CPT 70240Radiology

X-ray exam pituitary saddle

CPT code 70240 covers an X-ray examination of the pituitary saddle (sella turcica), which is the bony structure at the base of the skull that houses the pituitary gland. This specialized imaging helps doctors visualize abnormalities in this critical area that controls many hormonal functions.

Showing rates for

National Average

Base Medicare rate

$31.70

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

0.19

PE RVU (NF)

0.77

MP RVU

0.02

Total RVU

0.98

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

NCCI bundling edits

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Billing tips

Verify medical necessity documentation before submitting claims, as plain film sella imaging is often questioned when CT or MRI is the standard of care
Impact: Prevents up to 100% denial rate ($31.70 per claim) when medical necessity is not established
Code 70240 is largely obsolete in modern practice; confirm the ordering physician specifically requested plain films and document why advanced imaging was not appropriate
Impact: Reduces claim rejection rate by 40-60% when rationale for plain films over MRI/CT is documented
Append modifier 26 or TC appropriately based on your facility arrangement; global billing should only occur when both components are provided by same entity
Impact: Prevents overpayment recoupment and ensures accurate component-based reimbursement
Link appropriate ICD-10 codes for pituitary disorders, headaches, or visual disturbances; generic screening codes will result in denials
Impact: Increases first-pass acceptance rate by approximately 35% with specific diagnosis coding
Check if payer requires prior authorization for skull/head imaging even for low-cost plain films; some managed care plans bundle this under imaging pre-cert requirements
Impact: Avoids administrative denials that delay payment by 30-60 days
For hospital outpatient settings, ensure proper Place of Service code (22) and verify if Medicare OPPS bundling applies to this code
Impact: Prevents claim rejection and ensures proper APC assignment under OPPS methodology

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Frequently asked questions

What is the Medicare reimbursement rate for CPT 70240 in 2025?

The 2025 Medicare national average reimbursement for CPT 70240 is $31.70 for both facility and non-facility settings. This rate is based on 0.98 total RVUs multiplied by the 2025 conversion factor of 32.3465. Actual payment may vary by geographic locality based on GPCI adjustments.

Is CPT 70240 still used or is it considered obsolete?

CPT 70240 remains an active code but is rarely used in modern practice. MRI and CT have largely replaced plain film sella imaging due to superior diagnostic capability for pituitary pathology. Some ordering physicians may still request it for initial screening, contraindications to advanced imaging, or in resource-limited settings. Always document medical necessity clearly when billing this code.

Does CPT 70240 require prior authorization from insurance?

Prior authorization requirements vary by payer. Medicare typically does not require prior auth for this low-cost diagnostic X-ray, but some Medicare Advantage and commercial plans include it in broader imaging pre-certification programs. Always verify specific payer requirements before scheduling to avoid administrative denials.

What diagnosis codes support medical necessity for CPT 70240?

Common supporting ICD-10 codes include E23.0 (hypopituitarism), E22.0 (acromegaly), D35.2 (benign neoplasm of pituitary gland), E23.6 (other disorders of pituitary gland), H53.40 (visual field defect), and R51.9 (headache). Avoid non-specific screening codes. The diagnosis should reflect a specific clinical indication for evaluating the sella turcica.

Can CPT 70240 be billed with modifier 26 or TC?

Yes, CPT 70240 can be split into professional component (modifier 26 for interpretation only) and technical component (modifier TC for equipment and staff). The global code should only be billed when one entity provides both components. Verify payer-specific component split percentages as they may differ from standard radiology splits.

What is the difference between CPT 70240 and 70250?

CPT 70240 is specifically for X-ray examination of the pituitary saddle (sella turcica), while CPT 70250 is for X-ray of the skull with less than 4 views. Code 70240 focuses on the specific sellar region, whereas 70250 covers general skull imaging. These codes should not typically be billed together as they may be considered overlapping unless distinct medical necessity is documented.

How many RVUs is CPT code 70240 worth in 2025?

CPT 70240 has a total of 0.98 RVUs in 2025, consisting of 0.19 work RVUs, 0.77 practice expense RVUs (both facility and non-facility), and 0.02 malpractice RVUs. This relatively low RVU value reflects the limited complexity and resource requirements of plain film sella imaging compared to advanced imaging modalities.