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Radiology CPT Codes 2026: Full List 70010-79999 + Modifiers

Radiology CPT Codes: The Complete 2026 List (70010 to 79999)

Category: Medical Billing

Posted By: Andrew Christian

Posted Date: Aug 21, 2026

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  • Two code ranges published widely online are outdated.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

  1. What Are Radiology CPT Codes?
  2. Radiology CPT Code Ranges: The Corrected 2026 List
  3. The Five Variables That Determine Every Radiology CPT Code
  4. Radiology CPT Codes Cheat Sheet 2026: Full List by Modality
  5. Contrast Rules in Radiology Coding: With, Without, and Without and With
  6. Modifier 26 vs Modifier TC: Component Billing in Radiology
  7. Radiology Modifiers Beyond 26 and TC
  8. Is a CPT Code a Radiology Code? How to Tell
  9. NCCI Edits, MUEs, and Bundling Rules in Radiology
  10. Medical Necessity and ICD-10 Pairing for Radiology Claims
  11. Prior Authorization for Radiology: What Requires It and Who Decides
  12. What Changed in Radiology CPT Codes for 2026
  13. Radiology CPT Codes Deleted for 2026: Do Not Bill These
  14. Category III Codes and AI in Radiology
  15. 2026 Radiology Reimbursement: MPFS, RVUs, and the Efficiency Adjustment
  16. Why Radiology Claims Get Denied and How to Fix Each One
  17. Download the 2026 Radiology CPT Codes Cheat Sheet
  18. Radiology Billing and Coding Services From MedSole RCM
  19. Radiology CPT Codes: Frequently Asked Questions
  20. 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.

  1. Modality. X-ray, CT, MRI, ultrasound, nuclear medicine, and fluoroscopy each carry separate code families.
  2. Body region. Head, neck, chest, spine, abdomen, pelvis, and extremity carry distinct codes inside a single modality.
  3. Contrast status. Most CT and MRI studies split into three codes: without contrast, with contrast, and without followed by with.
  4. Number of views. Plain film codes change with view count, and the report has to document every view billed.
  5. 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.

  1. Intravenous contrast only. Oral and rectal contrast don’t qualify a study for a with-contrast CPT code. Only intravenous contrast does.
  2. The report governs. When the order specifies non-contrast and the report documents contrast administration, the code follows the report.
  3. 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.

  1. Use the current subsection ranges. Radiologic guidance ends at 77022 and nuclear medicine starts at 78012.
  2. Code from the report, not the order. Contrast status and view count follow the documentation every time.
  3. Bill globally when one entity owns both components. Append 26 or TC only when two entities bill separately.
  4. Check the current quarter’s NCCI edit file. Version 32.2 took effect July 1, 2026, and 32.3 lands October 1.
  5. Audit the chargemaster against the current code set once a year. Deleted codes deny automatically.
  6. 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.

About the Author
Andrew Christian

Andrew Christian

Billing Manager

Andrew Christian is the Billing Manager at MedSole RCM, bringing 12+ years of experience in medical billing, coding, and revenue cycle management across multiple specialties. He is highly skilled in claims submission, denial management, payment posting, and payer follow-up, ensuring maximum reimbursement for providers. Andrew works closely with Medicare, Medicaid, and commercial payers, supporting hundreds of providers nationwide. His proven billing approach minimizes claim rejections, accelerates cash flow, and drives stronger financial performance from day one.