CPT 70470Radiology

Ct head/brain w/o & w/dye

CPT code 70470 covers a CT scan of the head or brain performed twice: first without contrast dye, then with contrast dye injected into a vein to highlight blood vessels and tissues.

Showing rates for

National Average

Base Medicare rate

$170.79

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

1.27

PE RVU (NF)

3.93

MP RVU

0.08

Total RVU

5.28

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

NCCI bundling edits

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Billing tips

Verify that both non-contrast AND contrast phases were actually performed and documented before billing 70470 instead of 70450 (without dye) or 70460 (with dye only)
Impact: Incorrect code selection can result in $50-80 payment variance and high audit risk; 70450 pays approximately $120 vs $170.79 for 70470
Document medical necessity for dual-phase imaging in the ordering physician's order and radiologist's indication - many payers require specific clinical reasons beyond general headache
Impact: Prevents denials for lack of medical necessity, which account for 35-40% of 70470 claim rejections
Ensure contrast administration documentation includes type, dose, route, time, and performing staff credentials - this is required for compliance and contrast reaction management
Impact: Missing contrast documentation can trigger downcoding to 70450, resulting in approximately $50 underpayment per study
Check renal function (eGFR/creatinine) documentation before contrast administration, especially for Medicare patients - CMS requires documented assessment
Impact: Lack of renal function screening documentation can result in medical necessity denials and potential quality measure penalties
Bill facility and professional components correctly based on your setting - hospitals bill globally, while private practices typically split 26/TC
Impact: Component billing errors can cause 100% claim denial; for 70470, PC and TC must reconcile to total RVU of 5.28
When imaging is performed for stroke evaluation, ensure documentation supports 70470 over CT angiography codes (70496) or CT perfusion codes, which are separately reportable

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Frequently asked questions

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

CPT 70450 is a CT head/brain without contrast dye ($120 approximate Medicare rate), 70460 is with contrast only, and 70470 is a complete study with both non-contrast and contrast phases ($170.79 Medicare rate). Code 70470 requires documentation that both imaging phases were medically necessary and actually performed.

How much does Medicare pay for CPT code 70470 in 2025?

Medicare pays $170.79 for CPT 70470 in 2025 based on the national average non-facility rate. This rate reflects 5.28 total RVUs multiplied by the 2025 conversion factor of 32.3465. Actual payment may vary by geographic locality based on GPCI adjustments.

Can you bill 70470 and 70496 together for stroke imaging?

Yes, CPT 70470 (CT head with and without contrast) and 70496 (CT angiography of the head) can be billed together when both are medically necessary for comprehensive stroke evaluation, but documentation must support the need for both studies. Use modifier 59 on 70470 if required by payer to indicate distinct procedural service.

What diagnosis codes support medical necessity for CPT 70470?

Common supporting diagnoses include brain neoplasms (C71.x, D33.x), metastatic disease to brain (C79.31), stroke/TIA (I63.x, G45.9), seizures (G40.x, R56.9), meningitis/encephalitis (G03.x, G04.x), multiple sclerosis (G35), and vascular malformations (Q28.2, Q28.3). The specific indication must support the need for both pre- and post-contrast imaging.

Do I need modifier 26 or TC when billing 70470?

Use modifier 26 when billing only the professional component (physician interpretation). Use modifier TC when billing only the technical component (equipment, staff, supplies). Hospital outpatient departments typically bill the complete code without modifiers. The professional component represents approximately 25-30% of the total RVU value.

What are the RVU values for CPT 70470 in 2025?

CPT 70470 has 1.27 work RVUs, 3.93 practice expense RVUs (both facility and non-facility), and 0.08 malpractice RVUs, totaling 5.28 RVUs. These values are from the CMS Medicare Physician Fee Schedule RVU25A released December 23, 2024.

How do I appeal a denial for CPT 70470 downcoded to 70450?

Submit documentation proving both pre-contrast and post-contrast phases were performed and medically necessary. Include the complete radiology report describing findings from both phases, contrast administration records with agent type and dose, and clinical notes explaining why dual-phase imaging was required for the specific diagnosis. Reference ACR Appropriateness Criteria if applicable to support the protocol choice.