CPT 70498Radiology

Ct angiography neck

CPT code 70498 covers a specialized CT scan that uses contrast dye to create detailed images of blood vessels in the neck. This imaging helps doctors diagnose blockages, aneurysms, or abnormalities in the carotid arteries and other neck vessels.

Showing rates for

National Average

Base Medicare rate

$272.03

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

1.75

PE RVU (NF)

6.55

MP RVU

0.11

Total RVU

8.41

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

NCCI bundling edits

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Billing tips

Ensure contrast administration is clearly documented in the radiology report and technical notes, as CPT 70498 specifically requires contrast
Impact: Missing contrast documentation is the #1 reason for downcoding to non-contrast neck CT (70490), which reimburses approximately $90 less
Bill professional and technical components separately when applicable, using modifiers 26 and TC appropriately based on ownership structure
Impact: Improper component billing can result in 100% denial or significant underpayment; verify facility vs non-facility settings
Verify that orders specify 'CTA' or 'CT angiography' rather than just 'CT neck with contrast' to support medical necessity
Impact: Vague ordering language increases denial risk by 40-60% and complicates appeal processes
Check for bilateral studies and ensure single code submission, as 70498 inherently includes bilateral neck vasculature evaluation
Impact: Billing 70498 with modifier 50 or twice will result in denial; code is already comprehensive
Review LCD policies for diagnosis code requirements; most payers require specific vascular indications like carotid stenosis, dissection, or stroke workup
Impact: Non-covered diagnosis codes trigger automatic denials; pre-authorization may be required for certain commercial payers, adding 3-7 day delays
When billing same-day with other neck imaging, append modifier 59 only if truly distinct and document separate clinical indications
Impact: Inappropriate modifier 59 use triggers audits; proper use can recover $200-400 in bundled denials

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Frequently asked questions

What is the Medicare reimbursement rate for CPT 70498 in 2025?

The 2025 Medicare national average reimbursement for CPT 70498 is $272.03 for both facility and non-facility settings. This rate is based on 8.41 total RVUs multiplied by the 2025 conversion factor of 32.3465.

Does CPT 70498 require prior authorization from Medicare or commercial payers?

Medicare typically does not require prior authorization for 70498 when medical necessity is established, but many Medicare Advantage and commercial plans do require pre-authorization. Check specific payer policies as requirements vary by plan, with some payers mandating radiology benefits management (RBM) review.

Can CPT 70498 be billed with a head CTA (70496) on the same day?

Yes, 70498 can be billed with 70496 when both are medically necessary, but many payers bundle these codes. Use modifier 59 on the secondary code only when documentation supports distinct clinical indications or the procedures were performed at separate sessions. Comprehensive stroke protocols often justify both studies.

What diagnosis codes support medical necessity for CPT 70498?

Common supporting diagnoses include carotid artery stenosis (I65.2x), cerebrovascular disease (I67.x), TIA (G45.x), personal history of stroke (Z86.73), carotid artery dissection (I77.71), and atherosclerosis of neck arteries (I65.2x). Always verify current LCD requirements for your MAC jurisdiction.

How many RVUs is CPT code 70498 worth in 2025?

CPT 70498 has a total of 8.41 RVUs in 2025, consisting of 1.75 work RVUs, 6.55 practice expense RVUs, and 0.11 malpractice RVUs. Both facility and non-facility PE RVU values are identical at 6.55.

What is the difference between CPT 70498 and 70490?

CPT 70498 is a CT angiography of the neck performed with IV contrast specifically to evaluate blood vessels, while 70490 is a standard CT of the soft tissues of the neck without contrast. Code 70498 requires angiographic technique with arterial phase timing and vascular-specific post-processing, whereas 70490 is used for non-vascular soft tissue evaluation.

Should I bill CPT 70498 with modifier 26 or TC in a hospital setting?

In a hospital outpatient setting, the facility bills 70498-TC for the technical component (equipment, contrast, staff), while the interpreting radiologist bills 70498-26 for the professional component (interpretation and report). In a freestanding imaging center owned by the radiologist group, bill 70498 without modifiers for the global service.