CPT 70150Radiology

X-ray exam of facial bones

CPT code 70150 covers an X-ray examination of the facial bones, which includes imaging of structures like the cheekbones, nasal bones, and eye sockets to detect fractures, infections, or other abnormalities. This is a basic diagnostic imaging procedure typically ordered after facial trauma or when facial pain of unknown origin is present.

Showing rates for

National Average

Base Medicare rate

$45.29

This calculator gives a typical-case estimate using standard Medicare modifier rules. Actual payment depends on payer policies, documentation, code-specific CMS status indicators, and locality. Verify before billing.

RVU breakdown

Work RVU

0.26

PE RVU (NF)

1.12

MP RVU

0.02

Total RVU

1.4

Conversion factor: 32.3465 · Source: CMS MPFS RVU25A · Confidence: High

NCCI bundling edits

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Billing tips

Verify the number and type of views obtained match CPT 70150 requirements (complete exam with multiple views). Single or limited views should be coded as 70140.
Impact: Prevents downcoding from 70150 ($45.29) to 70140, protecting revenue and avoiding potential audit findings
Document specific clinical indication beyond 'facial pain' or 'trauma' - include specific injury mechanism, affected anatomical area, or clinical findings that necessitate imaging.
Impact: Reduces denial rate by 30-40% for medical necessity; improves clean claim rate and reduces appeals workload
Split bill modifier 26 and TC components separately when professional and technical services occur at different facilities (e.g., imaging at hospital, interpretation by remote radiologist).
Impact: Ensures both parties receive appropriate reimbursement; prevents $45.29 payment from being incorrectly split or denied
Do not bill 70150 on the same date as comprehensive facial CT (70486-70488) without modifier 59 and clear documentation of distinct clinical need.
Impact: Prevents automatic denial for bundling; CCI edits may bundle plain films with CT when performed same day
When billing for repeat imaging same day (modifier 76), include radiology report or clinical note documenting change in clinical status or need for post-intervention confirmation.
Impact: Achieves full $45.29 reimbursement for repeat study instead of denial; documentation must clearly support medical necessity
Verify payer-specific policies on routine screening versus diagnostic imaging; some payers require specific ICD-10 codes indicating trauma or pathology rather than screening.

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Frequently asked questions

What is the Medicare reimbursement rate for CPT 70150 in 2025?

The 2025 Medicare national average reimbursement for CPT 70150 is $45.29 for both facility and non-facility settings. This rate is based on 1.4 total RVUs (0.26 work RVU, 1.12 practice expense RVU, 0.02 malpractice RVU) multiplied by the 2025 conversion factor of 32.3465.

What is the difference between CPT 70140 and 70150?

CPT 70140 is for a limited X-ray examination of facial bones (less than 3 views), while CPT 70150 represents a complete examination with 3 or more views. The number of views documented in the radiology report determines the correct code. Billing 70150 when only 1-2 views were obtained will result in downcoding to 70140.

Can CPT 70150 be billed with a facial CT scan on the same day?

Yes, but it requires careful documentation and typically modifier 59 to indicate a distinct procedural service. Payers may bundle these services under NCCI edits, so you must demonstrate separate medical necessity - for example, plain films obtained initially in the emergency setting followed by CT based on findings, or different clinical indications for each study.

What diagnosis codes support medical necessity for CPT 70150?

Common qualifying diagnoses include facial fractures (S02.2, S02.3, S02.4 series), facial trauma evaluation (S00-S09 codes), chronic sinusitis (J32.x), suspected osteomyelitis of facial bones (M86.x), facial pain with suspected structural cause (R51.9 when documented appropriately), and suspected tumors or cysts of facial bones. Vague or non-specific codes without supporting documentation often result in medical necessity denials.

Do I need modifier 26 or TC when billing CPT 70150?

Only use modifier 26 (professional component) if you are billing solely for the physician interpretation without providing the equipment or technical staff. Use modifier TC (technical component) if billing only for the equipment, supplies, and technologist without the interpretation. If your facility provides both the imaging service and interpretation, bill the global code 70150 without modifiers.

How many RVUs is CPT code 70150 worth?

CPT 70150 has a total of 1.4 RVUs in 2025, consisting of 0.26 work RVUs, 1.12 practice expense RVUs (both facility and non-facility), and 0.02 malpractice RVUs. These are relatively low RVU values reflecting the basic nature of the diagnostic service.

What views are typically included in a complete facial bone X-ray series (70150)?

A complete facial bone examination (70150) typically includes at least three standard views such as the Waters view (occipitomental projection for maxillary sinuses and orbits), Caldwell view (frontooccipital for frontal and ethmoid sinuses), and lateral view. Some protocols may include additional specialized projections. The specific views should be documented in the radiology report, and having fewer than three views may require coding as 70140 instead.