is a documentation checklist rather than a judgment call. Sonographers know the anatomy. The claim depends on whether the radiologist wrote it down, and plenty of reports don’t.
Common Ultrasound CPT Codes (2026)
|
Code |
Study |
2026 Status |
|---|---|---|
|
76700 |
Abdomen, complete |
Current |
|
76705 |
Abdomen, limited or follow-up |
Current |
|
76770 |
Retroperitoneal, complete |
Current |
|
76775 |
Retroperitoneal, limited |
Current |
|
76830 |
Transvaginal, non-obstetric |
Current |
|
76856 |
Pelvic, non-obstetric, complete |
Current |
|
76857 |
Pelvic, non-obstetric, limited |
Current |
|
76641 |
Breast, unilateral, complete |
Current |
|
76642 |
Breast, unilateral, limited |
Current |
|
76645 |
Breast ultrasound (retired) |
Deleted January 1, 2015 |
CPT 76700 requires documented imaging of the liver, gallbladder, common bile duct, pancreas, spleen, both kidneys, the upper abdominal aorta, and the inferior vena cava. Miss a single element and the study is 76705. Bowel gas obscuring the pancreas doesn’t change that.
Denial trigger: 76645 was deleted effective January 1, 2015 and replaced by 76641 for a complete unilateral study and 76642 for a limited one. It still appears on published code lists. Any claim carrying it rejects on submission.
Mammography and Breast Imaging CPT Codes
Breast imaging has been renumbered twice in the last decade, so retired codes survive in this family longer than most. The current set bundles computer-aided detection into the base mammography codes, so you don’t report CAD on its own line anymore.
Mammography and Breast Imaging CPT Codes (2026)
|
Code |
Study |
2026 Status |
|---|---|---|
|
77067 |
Screening mammography, bilateral, with CAD |
Current |
|
77065 |
Diagnostic mammography, unilateral, with CAD |
Current |
|
77066 |
Diagnostic mammography, bilateral, with CAD |
Current |
|
77061 |
Diagnostic tomosynthesis, unilateral |
Current |
|
77062 |
Diagnostic tomosynthesis, bilateral |
Current |
|
77063 |
Screening tomosynthesis, bilateral, add-on |
Current |
|
77046 to 77049 |
Breast MRI, unilateral and bilateral |
Current |
|
77055, 77056, 77057 |
Prior mammography codes |
Deleted January 1, 2017 |
|
77051, 77052 |
Prior CAD add-on codes |
Deleted January 1, 2017 |
|
77058, 77059 |
Prior breast MRI codes |
Deleted January 1, 2019 |
Worth knowing on the 2017 deletions: CPT retired 77055 through 77057 effective January 1, 2017, but CMS kept Medicare on G0202, G0204, and G0206 through that year and adopted the CPT codes on January 1, 2018. Both dates are correct, and they don’t contradict each other.
Documentation requires: when a screening mammogram converts to a diagnostic study the same day, append modifier GG to the diagnostic code. Medicare pays both. The report has to name the specific finding that triggered the conversion.
Nuclear Medicine and PET CPT Codes
Nuclear medicine claims lose money in a way other modalities don’t. The radiopharmaceutical bills separately under a HCPCS Level II code, and a claim that omits it walks away from the cost of an isotope the practice already bought and injected.
Common Nuclear Medicine and PET CPT Codes (2026)
|
Code |
Study |
2026 Status |
|---|---|---|
|
78012 |
Thyroid uptake, quantitative measurement |
Current |
|
78013 |
Thyroid imaging |
Current |
|
78014 |
Thyroid imaging with uptake |
Current |
|
78300 |
Bone and joint imaging, limited area |
Current |
|
78305 |
Bone and joint imaging, multiple areas |
Current |
|
78306 |
Bone and joint imaging, whole body |
Current |
|
78315 |
Bone and joint imaging, 3 phase study |
Current |
|
78451 |
Myocardial perfusion SPECT, single study |
Current |
|
78452 |
Myocardial perfusion SPECT, multiple studies |
Current |
|
78815 |
PET with CT, skull base to mid-thigh |
Current |
|
78816 |
PET with CT, whole body |
Current |
Two mix-ups repeat in this family. A whole-body bone scan is 78306, and 78300 covers a limited area only. A three-phase study is 78315, and it isn’t a whole-body scan even when your protocol includes whole-body planar imaging.
Bone and Joint Study CPT Codes
This subsection is small, and DXA carries most of the volume. Medicare covers bone mass measurement once every 24 months for qualified beneficiaries, so frequency decides payment more often than code selection does. Getting the code right won’t help if the interval is short.
Bone and Joint Study CPT Codes (2026)
|
Code |
Study |
2026 Status |
|---|---|---|
|
77072 |
Bone age studies |
Current |
|
77073 |
Bone length studies, scanogram |
Current |
|
77080 |
DXA, axial skeleton (hips, pelvis, spine) |
Current |
|
77081 |
DXA, appendicular skeleton, peripheral site |
Current |
|
77085 |
DXA axial with vertebral fracture assessment |
Current |
|
77086 |
Vertebral fracture assessment, DXA |
Current |
Billing DXA inside 24 months needs documented clinical justification in the record, not a rationale added to the appeal after the denial arrives. Monitoring a patient on long-term glucocorticoids qualifies. A routine recheck scheduled by the front desk doesn’t.
Radiation Oncology CPT Codes
Radiation oncology got restructured from the delivery codes up in 2026. External beam treatment delivery collapsed into three complexity levels, image guidance moved inside the delivery codes, and superficial radiation therapy got a new family. If your templates still say simple, intermediate, and complex, they’re out of date. ASTRO documents the delivery changes in its coding guidance.
Radiation Oncology CPT Codes and 2026 Changes
|
Code |
Service |
2026 Status |
|---|---|---|
|
77261 to 77263 |
Clinical treatment planning, simple to complex |
Current |
|
77280 to 77290 |
Therapeutic radiology simulation |
Current |
|
77295 |
3D radiotherapy plan, dose-volume histograms |
Current |
|
77301 |
IMRT plan, dose-volume histograms |
Current |
|
77402 |
Radiation treatment delivery, Level 1 |
Revised 2026 |
|
77407 |
Radiation treatment delivery, Level 2 |
Revised 2026 |
|
77412 |
Radiation treatment delivery, Level 3 |
Revised 2026 |
|
77387 |
Image guidance, professional component only |
Revised 2026 |
|
77427 |
Radiation treatment management, 5 fractions |
Current |
|
77436 to 77439 |
Surface radiation therapy family |
New 2026 |
|
77385, 77386 |
IMRT treatment delivery |
Deleted 2026 |
|
77014, 77401 |
CT guidance for RT fields; SRT delivery |
Deleted 2026 |
The delivery codes no longer separate 3D from IMRT. Complexity decides the level now, with multiple isocenters and active motion management pointing to 77412. CMS also deleted the G6001 through G6017 delivery series, so freestanding centers and hospitals don’t report different codes anymore.
Denial trigger: the technical component of image guidance is bundled into the revised delivery codes. Report 77387 for the professional component only. Appending TC to 77387 gets it rejected as not separately payable.
Interventional Radiology CPT Codes
Interventional radiology lost 16 codes and gained 46. Lower extremity revascularization went from 16 codes to 46, organized by vascular territory and lesion complexity, which the Society of Interventional Radiology walks through code family by code family.
Interventional Radiology CPT Codes and 2026 Changes
|
Code |
Service |
2026 Status |
|---|---|---|
|
76942 |
Ultrasound guidance for needle placement |
Current |
|
77001 |
Fluoroscopic guidance, central venous access |
Current |
|
77002 |
Fluoroscopic guidance for needle placement |
Current |
|
77012 |
CT guidance for needle placement |
Current |
|
77021 |
MR guidance for needle placement |
Current |
|
36245 |
Selective catheter placement, abdominal or pelvic |
Current |
|
75710 |
Angiography, extremity, unilateral |
Current |
|
37254 to 37299 |
Lower extremity revascularization, 46 codes |
New 2026 |
|
47384, 55877 |
Irreversible electroporation, liver and prostate |
New 2026 |
|
55707 to 55715 |
Prostate biopsy by approach and guidance |
New 2026 |
|
37220 to 37235 |
Prior lower extremity revascularization family |
Deleted 2026 |
|
75956 to 75959 |
TEVAR supervision and interpretation |
Deleted 2026 |
IR codes keep absorbing imaging guidance into the primary procedure. Codes 61624 and 61626 were revised for 2026 to include all radiological supervision and interpretation, roadmapping, and guidance. Read the descriptor before you add a separate 77000-series guidance code. If the intervention already includes it, you can’t bill it twice.
Contrast Rules in Radiology Coding: With, Without, and Without and With
Most CT and MRI studies carry three separate CPT codes based on contrast status, and the radiology report determines which one applies. Contrast misclassification is one of the most common sources of radiology denials and audit findings.
- Intravenous contrast only. Oral and rectal contrast don’t qualify a study for a with-contrast CPT code. Only intravenous contrast does.
- The report governs. When the order specifies non-contrast and the report documents contrast administration, the code follows the report.
- Ordered but not given. When contrast is withheld for a documented allergy or renal function, bill the without-contrast code. Intent doesn’t change the code.
The contrast agent bills on its own line under the appropriate HCPCS code, priced on the concentration and volume actually administered. In hospital outpatient settings paid under OPPS, contrast is frequently packaged into the APC payment and isn’t separately reimbursable.
Picture the study a payer pulls on audit. The technologist note says contrast administered. The radiologist’s report never mentions it. The claim went out as 74177. Ask which document the auditor reads first, and you already know how that review ends.
Modifier 26 vs Modifier TC: Component Billing in Radiology
Most radiology services split into two components. The technical component covers equipment, technologist time, and facility overhead. The professional component covers the radiologist’s interpretation and written report. Modifier TC reports the technical side, modifier 26 reports the professional side, and neither applies when one entity bills both.
Radiology Component Billing Scenarios
|
Scenario |
Modifier |
Who Bills |
What It Covers |
|---|---|---|---|
|
One entity owns equipment and interprets |
None (global) |
The practice |
Full fee schedule, both components |
|
Radiologist interprets, facility owns equipment |
26 |
Radiologist or group |
Interpretation and written report |
|
Facility owns equipment, outside radiologist reads |
TC |
Facility or imaging center |
Equipment, technologist, overhead |
Global billing rule: when one entity owns the equipment and employs the interpreting physician, bill the code globally with no modifier. Appending 26 or TC to a global claim reduces payment to a fraction of what the study earned.
The technical component usually carries the larger share of the global payment, because equipment and staffing cost more than interpretation time, and the ratio isn’t fixed across codes. Our modifier 26 professional component guide covers the interpretation side, and the TC modifier billing rules guide covers the equipment side.
Not every code supports a component split. Check the PC/TC indicator on the Medicare Physician Fee Schedule before appending either modifier. Only codes carrying the right indicator can be split, and appending 26 to a code that can’t be split generates a rejection rather than a reduced payment.
The most expensive component error is the duplicate global. When the facility and the interpreting radiologist both submit the global code for the same study, the payer sees a duplicate and denies one or both. That one surfaces on audit rather than on the remittance, which is why it doesn’t get caught for months.
Place of service is the quiet companion error. On a modifier 26 claim, place of service reflects where the imaging happened, not where the radiologist read it. Teleradiology makes that mistake routine, and it won’t surface until the payer recoups. Our place of service codes guide maps the codes that apply.
When component splits break across a whole payer mix, appeals won’t fix it. The claim build upstream needs correcting. That work sits inside outsourced medical billing services, so the split is right before the claim ever goes out.
Radiology Modifiers Beyond 26 and TC
Beyond the component modifiers, nine modifiers show up regularly on radiology claims. Each carries a distinct documentation requirement, and three of them draw audit attention on their own.
Common Radiology Modifiers and When They Apply
|
Modifier |
Meaning |
Radiology Use Case |
Audit Risk |
|---|---|---|---|
|
50 |
Bilateral procedure |
Same study both sides, same session |
Medium |
|
52 |
Reduced services |
Study partially completed, document why |
Low |
|
53 |
Discontinued procedure |
Stopped after starting, never if not started |
Low |
|
59 |
Distinct procedural service |
Separate anatomic study, same date |
High |
|
XE, XP, XS, XU |
Specific distinct-service subsets |
XS for separate structure is often sharper |
High |
|
76 |
Repeat by same physician |
Second study same day, changed clinical status |
Low |
|
77 |
Repeat by different physician |
Second read by a different radiologist |
Low |
|
LT and RT |
Laterality |
Required on unilateral extremity studies |
Medium |
|
GG |
Screening converted to diagnostic |
Same-day mammography conversion |
Medium |
The X modifiers are more specific than 59. Where one applies with equal accuracy, it holds up better on review, because it names the reason two services are distinct instead of leaving the payer to infer it. Modifier 59 doesn’t. Our modifier 59 and X modifiers guide covers the selection logic.
Placement rule most teams get wrong: the distinct-service modifier goes on the lower-valued code in the pair, not on whichever code the biller reaches for first. Reversing that is a documented cause of repeat denials on correctly unbundled claims.
Is a CPT Code a Radiology Code? How to Tell
A CPT code belongs to the radiology section when it falls between 70010 and 79999. Nuclear medicine and radiation oncology sit inside that range but get credentialed and billed separately at many organizations. Several services radiology departments perform every day fall outside it entirely.
Commonly Questioned Codes and Where They Actually Sit
|
Code |
In Radiology? |
Subsection or Location |
Why People Ask |
|---|---|---|---|
|
76000 |
Yes |
Diagnostic radiology |
Separate-procedure tag looks like a surgical add-on |
|
77065 |
Yes |
Breast and mammography |
Often assumed to be a surgical or E/M code |
|
77080 |
Yes |
Bone and joint studies |
DXA feels like a lab test |
|
78264 |
Yes |
Nuclear medicine |
Gastric emptying reads as a GI procedure |
|
78306 |
Yes |
Nuclear medicine |
Bone scan reads as orthopedic |
|
78452 |
Yes |
Nuclear medicine |
Cardiac stress imaging reads as cardiology |
|
93880 |
No |
Medicine section |
Carotid duplex is performed by vascular labs |
|
93970, 93971 |
No |
Medicine section |
Extremity venous duplex is performed in radiology |
|
36245 |
No |
Surgery section |
Catheter placement pairs with IR imaging codes |
|
19083 |
No |
Surgery section |
Breast biopsy with ultrasound guidance |
This matters operationally, not academically. Section placement decides which fee schedule column applies, whether the PC/TC split is available at all, and which credentialing panel the interpreting physician needs before the claim gets paid. Get that wrong and the code itself won’t save it.
NCCI Edits, MUEs, and Bundling Rules in Radiology
The National Correct Coding Initiative prevents payment for services that shouldn’t be reported together. Two edit types govern radiology claims: procedure-to-procedure edits, which block specific code pairs, and medically unlikely edits, which cap units per date of service.
The core radiology bundling rule: when a procedure’s descriptor or CPT instructions indicate that it includes radiologic guidance, a separate guidance code generally isn’t separately reportable. Most radiology bundling denials start here.
High-frequency radiology bundling pairs worth checking before submission:
- Fluoroscopic guidance billed alongside joint injection codes that already include it
- Ultrasound guidance billed with thoracentesis and paracentesis codes
- Imaging guidance billed with the new lower extremity revascularization codes, which include it
- Separate supervision and interpretation billed with revised TEVAR codes 33880 through 33886
- Guidance billed with 61624 or 61626, now inclusive of all supervision and interpretation
- Mammography billed with 19281 or 19282 for the same encounter
- 3D post-processing billed with CTA codes that already bundle image postprocessing
The NCCI Update Cadence Radiology Teams Miss
Two documents govern, and they don’t move on the same schedule. The NCCI Policy Manual updates annually, effective January 1. The procedure-to-procedure edit files update quarterly, effective January 1, April 1, July 1, and October 1.
Version 32.0 took effect January 1, 2026. Version 32.1 followed on April 1. CMS Transmittal R13667CP put Version 32.2 into effect on July 1, 2026, and CMS posted those files on June 1. Version 32.3 lands October 1, 2026. If you’re still checking against 32.0, you’re two quarters behind.
The Q3 update alone added 2,199 code pairs and deleted 708. A claim coded correctly under one quarter’s file still denies if your team checked the wrong quarter for that date of service. The current files sit on the CMS NCCI PTP edits page.
That’s the audit finding nobody expects. The code was right, the documentation was right, and the edit file the biller checked was three months stale. Those land as CO-97 bundling denials, and they appeal poorly because the edit was valid on the date of service.
Medical Necessity and ICD-10 Pairing for Radiology Claims
Every radiology claim needs an ICD-10-CM code that independently justifies the study. The diagnosis has to match the clinical indication documented in the ordering provider’s order. Symptom codes work only while no confirmed diagnosis exists, and payers expect the code to sharpen once imaging resolves the question.
Common Radiology ICD-10 to CPT Pairings
|
Clinical Indication |
ICD-10 |
Typical Study |
Documentation Note |
|---|---|---|---|
|
Low back pain, unspecified |
M54.50 |
Lumbar MRI 72148 |
Most payers require documented conservative care first |
|
Cervical radiculopathy |
M54.12 |
Cervical MRI 72141 |
Specify the level when imaging supports it |
|
Acute abdominal pain |
R10.9 |
CT abd/pelvis 74177 |
Upgrade to a specific code once confirmed |
|
Suspected appendicitis |
K35.80 |
CT abd/pelvis 74177 |
Unspecified acute appendicitis |
|
Kidney stone |
N20.0 |
CT abd/pelvis 74176 |
Non-contrast stone protocol |
|
Solitary pulmonary nodule |
R91.1 |
CT chest 71250 |
Follow published follow-up interval guidance |
|
Screening mammogram |
Z12.31 |
Mammography 77067 |
Preventive, no symptoms required |
|
Breast lump |
N63.x |
Mammography 77065 or 77066 |
Specify laterality and quadrant |
|
Osteoporosis screening |
M81.0 |
DXA 77080 |
24-month Medicare frequency limit |
|
Knee pain, right |
M25.561 |
Knee MRI 73721 |
Laterality modifier required on the claim |
Two of these families cause more back-and-forth than the rest. Our back pain ICD-10 codes guide covers the M54 category in depth, and the knee pain ICD-10 codes guide handles the laterality rule that trips up extremity MRI claims when the diagnosis and the modifier don’t agree.
Specificity Is What Survives Review
A category header with billable child codes underneath it isn’t billable itself. The claim needs the specific code the imaging supports. Defaulting to an unspecified symptom code when the report describes a structural finding creates avoidable denial risk and weakens the record if the payer audits later.
You know the pattern. The radiologist writes four precise paragraphs describing a structural abnormality, and the claim goes out with an unspecified symptom code because that’s what sat on the order. That claim comes back as a CO-50 medical necessity denial, and the appeal costs more staff time than the fix would have.
Prior Authorization for Radiology: What Requires It and Who Decides
Most commercial payers route advanced imaging through a radiology benefit manager that maintains its own code list, separate from the annual CPT update. CT, MRI, PET, and nuclear cardiology almost always require authorization. Plain film X-ray and most ultrasound rarely do.
Prior Authorization Requirements by Imaging Type
|
Service |
Commercial Auth |
Documentation Typically Required |
|---|---|---|
|
Plain film X-ray |
Rarely |
Clinical indication on the order |
|
Ultrasound |
Rarely |
Clinical indication on the order |
|
CT, outpatient |
Usually |
Indication, prior imaging, referring notes |
|
MRI, outpatient |
Usually |
Failed conservative treatment for spine MRI |
|
PET |
Nearly always |
Staging documentation, prior pathology |
|
Nuclear cardiology |
Usually |
Symptoms, EKG, prior stress test results |
|
Interventional radiology |
Nearly always |
Specialist evaluation, failed conservative care |
|
DXA inside 24 months |
Yes |
Documented indication for increased frequency |
Benefit manager code lists move on their own schedule, not the CPT calendar. Pull the current list per payer at least quarterly and build the check into scheduling instead of billing. That’s where prior authorization services belong operationally, because by the time a claim reaches the biller the study already happened.
Authorization has to be active on the date of service. An approval that expired between scheduling and the appointment denies the same as no approval at all. Retroactive authorization exists in limited circumstances, and it’s never something to plan around.
A technically perfect claim still denies. Correct code, correct modifier, complete documentation, and no active authorization equals a denied claim with no coding fix available. Those arrive as CO-197 authorization denials, and the study is already done.
What Changed in Radiology CPT Codes for 2026
The 2026 CPT code set introduced 418 editorial changes across all sections, including 288 new codes, 84 deletions, and 46 revisions, effective January 1, 2026, per the American Medical Association. Radiology and interventional radiology absorbed a large share of them.
2026 Radiology CPT Code Changes
|
2025 Reporting |
2026 Reporting |
What Changed |
|---|---|---|
|
70496 and 70498 reported together |
70471 |
New combined CTA head and neck code. The separate codes stay valid when only one region is imaged |
|
Category III 0042T |
70472 with concurrent CT or CTA, 70473 without |
CT cerebral perfusion moved from Category III to Category I |
|
Category III 0623T to 0626T |
75577 |
Coronary plaque quantification from software analysis of a coronary CTA dataset |
|
37220 to 37235 |
37254 to 37299 |
46 new codes organized by four vascular territories and lesion complexity |
|
55700 plus separate guidance |
55707 to 55715, with 55705 revised |
Prostate biopsy restructured by approach and guidance method |
|
Category III 0600T for liver and prostate |
47384 liver, 55877 prostate |
Irreversible electroporation moved to Category I. Both codes include imaging guidance |
|
61624 and 61626 with separate S and I |
61624 and 61626 revised |
Supervision, interpretation, roadmapping, and guidance now included in the intervention |
|
33884, 33889, 33891 plus 75956 to 75959 |
33880 to 33886, plus new 33882 |
TEVAR restructured and supervision and interpretation bundled into the procedure codes |
|
77385, 77386, and 77014 |
77402, 77407, 77412 |
Delivery consolidated into three complexity levels with image guidance bundled in |
|
77401 and Category III 0394T |
77436 to 77439 |
New surface radiation therapy family covering planning, delivery, and guidance |
The lower extremity rebuild is the one that changes daily documentation. Coding now depends on the vessel treated, the technology used, and whether the lesion is a stenosis or an occlusion. Most operative notes don’t capture all three yet. The American College of Cardiology summarizes the cardiovascular side of the same update.
Deleted codes deny automatically from the first January claim. Chargemasters, order sets, and EHR templates still pointing at retired codes generate front-end rejections no matter how good the documentation is. A medical coding audit against the current code set catches those before the payer does.
Radiology CPT Codes Deleted for 2026: Do Not Bill These
Claims submitted with deleted CPT codes deny automatically regardless of documentation quality. The codes below are invalid for the dates of service shown and need to come out of active chargemasters, order sets, and billing templates.
Radiology CPT Codes Deleted Effective January 1, 2026
|
Deleted Code |
Replaced By |
Note |
|---|---|---|
|
37220 to 37235 |
37254 to 37299 |
Lower extremity revascularization, now territory-based |
|
55700 |
55707 to 55715 |
55705 retained and revised for non-image-guided biopsy |
|
77401 |
77437 or 77438 |
Superficial and orthovoltage delivery, by kV |
|
0394T |
77437 |
Surface electronic brachytherapy |
|
0042T |
70472 or 70473 |
CT cerebral perfusion, add-on or standalone |
|
0623T to 0626T |
75577 |
Coronary plaque quantification |
|
77385 and 77386 |
77402, 77407, 77412 |
IMRT delivery folded into the three complexity levels |
|
77014 |
77387 for the professional component |
Technical component bundled into delivery |
|
G6001 to G6017 |
77402, 77407, 77412 |
HCPCS delivery series retired |
|
75956 to 75959 |
Bundled into 33880 to 33886 |
TEVAR supervision and interpretation |
|
33884, 33889, 33891 |
33880 to 33886, plus 33882 |
Thoracic endograft restructuring |
Do not assume 0600T went with them. CPT revised 0600T rather than deleting it. Use 47384 for liver and 55877 for prostate, and keep 0600T for irreversible electroporation of any other organ.
Older Deletions That Still Show Up on Claims
Five earlier deletions keep resurfacing because they still sit on published code lists and inherited cheat sheets. All five reject on submission.
Retired Radiology Codes Still in Circulation
|
Deleted Code |
Invalid From |
Replaced By |
|---|---|---|
|
77058 and 77059 |
January 1, 2019 |
77046 through 77049 |
|
77055, 77056, 77057 |
January 1, 2017 |
77065, 77066, 77067 |
|
76645 |
January 1, 2015 |
76641 complete, 76642 limited |
|
77031 and 77032 |
January 1, 2014 |
19081 to 19086, 19281 to 19288 |
|
78000 to 78011 |
January 1, 2013 |
78012, 78013, 78014 |
CMS still publishes 76645 in its breast imaging coverage article as valid for dates of service before January 1, 2015, which is how the code keeps getting scraped into lists that present it as current. It isn’t. The CMS breast imaging billing article lists 76641 and 76642 as the current codes.
A chargemaster audit against the current code set takes an afternoon, and it shuts down an entire category of automatic denials before they reach a payer.
Category III Codes and AI in Radiology
Category III codes are temporary codes for emerging technologies, used for data collection while evidence accumulates. They carry no assigned relative value units, so payment is set by individual payer policy rather than the Medicare fee schedule. Coverage varies widely, and many payers decline them outright.
AI and Augmentative Analysis Codes
The 2026 code set expanded coverage of services involving augmented intelligence. The clearest radiology example is coronary plaque quantification, which moved from Category III codes 0623T through 0626T to Category I code 75577. That migration is the signal worth watching. A Category III code becoming Category I is when payers start paying for it, and until that happens most won’t.
CPT 75577 is reported once per coronary CTA, and it doesn’t include interpretation and reporting of the coronary CTA itself, which stays with 75574.
Category III Effective Dates Radiology Teams Miss
Most teams watch January 1 and stop there. Category III codes release on a multi-date cadence, and radiology-adjacent additions carry mid-year and fourth-quarter effective dates. Charge capture has to account for more than one release date per year, and most chargemasters aren’t built that way.
Service categories worth tracking in the current cycle include three-dimensional modeling and surface mesh services, quantitative magnetic resonance analysis, brain MRI connectomic analysis, breast volumetric ultrasound tomography with algorithmic derivation, and high-intensity focused ultrasound ablation of incompetent extremity veins.
Documentation requires: confirm individual Category III descriptors and effective dates against a licensed AMA CPT source before you build them into a chargemaster. Payer readiness lags the effective date, often by a full coverage cycle.
2026 Radiology Reimbursement: MPFS, RVUs, and the Efficiency Adjustment
Medicare payment for a radiology code is built from work, practice expense, and malpractice relative value units, multiplied by a conversion factor, then adjusted by geographic index for the locality where the service was performed. That structure explains why the same code pays differently across markets.
CMS finalized an efficiency adjustment for CY 2026 that reduces work RVUs and the intraservice portion of physician time by 2.5% for non-time-based services. Time-based codes, services on the telehealth list, and maternity codes with an MMM global period are excluded. Radiology sits inside the affected group, and there’s no opting out of it.
Two conversion factors, starting January 1, 2026: Medicare pays $33.5675 for clinicians who are qualifying participants in an advanced alternative payment model, and $33.4009 for everyone else. Most radiology practices can’t participate in those models, so most are paid at the lower rate.
For the technical component of certain diagnostic imaging procedures including CT, Medicare pays the lower of the outpatient prospective payment system amount or the fee schedule amount. That cap explains a discrepancy radiology teams see constantly between what the RVU math predicts and what the claim pays. The math isn’t wrong. The cap gets applied after it.
The gap between billed charge and allowed amount shows up on the remittance as a CO-45 contractual adjustment, which is a write-off rather than a denial. Reading those as denials wastes appeal capacity on claims that paid correctly.
Don’t print a static dollar figure on a wall chart. Relative value files update through the year, and any number you post is stale within a quarter. Pull rates from the CMS Physician Fee Schedule when you need them.
Why Radiology Claims Get Denied and How to Fix Each One
Most radiology denials trace to a short list of repeatable errors. Each one maps to a specific reason code and, more usefully, to a specific upstream fix that stops the next claim from failing the same way.
Top Radiology Denial Causes and Fixes
|
Denial Cause |
Typical Reason Code |
Upstream Fix |
|---|---|---|
|
Wrong contrast code billed |
CO-4 or medical review |
Pull contrast status from the report, not the order |
|
Missing component modifier |
CO-4 |
Build modifier rules from billing entity and place of service |
|
Duplicate global billing |
Duplicate claim denial |
Written component agreement between facility and reading group |
|
Guidance code unbundled |
CO-97 |
Run an NCCI check against the current quarter file |
|
Missing laterality |
CO-16 |
Flag unilateral extremity codes lacking LT or RT before submission |
|
Diagnosis does not support study |
CO-50 |
Work with ordering providers on indication specificity |
|
No active prior authorization |
CO-197 |
Verify at scheduling and track the expiration date |
|
Complete study documented as partial |
Medical review |
Enforce organ checklists on complete ultrasound codes |
|
Deleted code submitted |
Front-end rejection |
Annual chargemaster audit against the current code set |
Two of these codes carry most of the volume in radiology. CO-4 denials point at modifier problems, and CO-16 denials point at missing information, usually laterality on an extremity study.
Working one denial fixes one claim. Finding the pattern behind it stops the next ten. Categorize by reason code, appeal with documentation, and route the cause back to whoever can prevent it: the front desk, the coder, or the ordering provider.
If next month’s report shows the same three denial categories, the cause sits upstream of the appeal. Radiology denial management works each claim, documents the root cause, and feeds it back to the person who can stop the repeat.
Download the 2026 Radiology CPT Codes Cheat Sheet
The download collects every table on this page into one printable reference you don’t have to scroll for: all seven code ranges, the modality tables with their 2026 status column, both deleted-code tables, the modifier reference, and the denial-cause matrix.
It’s checked against the 2026 code set and dated, so you can tell at a glance whether the copy on your desk is current.
File: medsole-radiology-cpt-codes-cheat-sheet-2026.pdf
Radiology Billing and Coding Services From MedSole RCM
This section is for radiology groups splitting professional and technical components across entities, imaging centers billing the technical side, hospital outpatient departments reconciling OPPS packaging, and the ordering specialties that generate imaging volume daily: cardiology, orthopedics, oncology, urology, and emergency medicine.
MedSole RCM prices full-service medical billing at 2.99% of collections. Independent 2026 pricing guides put the outsourced billing range at 4% to 10% of net collections, with most small and mid-sized practices quoted 5% to 8%.
Provider credentialing and payer enrollment run $99 per payer, against a common industry range of $175 to $275 per enrollment. No setup fee, no long-term contract, month to month. A radiology group enrolling across 15 payers pays $1,485 total.
That price holds because one team runs the whole cycle. The people confirming authorization before an MRI are the same people tracking the current NCCI edit file and the same people reading the denial pattern review for repeats. One accountability line instead of three vendors who don’t talk to each other, each holding a piece of the same claim.
What Radiology Billing Includes at 2.99%
- Eligibility verification and benefit checks before the study
- Prior authorization tracking, including expiration dates against the date of service
- Coding review against the radiologist’s documentation, not the order
- Claim scrubbing and electronic submission
- Payment posting and reconciliation
- Denial management with documented root-cause correction
- Monthly performance reporting by payer and denial category
All of it runs inside end-to-end revenue cycle management, so the contrast rule, the modifier logic, and the authorization check live with the same team.
If radiology denials keep landing in the same three categories, a free billing analysis will show you which ones and what they cost. No commitment, no contract. When you’re ready, start with a claims review.
Radiology CPT Codes: Frequently Asked Questions
What are radiology CPT codes?
Radiology CPT codes are five-digit procedure codes maintained by the American Medical Association that report diagnostic imaging, image-guided procedures, and radiation therapy. They occupy the 70010 to 79999 range and appear on nearly every imaging claim submitted in the United States.
What is the CPT code range for radiology services?
Radiology CPT codes run from 70010 to 79999. That span divides into seven subsections: diagnostic radiology, diagnostic ultrasound, radiologic guidance, breast and mammography, bone and joint studies, radiation oncology, and nuclear medicine.
How is the CPT radiology section organized?
The CPT radiology section is organized into seven subsections by modality and service type: 70010 to 76499, 76506 to 76999, 77001 to 77022, 77046 to 77067, 77071 to 77092, 77261 to 77799, and 78012 to 79999.
Is CPT 76000 a radiology code?
Yes. CPT 76000 reports fluoroscopy and sits in the diagnostic radiology subsection. Its separate-procedure designation makes it look like a surgical add-on, which is why coders question it, but it belongs to the radiology section.
Is CPT 78452 a radiology code?
Yes. CPT 78452 reports myocardial perfusion imaging by SPECT, multiple studies, and it sits in the nuclear medicine subsection of the radiology section. Cardiology practices bill it constantly, which is why it reads as a cardiology code.
Is CPT 78306 radiology?
Yes. CPT 78306 reports a whole-body bone scan and belongs to the nuclear medicine subsection. Use 78300 for a limited area and 78305 for multiple areas. A three-phase study is 78315, and it isn’t a whole-body code.
What are the new CPT codes for radiology in 2026?
CPT 2026 added 70471 for combined CTA of the head and neck, plus 70472 and 70473 for CT cerebral perfusion. Lower extremity revascularization moved to 46 new codes, 37254 through 37299, and surface radiation therapy gained 77436 through 77439.
What is the difference between modifier TC and modifier 26?
Modifier TC reports the technical component: equipment, technologist time, and facility overhead. Modifier 26 reports the professional component, meaning the radiologist’s interpretation and written report. When one entity owns both, bill the code globally with no modifier.
What are the CPT codes for MRI and CT scans?
Most CT and MRI studies carry three codes by contrast status. CT of the abdomen and pelvis uses 74176, 74177, and 74178. MRI of the brain uses 70551, 70552, and 70553. MRI of the lumbar spine uses 72148, 72149, and 72158.
Is CPT 77080 a DEXA scan?
Yes. CPT 77080 reports a DXA bone density study of the axial skeleton, covering the hips, pelvis, and spine. Medicare covers bone mass measurement once every 24 months for qualified beneficiaries unless documentation supports a shorter interval.
Do radiology CPT codes change every year?
Yes. The American Medical Association publishes a new CPT code set every January 1. Deleted codes deny automatically from the first claim of the year, so chargemasters, order sets, and templates need an annual review against the current set.
Do radiology CPT codes require prior authorization?
It depends on the modality and the payer. CT, MRI, PET, and nuclear cardiology almost always require authorization through a radiology benefit manager. Plain film X-ray and most ultrasound rarely do. Benefit manager lists change independently of CPT.
What does radiology medical billing cost?
Radiology billing is usually priced as a percentage of collections. MedSole RCM charges 2.99% of collections for full-service billing, against a 2026 industry range of 4% to 10% of net collections, with no setup fee and no long-term contract.
What is the most affordable medical billing and credentialing company?
Pricing varies widely by vendor. MedSole RCM prices full-service medical billing at 2.99% of collections against a 2026 industry range of 4% to 10%, and provider credentialing at $99 per payer enrollment against a common range of $175 to $275.
Radiology CPT Coding in 2026: What Actually Keeps Claims Paid
Six rules carry most of the weight. Each one stands on its own, and each one maps to a denial you can stop this month.
- Use the current subsection ranges. Radiologic guidance ends at 77022 and nuclear medicine starts at 78012.
- Code from the report, not the order. Contrast status and view count follow the documentation every time.
- Bill globally when one entity owns both components. Append 26 or TC only when two entities bill separately.
- Check the current quarter’s NCCI edit file. Version 32.2 took effect July 1, 2026, and 32.3 lands October 1.
- Audit the chargemaster against the current code set once a year. Deleted codes deny automatically.
- Verify authorization at scheduling and track its expiration. A correct claim with no active authorization still denies.
The codes change every January and the edit files change every quarter. The practices that stay paid are the ones checking both, and they don’t wait for a denial to tell them something moved.