CPT 70336Radiology

Magnetic image jaw joint

CPT code 70336 covers an MRI (magnetic resonance imaging) scan of the jaw joint, also called the temporomandibular joint or TMJ. This imaging test uses magnets and radio waves to create detailed pictures of the jaw joint without using radiation.

Showing rates for

National Average

Base Medicare rate

$257.80

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

1.48

PE RVU (NF)

6.39

MP RVU

0.1

Total RVU

7.97

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

NCCI bundling edits

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Billing tips

Always append laterality modifiers (LT, RT, or 50) as most payers now require these for TMJ imaging codes
Impact: Prevents automatic denials for missing laterality information, which account for 25-30% of initial rejections
Verify whether bilateral TMJ imaging should be billed as one line with modifier 50 or two lines with LT/RT based on specific payer policy
Impact: Incorrect bilateral billing can result in underpayment of $128.90 (50% of allowed amount) or claim rejection
Ensure medical necessity documentation clearly links TMJ imaging to covered diagnosis codes such as TMJ disorder (M26.6x), disc displacement (M26.63), or osteoarthritis (M19.01x)
Impact: Lack of medical necessity is the #1 denial reason, affecting 40% of appeals and potentially negating the full $257.80 payment
Split bill 70336 with modifier 26 (professional) and TC (technical) when different entities provide interpretation versus imaging services
Impact: Prevents coordination of benefits issues and ensures both facility and physician receive appropriate portions of the $257.80 total
Document whether study was performed with open-mouth and closed-mouth positioning in the radiology report to support code selection
Impact: Enhances audit defensibility and differentiates from limited TMJ studies, protecting against downcoding to lower-value codes
Check if prior authorization is required before scheduling as many commercial payers require PA for outpatient MRI studies
Impact: Retroactive denials for lack of authorization can result in complete loss of $257.80 reimbursement with limited appeal options

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Frequently asked questions

What is the Medicare reimbursement rate for CPT 70336 in 2025?

The 2025 Medicare national average payment for CPT 70336 is $257.80 for both facility and non-facility settings. This is based on 7.97 total RVUs multiplied by the 2025 conversion factor of 32.3465. Actual reimbursement may vary by geographic locality adjustment.

Does CPT 70336 require a modifier for left or right TMJ?

Yes, CPT 70336 requires laterality modifiers. Use modifier LT for left TMJ, RT for right TMJ, or modifier 50 for bilateral imaging. Most payers mandate these modifiers and will deny or reject claims without proper laterality designation.

Can you bill CPT 70336 for both TMJ joints on the same day?

Yes, bilateral TMJ imaging can be billed either as one line with modifier 50 (bilateral) or as two separate lines with LT and RT modifiers depending on payer policy. Verify specific payer requirements as bilateral reimbursement policies vary significantly between Medicare and commercial insurers.

What diagnosis codes support medical necessity for CPT 70336?

Common supporting diagnoses include M26.60-M26.69 (TMJ disorders), M26.63 (articular disc disorder), S03.4 (sprain of jaw), M19.01x (primary osteoarthritis of TMJ), and R68.84 (jaw pain). Documentation should clearly link symptoms to the need for advanced imaging.

How many RVUs is CPT code 70336 worth in 2025?

CPT 70336 has 7.97 total RVUs in 2025, comprised of 1.48 work RVUs, 6.39 practice expense RVUs (both facility and non-facility), and 0.10 malpractice RVUs according to the CMS Medicare Physician Fee Schedule.

Do I need prior authorization for CPT 70336 MRI of TMJ?

Prior authorization requirements vary by payer. Medicare Advantage plans and most commercial insurers require pre-authorization for outpatient MRI studies including TMJ imaging. Original Medicare typically does not require PA but does require medical necessity. Always verify specific payer requirements before scheduling.

What is the difference between CPT 70336 and 70328 for TMJ imaging?

CPT 70336 is an MRI of the temporomandibular joint without contrast, while 70328 is a CT scan of the TMJ. MRI (70336) is preferred for soft tissue evaluation including disc position and inflammation, whereas CT is better for bony pathology. The codes are not interchangeable and require different clinical justification.