CPT70553

MRI Brain Cost in California

Mri brain stem w/o & w/dye

$673Hospital outpatient total2026 Medicare, physician + facility
Hospital payments are wage-adjusted by locality, so the ZIP changes the numbers.
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California Medicare physician rate (2026)

+13.8% vs national

Average of 29 localities. Office range $338.53–$427.51.

California (Hospital)
$360.66
Facility physician fee
Private plan est.
$469–$721
~130–200% of Medicare
Cash / self-pay est.
$289–$541
~80–150% of Medicare

What the whole procedure costs

The rate above is the physician’s fee on its own. The facility bills separately, and for most procedures the facility is the larger half of the bill. These are 2026 national Medicare amounts.

Surgery centre, total
$510
$317 physician + $193 facility
Physician fee alone
$317
Only 47% of the hospital total

Choosing a surgery centre over a hospital saves about $164 on the Medicare allowed amount for mri brain. Ask whether your procedure can be done at an ambulatory surgery centre.

Medicare may pay the facility separately for this code or package it into another service on the same day, so treat the facility share as an upper bound. Medicare allowed amounts are not what an uninsured patient is charged, and not a quote. Private plans typically allow more.

Your ZIP in California

A ZIP-level lookup matters more in California than in any other state; compare your area, whether that is the Bay Area, Los Angeles, San Diego, Sacramento, the Central Valley, or the rural north.

What mri brain costs at hospitals near you

Everything above is a national average. The hospital you pick in California moves the bill more than anything else you control.

Locked

Rates for your ZIP, 5 named hospitals with CMS ratings, the add-on codes, and the scheduler script.

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What these numbers are

Every figure on this page is a 2026 Medicare allowed amount: the physician line comes from the Physician Fee Schedule adjusted by geographic practice-cost indices, and the facility totals come from the CMS hospital outpatient (OPPS) and ambulatory surgery centre rates. None of them is a hospital chargemaster price, your insurer's contracted rate, or a quote. Anesthesia, pathology, imaging reads and follow-up care are billed under their own codes when they apply, and an inpatient stay is paid a different way again.

National vs California

National office$316.97
National hospital (physician)$316.97
California vs national14% above the national office rate of $316.97

Where California ranks for this CPT

Rank (lowest physician fee first)#49 of 51
Lowest stateArkansas ($280.94)
Highest stateAlaska ($367.23)

CPT 70553 by California locality

LocalityOffice
san jose-sunnyvale-santa clara (san benito cnty)$427.51
san jose-sunnyvale-santa clara (santa clara cnty)$426.76
san francisco-oakland-berkeley (marin cnty)$418.39
san francisco-oakland-berkeley (san francisco/san mateo/alameda/contra costa cnty)$418.21
napa$394.45
vallejo$394.19
santa rosa-petaluma$370.80
santa cruz-watsonville$367.05
san diego-chula vista-carlsbad$363.24
los angeles-long beach-anaheim (los angeles/orange cnty)$361.63
oxnard-thousand oaks-ventura$360.21
santa maria-santa barbara$355.95
sacramento-roseville-folsom$355.83
salinas$354.51
san luis obispo-paso robles$348.72
riverside-san bernardino-ontario$340.30
bakersfield$339.07
el centro$338.55
chico$338.53
fresno$338.53
hanford-corcoran$338.53
madera$338.53
merced$338.53
modesto$338.53
redding$338.53
stockton$338.53
visalia$338.53
yuba city$338.53
rest of california$338.53

PE GPCI ranges from 1.096 to 1.442 in California. That index is why the same CPT is not one price statewide.

MRI Brain and how California is priced

California is the most finely divided state in the Medicare fee schedule, with roughly thirty payment localities drawn around metropolitan statistical areas after CMS reformed the state's locality map. The San Francisco Bay Area carries some of the highest geographic adjustments in the nation, with San Francisco, San Jose, and the East Bay each priced separately, while Los Angeles, Orange County, San Diego, and Sacramento have their own localities at somewhat lower levels. Rural and inland counties fall into lower-cost localities, so the same procedure can carry meaningfully different Medicare-approved amounts within a single day's drive. No other state shows this much in-state variation on the fee schedule itself.

California's markets differ sharply: the Bay Area combines high wages with heavily consolidated hospital systems, Los Angeles offers enormous choice across a sprawling region, and the Central Valley and far north face genuine access shortages. Where you are treated within the state matters more here than almost anywhere else in the country. Academic medical centers in the Bay Area, Los Angeles, San Diego, and Sacramento handle much of the complex referral care.

This procedure: This is the most complete brain MRI protocol: the scanner first takes a full set of images without dye, then repeats key sequences after an IV gadolinium injection, letting the radiologist compare the two. It is the standard workup for suspected brain tumors, multiple sclerosis, pituitary problems, and infection. Plan for 45 to 60 minutes in the scanner with an IV in your arm, making it the longest and most expensive of the three brain MRI codes.

What Is MRI Brain?

This is the most complete brain MRI protocol: the scanner first takes a full set of images without dye, then repeats key sequences after an IV gadolinium injection, letting the radiologist compare the two. It is the standard workup for suspected brain tumors, multiple sclerosis, pituitary problems, and infection. Plan for 45 to 60 minutes in the scanner with an IV in your arm, making it the longest and most expensive of the three brain MRI codes.

What Affects the Cost

  • As the combined protocol, 70553 carries the highest base price of the brain MRI family, before facility markup differences.
  • Hospital imaging departments charge far more than independent centers for this long scan.
  • The gadolinium dose is a separate supply charge on top of the imaging codes.
  • Longer scanner time means claustrophobia or movement problems are more likely to require sedation or a rescan, each adding cost.
  • Follow-up MRIs to track a finding over time repeat the full cost at each interval, so the surveillance schedule matters as much as the single-scan price.

Questions to Ask Before Booking

  • 1.Was the full without-and-with-contrast protocol authorized, or only a plain MRI?
  • 2.What is your global price for this study at a freestanding center?
  • 3.How many follow-up scans is my condition likely to need, and at what interval?
  • 4.Are the contrast agent and radiologist reading included in the quoted price?
  • 5.If my insurer pushes back, will my doctor do a peer-to-peer review to defend this protocol?

MRI Brain in California: questions

The 2026 Medicare physician office rate for CPT 70553 averages $360.66 across 29 California localities, from $338.53 in CHICO to $427.51 in SAN JOSE-SUNNYVALE-SANTA CLARA (SAN BENITO CNTY). The hospital physician rate averages $360.66. Enter a ZIP for the exact locality.

Yes. CMS splits California into 29 payment localities. For this CPT the office physician fee spans $88.98 from the lowest to highest locality. A ZIP-level lookup matters more in California than in any other state; compare your area, whether that is the Bay Area, Los Angeles, San Diego, Sacramento, the Central Valley, or the rural north.

After the Part B deductible, coinsurance is usually 20% of the allowed amount: about $72 for the office physician line or $72 for the hospital physician line in California. Medigap may cover that 20%. This is not the hospital facility fee.

No. $360.66 is only the physician's share. Adding Medicare's facility payment brings the total to about $673 in a hospital outpatient department, or about $510 at an ambulatory surgery centre. Anesthesia, pathology and other codes billed the same day are extra. California ranks #49 of 51 states on the physician line (14% above the national office rate of $316.97).

Data source: 2026 Medicare Physician Fee Schedule (CMS PPRRVU26B, released March 2026). Conversion factor: $33.4009. Prices shown are Medicare allowed amounts for the physician service and may not match what you are billed. Private insurance and self-pay ranges, when shown, are labeled estimates (typical multiples of Medicare), not quotes. This site is an independent cost tool, not medical advice.