Radiology BillingComplete Coding & Revenue Guide (2026)Top CPT codes with current RVU data, denial patterns, modifier rules, bundling pitfalls, and revenue opportunities for radiology practices.
Top CPT Codes
The highest-value radiology CPT codes with current RVU data and Medicare payment from the CY 2026 Physician Fee Schedule. Click any code for the full payment, bundling, and modifier guide.
Most practices under-capture revenue on these codes through downcoding, missed modifier 25, stale fee schedules, or misapplied bundling. Our coders audit every line against the documentation before submission so the revenue earned actually gets billed.
Bundling Pitfalls
5 trapsThe code pairs that trigger NCCI edits and CO-97 denials in radiology. Know these before billing.
74177: 74178: CT abdomen/pelvis with contrast (74177) bundles with CT abdomen/pelvis without and with (74178). Bill the study that was ACTUALLY performed. If you did both phases, bill 74178 (without + with). Do not bill 74176 + 74177.
71260: 71275: CT chest with contrast (71260) vs CT angiography chest (71275). CTA includes standard chest CT — do NOT bill both. If CTA was performed for PE, bill 71275 only.
70553: 70551: MRI brain without and with contrast (70553) includes the without-contrast phase. Do not bill 70551 + 70553. Bill 70553 for complete study.
77067: 77065: Screening mammogram (77067) is the bilateral screening code. 77065 is unilateral diagnostic. Do not bill 77065 + 77066 for bilateral screening — use 77067.
76700: 76705: Complete abdominal US (76700) bundles with limited (76705). If you do complete, bill 76700 only.
CO-97 bundling denials are recoverable with correct modifier documentation. Most billers write them off. We work each one against the clinical record and resubmit with the right modifier 25 or 59 path.
Modifier Guidance
When to apply each modifier in radiology claims. Wrong modifier application is the top single-line denial trigger and a leading audit target.
Professional component — THE most important modifier in radiology. When the radiologist interprets but the facility performs the technical portion, bill with -26. The facility bills -TC. Most employed radiologists bill only -26.
Bilateral — use for bilateral studies (bilateral mammo, bilateral knee MRI). Some payers prefer separate lines with RT/LT.
Reduced study — use when a study is abbreviated (limited views, incomplete exam due to patient inability).
Distinct procedure — use when performing separate studies on different body regions same day (chest CT + abdomen CT when not ordered as combined).
Repeat study — use when repeating a study same day due to technical issues (motion artifact, inadequate prep).
Repeat study by different physician — use when a second radiologist re-reads a study same day.
Technical component — facility bills TC for equipment, staff, supplies. Independent imaging centers bill global (no modifier). Hospital-based: always split 26/TC.
Resident billing — required when resident performs interpretation under attending supervision.
Revenue Opportunities
6 playsThe billing codes and services most radiology practices under-capture. Each one is a recurring revenue lift, not a one-time fix.
Imaging center ownership: Radiologists who own imaging centers capture both 26 (professional) and TC (technical) components. TC is typically 3-5x the professional component. MRI center generating 10 studies/day = $1M+/year in TC revenue.
Breast imaging center: Mammography (77067 = $200-300), breast ultrasound (76641/76642 = $100-200), breast MRI (77048/77049 = $500-800), stereotactic biopsy (19081 = $400-600). Comprehensive breast center with 20 patients/day = $1M+/year.
Interventional radiology procedures: Vascular interventions (angioplasty 37220-37231, embolization 37241-37244, port placement 36561) generate $500-5,000 per procedure. IR practices doing 5-10 procedures/day = $2M+/year.
Radiation oncology: Treatment planning (77263 = $800-1,200) + daily fractions (77412 x 30 fractions = $4,500-6,000 per course). Each radiation patient = $5,000-8,000 in professional revenue.
AI-assisted reading: Computer-aided detection for mammography (77061/77062) and lung screening generates additional per-study revenue while improving detection rates.
Teleradiology/nighthawk: After-hours reading services generate premium rates (1.5-2x daytime). Radiology groups offering 24/7 coverage through teleradiology capture this premium.
Documentation Checklist
What the chart must contain to support billing. Missing documentation means audit vulnerability.
- CT interpretation: Document indication, comparison studies, technique (contrast type, dose, phase), findings by organ system, and impression with specific diagnoses and recommendations (ACR Actionable findings reporting).
- MRI interpretation: Document indication, sequences performed, comparison studies, findings with measurements of lesions/abnormalities, and impression with differential diagnosis and follow-up recommendations.
- Mammography (77065-77067): Document breast density (A-D per ACR BI-RADS), findings description, BI-RADS assessment category (0-6), and management recommendation. Screening (77067) requires BI-RADS final assessment.
- Ultrasound: Document indication, organs/structures evaluated, measurements, Doppler findings if performed, and impression. For OB ultrasound: biometry, AFI, placental location, fetal presentation.
- Interventional radiology (36245-36248): Document vascular access site, catheter type, contrast used, fluoroscopy time, vessels catheterized, findings, and intervention performed. Code selective catheterization by vessel order.
- Radiation therapy planning (77263-77290): Document treatment site, simulation technique, number of treatment portals, beam arrangements, isodose distribution, and dose prescription. Separate from daily treatment delivery (77412).
Coding Workflow
Step by step approach for coding radiology encounters correctly.
1. Determine study type: diagnostic imaging (interpretation) vs interventional procedure vs radiation therapy. 2. For diagnostic imaging: bill with modifier 26 (professional only) unless you own the equipment (then bill global). 3. For CT/MRI: select the EXACT code matching what was performed — with contrast (single phase), without contrast, or without AND with contrast (two phases). 4. For interventional procedures: bill catheterization codes (36245-36248) + intervention codes (angioplasty, stent, embolization) separately. 5. For mammography: use screening code (77067) for asymptomatic patients, diagnostic codes (77065/77066) for symptomatic or follow-up studies. 6. For radiation therapy: bill planning (77263-77290), simulation (77280-77290), and daily treatment (77412 per fraction) as separate services.
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Everything about Radiology billing
What CPT codes does Radiology bill most often?
Top Radiology codes include 70553 (MRI brain with and without contrast); 70551 (Mri brain stem without dye); 70552 (Mri brain stem with contrast); 70486 (Ct maxillofacial without dye); 70491 (Ct soft tissue neck with contrast).
What are the most common denials in Radiology billing?
Radiology denials concentrate around medical necessity, bundling, prior authorization, and modifier errors.
Does Go Medical Billing handle Radiology?
Yes. Go Medical Billing handles Radiology billing with AAPC-certified coders, payer-specific scrub rules, and dedicated account management. Starting at 2.49 percent of collections with no setup fees.
Specialty content reviewed by AAPC-certified coders. CPT codes and descriptions are copyright of the AMA. Medicare payment varies by locality. Commercial rates vary by contract.
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