CPT 71270Radiology

Ct thorax dx c-/c+

CPT code 71270 represents a CT scan of the chest performed twice: once without contrast dye, then again after injecting contrast material into a vein. This dual-phase imaging helps doctors see blood vessels, tumors, and other chest abnormalities more clearly than a single scan.

Showing rates for

National Average

Base Medicare rate

$193.11

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

1.25

PE RVU (NF)

4.64

MP RVU

0.08

Total RVU

5.97

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

NCCI bundling edits

Loading bundling edits…

Billing tips

Verify medical necessity documentation specifically justifies BOTH non-contrast and contrast phases before billing 71270
Impact: Prevents downcoding to 71260 (contrast only) or 71250 (non-contrast only), which would reduce reimbursement by approximately $40-60 per study
Confirm contrast administration documentation includes type, volume, route, and timing to support the contrast-enhanced component
Impact: Missing contrast documentation triggers automatic denials or audits; recovery requires chart amendments and appeals, delaying payment 45-90 days
Review indication to ensure it supports dual-phase imaging rather than single-phase protocol (71250 or 71260)
Impact: Inappropriate use of 71270 when 71260 is indicated results in overpayment recoveries averaging $50-70 per case in audits
Separate professional and technical components when different entities provide interpretation versus imaging
Impact: Failure to split components causes payment to wrong provider and requires costly refund/rebilling; use modifier 26 or TC appropriately
Check for recent prior chest CT studies to avoid duplicate service denials within short timeframes
Impact: Medicare may deny studies within 30 days of previous chest CT without clear documentation of clinical change; use modifier 76 with strong justification
Ensure ACR accreditation and contrast safety protocols are current, as payers increasingly verify before processing claims
Impact: Non-accredited facilities face denials or 15-25% payment reductions; accreditation lapses can trigger retroactive claim reviews

Live Field Datano reports yet

Real billers contribute denial patterns and appeal strategies for this code. Once 5+ reports come in, you’ll see live aggregated data here — the only place this exists, free.

Working with CPT 71270?

Get the free Revenue Protection Toolkit — the denial triggers, modifier pitfalls, and bundling conflicts that quietly cost you reimbursement. Instant download.

Help build the field knowledge

MedPayIQ gets smarter as billers contribute. If you've had this code denied, share what happened so others learn from it. Anonymous, no patient info.

Related actions

Frequently asked questions

What is the Medicare reimbursement rate for CPT 71270 in 2025?

The 2025 Medicare national average reimbursement for CPT 71270 is $193.11 for both facility and non-facility settings. This rate is based on 5.97 total RVUs multiplied by the 2025 conversion factor of 32.3465. Local rates may vary based on geographic practice cost indices (GPCI).

What is the difference between CPT codes 71250, 71260, and 71270?

CPT 71250 is a chest CT without contrast, 71260 is with contrast only, and 71270 includes both non-contrast and contrast-enhanced phases. Code 71270 should only be used when medical necessity requires evaluation of enhancement characteristics by comparing pre- and post-contrast images, such as characterizing pulmonary nodules or mediastinal masses.

How many RVUs is CPT code 71270 worth in 2025?

CPT 71270 has a total of 5.97 RVUs in 2025, consisting of 1.25 work RVUs, 4.64 practice expense RVUs, and 0.08 malpractice RVUs. The practice expense RVU is the same for both facility and non-facility settings at 4.64.

Can CPT 71270 be billed with modifier 26 or TC?

Yes, CPT 71270 can be split using modifier 26 (professional component for radiologist interpretation only) or TC (technical component for equipment and staff only) when different entities provide the interpretation and technical services. Without modifiers, the code represents the global service including both components.

What documentation is required to bill CPT 71270?

Documentation must include the medical indication justifying dual-phase imaging, confirmation that both non-contrast and contrast-enhanced acquisitions were performed, contrast administration details (type, volume, route), patient consent, renal function assessment, and a complete radiologist interpretation addressing findings from both phases. The medical necessity for both phases must be clearly established.

When is CPT 71270 medically necessary instead of 71260?

CPT 71270 is medically necessary when both non-enhanced and enhanced images are required for diagnosis, such as characterizing indeterminate pulmonary nodules (to assess enhancement), evaluating mediastinal masses (to determine vascularity), detecting calcium in lesions while also assessing enhancement, or when hemorrhage versus enhancement must be differentiated. Single-phase studies (71260) are adequate for most routine indications.

What are common denial reasons for CPT 71270 claims?

Common denials include lack of medical necessity documentation for dual-phase imaging, insufficient proof of contrast administration, billing 71270 when single-phase study (71250 or 71260) was appropriate, duplicate service when performed too soon after previous chest CT, and missing elements like renal function assessment or contrast consent documentation.