CPT 70370Radiology

Throat x-ray & fluoroscopy

CPT code 70370 represents an x-ray examination of the throat with fluoroscopy (real-time moving images), typically performed to evaluate swallowing problems, foreign bodies, or structural abnormalities in the pharynx and upper esophageal area.

Showing rates for

National Average

Base Medicare rate

$99.63

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

0.32

PE RVU (NF)

2.73

MP RVU

0.03

Total RVU

3.08

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

NCCI bundling edits

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Billing tips

Always document whether study is billed globally or split between 26/TC components based on practice ownership of equipment
Impact: Incorrect component billing leads to 100% denials; proper splitting ensures $99.63 total payment is distributed correctly between professional and technical components
Document fluoroscopy time and number of spot films taken to justify use of 70370 versus simpler pharyngeal radiography
Impact: Missing fluoroscopic documentation can trigger downcoding to plain film codes (70370 pays $99.63 vs approximately $40-50 for plain films)
Link to specific swallowing disorder ICD-10 codes (R13.x series) rather than generic symptom codes to improve approval rates
Impact: Specific diagnosis coding reduces medical necessity denials by 30-40% and supports 3.08 total RVUs
Do not bill 70370 on same date as modified barium swallow (74230) without modifier 59 and separate documentation
Impact: CCI edits bundle these studies; missing modifier results in $99.63 denial for 70370
For hospital-based radiologists, verify whether facility is billing globally or expecting professional component billing to prevent duplicate claims
Impact: Duplicate billing triggers recoupment of entire $99.63 payment plus potential fraud investigation
Include contrast administration details if performed, though contrast is typically included in 70370 base code
Impact: Separately billing contrast with 70370 risks unbundling audits; contrast is included in the $99.63 rate

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Frequently asked questions

What is the Medicare reimbursement rate for CPT 70370 in 2025?

The 2025 Medicare national average reimbursement rate for CPT 70370 is $99.63 for both facility and non-facility settings. This rate is based on 3.08 total RVUs multiplied by the 2025 conversion factor of 32.3465.

What is the difference between CPT 70370 and 74230?

CPT 70370 is a pharyngeal x-ray with fluoroscopy focusing on the throat and upper swallowing mechanism, while 74230 is a modified barium swallow study that evaluates the entire swallowing mechanism from mouth through esophagus. Code 74230 is more comprehensive and typically involves a speech pathologist for functional swallowing assessment.

Can CPT 70370 be billed with modifier 26 for professional component only?

Yes, modifier 26 should be appended when the radiologist provides only the interpretation and report but does not own the imaging equipment. The technical component (TC modifier) would be billed separately by the facility that owns the equipment.

How many RVUs is CPT code 70370 worth in 2025?

CPT 70370 has 3.08 total RVUs in 2025, consisting of 0.32 work RVUs, 2.73 practice expense RVUs (both facility and non-facility), and 0.03 malpractice RVUs according to CMS Medicare Physician Fee Schedule RVU25A.

What diagnosis codes support medical necessity for CPT 70370?

Common supporting diagnosis codes include R13.10-R13.19 (dysphagia), R49.0 (dysphonia), T17.2 (foreign body in pharynx), C10-C14 (malignant neoplasms of pharynx), J39.2 (pharyngeal disorders), and Z85.819 (personal history of malignant neoplasm of head and neck).

Is CPT 70370 a bilateral procedure requiring modifier 50?

No, CPT 70370 is not a bilateral procedure. The pharyngeal examination is inherently midline and evaluates both sides of the throat anatomy as part of the standard examination. Modifier 50 should not be used with this code.

What are the most common billing errors for CPT 70370?

The most common errors include incorrect component billing (missing 26/TC modifiers when appropriate), bundling issues when billed with 74230 without modifier 59, insufficient documentation of fluoroscopic component, and weak medical necessity documentation for repeat studies within short timeframes.