Radiology Billing Cheat Sheet (2026)
Every radiology claim splits in two: a technical component for acquiring the image and a professional component for reading it. Who owns the equipment and who reads the study decides which you bill, and getting it wrong either double-counts or forfeits half the fee.
Quick reference for radiology billers. Last updated .
Top Radiology CPT Codes & 2026 Medicare Allowables
| Code | Description | Non-Facility | Facility | Total RVU |
|---|---|---|---|---|
| 70450 | CT head or brain without contrast | $106.55 | $106.55 | 3.19 |
| 71250 | CT chest without contrast | $132.60 | $132.60 | 3.97 |
| 72148 | MRI lumbar spine without contrast | $191.72 | $191.72 | 5.74 |
| 73721 | MRI lower extremity joint without contrast | $204.41 | $204.41 | 6.12 |
| 74177 | CT abdomen and pelvis with contrast | $300.27 | $300.27 | 8.99 |
| 76700 | Abdominal ultrasound, complete | $114.23 | $114.23 | 3.42 |
| 76830 | Transvaginal ultrasound | $117.57 | $117.57 | 3.52 |
| 77065 | Diagnostic mammography, unilateral | $123.92 | $123.92 | 3.71 |
| 77067 | Screening mammography, bilateral | $126.26 | $126.26 | 3.78 |
| 76536 | Soft tissue head and neck ultrasound | $108.55 | $108.55 | 3.25 |
National 2026 Medicare Physician Fee Schedule estimates (total RVU multiplied by the conversion factor). These are adjusted by state locality. See the per-state table on the Radiology billing services page.
Modifiers That Prevent Radiology Denials
The professional interpretation only, when the radiologist reads a study performed on equipment the practice does not own.
The technical component only, when the practice owns the equipment and another entity reads the study.
A distinct study separate from another that NCCI would otherwise bundle.
A repeat study by the same (76) or different (77) physician, with the medical reason documented.
A bilateral imaging study where the code is not inherently bilateral and the payer expects modifier 50.
A diagnostic mammogram performed the same day as a screening mammogram after an abnormal screening finding.
Top Radiology Denials → Quick Fix
Bill modifier 26 for the interpretation only when the practice does not own the equipment. Billing globally double-counts the technical component and denies.
Use the screening code (77067) for a screening exam and the diagnostic code (77065, 77066) only with a documented indication. Intent, not the image, sets it.
The with-or-without-contrast code must match the report. Document contrast administered, route, and agent so the code is supportable.
Append modifier 76 or 77 with the medical reason for the repeat so it is not rejected as an exact duplicate.
When studies are distinct, append modifier 59 or XU and document the separate anatomic sites or clinical indications.
NCCI Bundling Watch-Outs
Code pairs from this specialty's set that carry NCCI edits. Billing both without a justified modifier triggers a bundling denial.
| Code | Bundles With | Rationale |
|---|---|---|
| 70450 | 01922 | Anesthesia service included in surgical procedure |
| 70450 | 36591 | CPT Manual or CMS manual coding instruction |
| 71250 | 01922 | Anesthesia service included in surgical procedure |
| 71250 | 0558T | CPT Manual or CMS manual coding instruction |
| 72148 | 01922 | Anesthesia service included in surgical procedure |
| 72148 | 0609T | CPT Manual or CMS manual coding instruction |
| 73721 | 01922 | Anesthesia service included in surgical procedure |
| 73721 | 36591 | CPT Manual or CMS manual coding instruction |
Documentation That Holds Up on Appeal
Equipment ownership and who interpreted it, to support the global, technical (TC), or professional (26) billing.
Screening versus diagnostic intent and the indication for a diagnostic study.
Whether contrast was administered, the route, and the agent, matching the with-or-without code.
The medical reason for the repeat, supporting modifier 76 or 77.
Each anatomic site and indication, supporting separate codes with modifier 59 where distinct.
Revenue Radiology Practices Leave on the Table
Billing globally for read-only work and triggering technical-component denials, or billing 26-only when the practice also owns the equipment.
Coding a screening mammogram as diagnostic and disrupting the patient's preventive benefit.
Contrast code mismatched to the report, which down-codes or denies the study.
Repeat studies rejected as duplicates because modifier 76 or 77 and the reason were omitted.
Radiology Billing FAQ
When do I use modifier 26 versus TC?
26 for the interpretation only when your physician reads a study on equipment the practice does not own. TC for the technical component when the practice owns the equipment but does not read it. Global only when you own and read.
Screening or diagnostic mammogram?
Screening (77067) for an asymptomatic screening exam. Diagnostic (77065, 77066) only with a documented clinical indication. Billing screening as diagnostic disrupts the patient's preventive benefit and denies.
How do I bill a repeat study?
Append modifier 76 for the same physician or 77 for a different one, with the medical reason documented, so it is not rejected as an exact duplicate.
Why do contrast studies deny?
Because the with-or-without-contrast code does not match the report. Document whether contrast was given, the route, and the agent, and code to that.
Stop Losing Radiology Revenue to Preventable Denials
Our AAPC-certified radiology coders apply every rule on this sheet to your claims. Call 888-701-6090 for a free billing assessment.