CPT 70390Radiology

X-ray exam of salivary duct

CPT code 70390 covers an X-ray examination of the salivary ducts, the tubes that carry saliva from your salivary glands to your mouth. This imaging study is typically performed to detect blockages, stones, or other abnormalities affecting saliva flow.

Showing rates for

National Average

Base Medicare rate

$109.65

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

0.38

PE RVU (NF)

2.98

MP RVU

0.03

Total RVU

3.39

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

NCCI bundling edits

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Billing tips

Document which specific salivary gland duct was examined (parotid vs submandibular) and use laterality modifiers (RT/LT) consistently
Impact: Prevents denials for lack of specificity and supports medical necessity; can prevent 15-20% denial rate
Bill contrast media separately using HCPCS code Q9966 or appropriate contrast agent code when performing technical component
Impact: Recovers additional $20-40 in contrast material costs not included in the $109.65 base rate
When performed in hospital setting, ensure split billing is coordinated - facility bills TC, radiologist bills 26 modifier to avoid duplicate billing
Impact: Prevents claim rejections and compliance issues; proper split ensures full $109.65 is captured between both parties
Link to appropriate ICD-10 diagnosis codes (K11.5 for sialolithiasis, K11.20 for sialadenitis, K11.8 for other disease) to establish medical necessity
Impact: Reduces medical necessity denials by approximately 25-30% when specific diagnosis is documented
Document failed attempt or contraindication if procedure is attempted but cannot be completed; bill with modifier 53 for discontinued procedure
Impact: Allows partial reimbursement (typically 50-75% or approximately $55-82) rather than complete denial
Verify that sialography is not being replaced by alternative imaging (MR sialography, ultrasound) which may be preferred by some payers as first-line
Impact: Prevents denials for non-covered services or lack of prior authorization; some payers require pre-auth

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Frequently asked questions

What is the Medicare reimbursement rate for CPT 70390 in 2025?

The 2025 Medicare national average reimbursement rate for CPT 70390 is $109.65 for both facility and non-facility settings. This rate is based on 3.39 total RVUs multiplied by the 2025 conversion factor of 32.3465.

Can CPT 70390 be billed bilaterally for both salivary ducts?

Yes, if both right and left salivary ducts (or different gland systems) are examined separately, you can bill 70390 twice with RT and LT modifiers. However, documentation must clearly support the medical necessity for bilateral examination, and some payers may require modifier 50 instead or may have specific bilateral billing policies.

What is the difference between CPT 70390 and MR sialography?

CPT 70390 is conventional X-ray sialography requiring direct cannulation of the duct and injection of iodinated contrast, while MR sialography (CPT 70336) is a non-invasive MRI technique that visualizes salivary ducts without cannulation or contrast injection. Many payers now prefer MR sialography as first-line imaging due to its non-invasive nature.

Do I need prior authorization for CPT 70390?

Prior authorization requirements vary by payer. Many commercial insurers and Medicare Advantage plans now require pre-authorization for sialography, particularly as they may prefer less invasive alternatives like ultrasound or MR sialography as first-line diagnostic tools. Always verify with the specific payer before scheduling.

How should I bill the contrast media used in CPT 70390?

Contrast media should be billed separately using appropriate HCPCS codes (such as Q9966 for low osmolar contrast or specific contrast agent codes). The contrast is not included in the $109.65 CPT 70390 reimbursement. Document the type and volume of contrast used in the procedure note.

What are the work RVUs for CPT 70390?

CPT 70390 has 0.38 work RVUs, 2.98 practice expense RVUs (both facility and non-facility), and 0.03 malpractice RVUs, totaling 3.39 RVUs for 2025. This relatively low RVU value reflects the brief procedure and interpretation time.

Can CPT 70390 be billed with an E/M service on the same day?

Yes, but the E/M service must be separately identifiable and documented with modifier 25. The E/M should document the evaluation that led to the decision to perform the sialography, or address a separate medical issue. If the only purpose of the visit is the pre-scheduled sialography, an E/M is typically not separately billable.