CPT 70170Radiology

X-ray exam of tear duct

CPT code 70170 covers X-ray imaging of the tear duct system (dacryocystography), which helps doctors visualize blockages or abnormalities in the drainage pathways that carry tears from the eye to the nose.

Showing rates for

National Average

Base Medicare rate

$13.91

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

0.3

PE RVU (NF)

0.11

MP RVU

0.02

Total RVU

0.43

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

NCCI bundling edits

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Billing tips

Always verify laterality and append RT, LT, or 50 modifiers as appropriate
Impact: Prevents automatic denials for missing laterality; some payers reject claims without proper laterality modifiers for this code
Bill contrast media separately using HCPCS code Q9965 or Q9966 if applicable
Impact: Contrast is not bundled into 70170; can add $15-40 to total reimbursement depending on contrast type and volume used
Document physician presence and direct supervision in facility settings
Impact: Medicare requires physician supervision for proper payment; absent documentation can trigger 100% recoupment during audits
Split bill using 26 and TC modifiers when professional and technical services are provided by different entities
Impact: Ensures proper payment distribution; prevents overpayment flags that trigger audits
Code any diagnostic injection/cannulation separately if performed as distinct service
Impact: Cannulation is typically included in 70170; unbundling risks denial and potential fraud investigation
Submit with appropriate ICD-10 codes documenting medical necessity (H04.5x series for stenosis/obstruction)
Impact: Prevents medical necessity denials; missing or inappropriate diagnosis codes result in 85% denial rate for this procedure

Common denials

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Frequently asked questions

What is the Medicare reimbursement rate for CPT 70170 in 2025?

The 2025 Medicare national average payment for CPT 70170 is $13.91 for both facility and non-facility settings. This rate is based on 0.43 total RVUs multiplied by the 2025 conversion factor of 32.3465.

Can CPT 70170 be billed bilaterally with modifier 50?

Yes, CPT 70170 can be billed with modifier 50 when dacryocystography is performed on both the right and left tear duct systems during the same session. Check individual payer policies as some may require separate line items with RT and LT modifiers instead.

What diagnosis codes support medical necessity for CPT 70170?

Common supporting ICD-10 codes include H04.411-H04.429 (stenosis of lacrimal passages), H04.511-H04.539 (stenosis/insufficiency of lacrimal duct), and H04.20-H04.209 (epiphora). Documentation must show chronic symptoms and failed conservative management.

Is contrast media included in CPT 70170 reimbursement?

No, contrast media is not included in the CPT 70170 payment. Bill contrast separately using appropriate HCPCS codes (such as Q9965 or Q9966) based on the type and amount of contrast agent used during the dacryocystography procedure.

Do I need modifier 26 or TC when billing CPT 70170?

Use modifier 26 when billing only the professional component (physician interpretation) and modifier TC when billing only the technical component (equipment and technician). If one entity provides both components, bill 70170 without modifiers as a global service.

How many RVUs is CPT code 70170 worth in 2025?

CPT 70170 has 0.43 total RVUs in 2025, consisting of 0.3 work RVU, 0.11 practice expense RVU (both facility and non-facility), and 0.02 malpractice RVU. This is one of the lower-valued radiologic procedures.

What specialties typically bill CPT code 70170?

CPT 70170 is primarily billed by ophthalmologists, radiologists, and interventional radiologists. Some otolaryngologists also perform and bill this procedure when evaluating nasolacrimal duct obstruction as part of comprehensive tear drainage system assessment.