CPT 70380Radiology

X-ray exam of salivary gland

CPT code 70380 covers an X-ray examination of the salivary glands, which are the structures in your mouth and throat that produce saliva. This imaging test helps doctors diagnose problems like blocked ducts, stones, infections, or tumors in these glands.

Showing rates for

National Average

Base Medicare rate

$36.23

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)

0.93

MP RVU

0.02

Total RVU

1.12

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

NCCI bundling edits

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Billing tips

Verify that more advanced imaging (sialography, CT, MRI) was not performed on the same date, as payers may consider plain X-ray medically unnecessary if advanced imaging was ordered
Impact: Prevents denials for medical necessity; documentation should justify why plain X-ray was appropriate initial study
Document the specific salivary gland(s) examined (parotid, submandibular, sublingual) and clinical indication in the order and report
Impact: Reduces medical necessity denials by 30-40% when anatomic specificity and clear indication are present
Bill as a complete procedure regardless of number of views obtained; multiple views are included in 70380 and should not be separately reported
Impact: Prevents unbundling denials and compliance issues; the $36.23 rate covers all standard views
Ensure written report is finalized and signed within 24-48 hours of exam; delayed documentation triggers audit risk
Impact: Maintains compliance and supports timely claim submission; delayed reports can result in payment recoupment
For bilateral examinations, bill 70380 once without bilateral modifier unless payer-specific policy requires modifier 50
Impact: Most payers consider bilateral imaging inherent to 70380; inappropriate use of modifier 50 may trigger denial
Verify that contrast media was NOT used; if sialography with contrast was performed, use CPT 70390 instead of 70380
Impact: Using wrong code when contrast administered results in undercoding; 70390 has higher reimbursement rate

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Frequently asked questions

What is the Medicare reimbursement rate for CPT 70380 in 2025?

The 2025 Medicare national average reimbursement rate for CPT 70380 is $36.23 for both facility and non-facility settings. This rate is based on 1.12 total RVUs multiplied by the 2025 conversion factor of 32.3465.

Does CPT 70380 include bilateral salivary gland X-rays?

Yes, CPT 70380 typically includes examination of salivary glands bilaterally when clinically indicated. The code is generally billed once per session regardless of whether one or both sides are imaged, unless specific payer policy requires bilateral modifier 50.

What is the difference between CPT 70380 and 70390?

CPT 70380 is a plain X-ray of the salivary gland without contrast, while CPT 70390 is a sialography procedure that includes injection of contrast material into the salivary duct system followed by X-ray imaging. Code 70390 is used for more detailed ductal evaluation and has higher reimbursement.

Can CPT 70380 be billed with an E/M service on the same day?

Yes, CPT 70380 can be billed with an E/M service on the same day when the imaging is a separately identifiable service with its own order and indication. The E/M service may require modifier 25 to indicate it was significant and separately identifiable from the care related to ordering the X-ray.

What diagnosis codes support medical necessity for CPT 70380?

Common supporting diagnosis codes include K11.5 (sialolithiasis/salivary stones), K11.20 (sialadenitis), K11.6 (mucocele of salivary gland), K11.8 (other diseases of salivary glands), R22.0 (localized swelling of head), and D11.x codes for neoplasms of major salivary glands.

How many RVUs is CPT 70380 worth in 2025?

CPT 70380 has a total of 1.12 RVUs in 2025, consisting of 0.17 work RVUs, 0.93 practice expense RVUs, and 0.02 malpractice RVUs. The PE RVUs are the same for both facility and non-facility settings.

Do I need prior authorization for CPT 70380?

Prior authorization requirements vary by payer and state. Most Medicare Advantage and commercial plans do not require prior authorization for basic salivary gland X-rays, but some managed care plans may require it as part of radiology benefit management programs. Always verify with the specific payer before performing the study.