CPT 70460Radiology

Ct head/brain w/dye

CPT 70460 covers a CT (computed tomography) scan of the head or brain performed with contrast dye injected into a vein. The contrast helps radiologists see blood vessels, tumors, and other structures more clearly than a scan without dye.

Showing rates for

National Average

Base Medicare rate

$146.21

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

1.13

PE RVU (NF)

3.32

MP RVU

0.07

Total RVU

4.52

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

NCCI bundling edits

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Billing tips

Always verify that contrast was actually administered intravenously before billing 70460 instead of 70450 (non-contrast)
Impact: $146.21 vs $112.58 difference - incorrect code selection results in either underpayment or denial for lack of medical necessity
Do not separately bill contrast material (Q9965-Q9967) or injection codes (96374) as these are bundled into 70460
Impact: Prevents automatic denials and potential audit flags; unbundling can trigger compliance reviews and repayment demands
Document medical necessity clearly in ordering physician notes - contrast studies require justification beyond routine screening
Impact: Reduces denial rate by 30-40%; Medicare LCD requirements mandate specific indications for contrast-enhanced studies
When both non-contrast and contrast phases are performed, bill 70470 (combined without and with contrast) instead of 70450 + 70460
Impact: 70470 pays approximately $218-225, whereas attempting to bill both separately will result in denial of the second code
Verify patient kidney function (eGFR) documentation before contrast administration to support medical appropriateness
Impact: Protects against medical necessity denials and supports compliance with safety protocols that auditors verify
Split bill between professional (modifier 26) and technical (modifier TC) components only when different entities provide each service
Impact: Ensures accurate payment distribution; facilities performing both must bill global code without modifiers to receive full $146.21

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Frequently asked questions

What is the Medicare reimbursement rate for CPT 70460 in 2025?

The 2025 Medicare national average payment for CPT 70460 is $146.21 for both facility and non-facility settings. This rate is based on 4.52 total RVUs multiplied by the 2025 conversion factor of 32.3465. Actual payment may vary by geographic locality based on GPCI adjustments.

What is the difference between CPT 70450, 70460, and 70470?

CPT 70450 is a CT head/brain without contrast, 70460 is with intravenous contrast only, and 70470 is without contrast followed by with contrast (combined study). You should only bill one of these codes per session - never bill 70450 and 70460 together, as the combined study is 70470.

Can I bill separately for contrast material with CPT 70460?

No, contrast material and its administration are bundled into CPT 70460. You cannot separately bill HCPCS codes for contrast agents (Q9965-Q9967) or injection/infusion codes (96374, 96375) when billing 70460. These are considered inclusive components of the procedure.

How many RVUs is CPT code 70460 worth in 2025?

CPT 70460 has 4.52 total RVUs in 2025, consisting of 1.13 work RVUs, 3.32 practice expense RVUs, and 0.07 malpractice RVUs. The PE RVU value is identical for both facility and non-facility settings at 3.32.

Does CPT 70460 require prior authorization from Medicare?

While traditional Medicare does not universally require prior authorization for 70460, many Medicare Advantage plans do require it. Additionally, the Medicare Appropriate Use Criteria (AUC) program requires consulting qualified clinical decision support for advanced imaging. Commercial payers frequently require prior authorization for all CT scans including 70460.

When should I use modifier 26 with CPT 70460?

Use modifier 26 when billing only for the physician's professional interpretation and written report, not the technical equipment and staff. This typically occurs when a radiologist interprets a scan performed at a separate facility. The physician receives approximately 40-50% of the total allowable, while the facility bills the TC (technical component) modifier.

What diagnosis codes support medical necessity for CPT 70460?

Common supporting diagnoses include brain neoplasms (C71.x, D33.x), headache with neurological findings (R51.9 with supporting codes), cerebrovascular disease (I63.x, I67.x), seizures (R56.x, G40.x), altered mental status (R41.x), suspected infection/abscess (G06.x), and metastatic disease workup (C79.31). The key is documenting why contrast enhancement is specifically needed versus non-contrast imaging.