CPT 70487Radiology

Ct maxillofacial w/dye

CPT code 70487 covers a CT scan of the face and jaw bones performed with contrast dye injected into a vein to help certain structures show up more clearly on the images.

Showing rates for

National Average

Base Medicare rate

$149.76

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)

3.43

MP RVU

0.07

Total RVU

4.63

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

NCCI bundling edits

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Billing tips

Verify contrast administration documentation is present in the radiology report or procedure note, including contrast type, dose, route, and time of administration
Impact: Missing contrast documentation can result in downcoding to 70486 (without contrast), reducing reimbursement by approximately $30-50
Confirm medical necessity is clearly documented with specific clinical indications rather than screening or vague symptoms
Impact: Vague indications like 'facial pain' without further specificity lead to 15-25% denial rate; specific diagnoses improve first-pass payment
When billing both professional and technical components, ensure the global code 70487 is not submitted if split billing with modifiers 26 and TC
Impact: Duplicate billing of global and split components will trigger 100% denial and potential audit flags
Check for proper time interval documentation when billing repeat imaging within 30 days to justify medical necessity
Impact: Repeat imaging within 30 days without documented change in clinical status results in 40-60% denial rate
Verify patient renal function documentation (GFR/creatinine) is present before contrast administration to meet safety protocols
Impact: Missing renal function documentation can lead to quality audit findings and potential denial of payment as medically unnecessary risk
Bundle appropriately with same-day maxillofacial procedures and avoid unbundling component services that are included in the CT interpretation
Impact: Incorrect unbundling of separately billable services can trigger recoupment of $149.76 plus penalties in post-payment audits

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Frequently asked questions

What is the Medicare reimbursement rate for CPT 70487 in 2025?

The 2025 Medicare national average reimbursement rate for CPT 70487 is $149.76 for both facility and non-facility settings. This rate is based on 4.63 total RVUs multiplied by the 2025 conversion factor of 32.3465.

What is the difference between CPT 70487 and 70486?

CPT 70487 is a CT scan of the maxillofacial area performed with intravenous contrast material, while 70486 is the same anatomical study performed without contrast. The contrast version (70487) provides enhanced visualization of vascular structures and soft tissue pathology but requires additional documentation and carries slightly higher reimbursement.

Can CPT 70487 be billed with modifier 26 for professional component only?

Yes, CPT 70487 can be split into professional and technical components. Use modifier 26 when billing only the physician interpretation and report reading. The facility or imaging center would separately bill the technical component with modifier TC. Do not bill the global code if splitting components.

What documentation is required to bill CPT 70487 and avoid denials?

Required documentation includes a physician order with specific clinical indication, documented contrast administration (type, dose, route, time), pre-procedure renal function assessment, patient consent, and a radiologist interpretation report that specifically describes contrast-enhanced findings. Medical necessity must be clearly established with appropriate ICD-10 diagnosis codes.

How many RVUs is CPT code 70487 worth in 2025?

CPT 70487 has 4.63 total RVUs in 2025, comprised of 1.13 work RVUs, 3.43 practice expense RVUs, and 0.07 malpractice RVUs. The facility and non-facility practice expense RVUs are the same at 3.43.

What are common denial reasons for CPT 70487 claims?

Common denials include medical necessity not established for contrast use, insufficient documentation of contrast administration leading to downcoding to 70486, duplicate service denials for repeat imaging within 30 days, and bundling denials when billed with other same-day procedures without appropriate modifiers.

Can CPT 70487 be billed twice on the same day?

CPT 70487 can be billed twice on the same day only with strong medical necessity documentation and the appropriate modifier (76 for repeat by same physician, 77 for repeat by different physician). Most payers scrutinize same-day repeat imaging heavily and require documentation of clinical change or technical issues with the first study necessitating the repeat.