CPT 70350Radiology

X-ray head for orthodontia

CPT code 70350 is used for X-ray imaging of the head specifically for orthodontic treatment planning and evaluation. This is a specialized radiographic study that helps orthodontists assess jaw alignment, tooth positioning, and facial bone structure before beginning braces or other corrective treatments.

Showing rates for

National Average

Base Medicare rate

$17.14

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

0.17

PE RVU (NF)

0.34

MP RVU

0.02

Total RVU

0.53

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

NCCI bundling edits

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Billing tips

Verify medical necessity documentation before billing Medicare or medical insurance; most orthodontic services including 70350 are excluded from Medicare coverage unless performed for medical (non-cosmetic) reasons such as trauma, congenital defects, or pathology
Impact: Prevents denials and compliance issues; most 70350 claims to Medicare will deny, potentially costing $17.14 per claim in administrative burden
Bill patients directly when performed purely for orthodontic treatment planning, or verify dental insurance coverage rather than medical insurance for routine orthodontic cases
Impact: Improves collection rates; dental plans may reimburse $25-75 for orthodontic radiographs versus medical denial
When billing medical insurance, link to appropriate ICD-10 codes indicating medical necessity such as M26.4 (malocclusion), Q75.x (craniofacial anomalies), or S02.x (facial fracture) rather than orthodontic-only diagnoses
Impact: Increases approval likelihood by 40-60% when genuine medical indication exists
Do not bill 70350 on the same date as comprehensive oral evaluation codes (D0150, D0180) or panoramic radiographs (70355) without clear documentation of separate medical necessity
Impact: Prevents bundling denials and potential fraud allegations; each service must have distinct clinical justification
Use modifier 26 when interpreting studies performed at hospital or imaging center, and ensure split billing is coordinated to avoid duplicate claims
Impact: Ensures proper component billing; errors can result in 100% denial or overpayment recovery of $17.14 per occurrence
Issue an Advance Beneficiary Notice (ABN) for Medicare patients prior to service, as orthodontic radiographs are typically non-covered; use modifier GA when ABN is on file

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Frequently asked questions

What is CPT code 70350 used for?

CPT code 70350 is used for X-ray imaging of the head specifically for orthodontic purposes. This typically includes cephalometric radiographs that measure jaw relationships, facial bone structure, and tooth positioning to help orthodontists plan treatment with braces or other corrective appliances.

Does Medicare cover CPT 70350?

Medicare typically does not cover CPT 70350 because orthodontic services are generally excluded as cosmetic. However, coverage may be available when the radiograph is performed for medical purposes such as evaluation of congenital craniofacial anomalies, facial trauma, pathology, or pre-surgical planning for medically necessary jaw surgery. An Advance Beneficiary Notice (ABN) should be issued when denial is expected.

What is the reimbursement rate for CPT 70350 in 2025?

The 2025 Medicare national average reimbursement rate for CPT 70350 is $17.14 for both facility and non-facility settings. This is based on 0.53 total RVUs multiplied by the 2025 conversion factor of 32.3465. Actual payment may vary by locality and payer.

Is 70350 a dental or medical code?

CPT 70350 is a medical procedure code from the Current Procedural Terminology system used for medical insurance billing. However, because it describes orthodontic radiography, it is typically billed to dental insurance plans rather than medical insurance. Medical insurance may cover it only when performed for medical (non-orthodontic) indications such as trauma or congenital anomalies.

What is the difference between CPT 70350 and 70355?

CPT 70350 is an X-ray of the head for orthodontic purposes (typically lateral cephalometric views), while CPT 70355 is a panoramic X-ray of the mandible and maxilla (Panorex). Code 70350 focuses on cephalometric measurements for orthodontic treatment planning, whereas 70355 provides a broad view of all teeth, jaws, and surrounding structures. They serve different diagnostic purposes and should not typically be billed together without distinct medical necessity.

What modifiers are commonly used with CPT 70350?

Common modifiers for CPT 70350 include: modifier 26 for professional component only (interpretation), modifier TC for technical component only (equipment and technologist), modifier 76 for repeat procedure by same provider, modifier GY for statutorily excluded services (most orthodontic cases), and modifier GA when an Advance Beneficiary Notice is on file for expected Medicare denials.

How many RVUs is CPT code 70350 worth?

CPT code 70350 has a total of 0.53 RVUs in 2025, consisting of 0.17 work RVUs, 0.34 practice expense RVUs (both facility and non-facility), and 0.02 malpractice RVUs. This relatively low RVU value reflects the limited complexity and time required for orthodontic head radiography.