A single panoramic radiograph that captures the upper and lower jaws, teeth, and temporomandibular joints in one sweep of the tube around the head.
- Medicare
- $19.37
- Work RVU
- 0.2
- Global, days
- Region
- Other
Documentation requirements
What must appear in the operative or office note to support the claim.
Source · Editorial brief grounded in 3 cited references ↓
- Signed order naming the medical reason for the film
- Diagnosis code tied to a medical condition, not a routine dental exam
- Written interpretation by the reading provider
- Surgeon's clearance request in the chart when the film is part of a pre-op workup
- Date of service and the facility or office where the film was taken
Applicable modifiers
Modifiers commonly billed with this code.
Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual
What this code covers
Source · Editorial summary grounded in 3 cited references ↓
70355 is the panoramic jaw film most people call a Panorex. It shows both jaws, the dentition, and the TMJs on one image. It is a radiology code, not a dental CDT code, so it goes on a medical claim when there is a medical reason for it.
Orthopedic practices almost never perform it. Where it shows up is in the pre-op workup for a joint replacement or spine hardware case. Plenty of surgeons ask for dental clearance before implanting metal, and an abscessed tooth found on a panoramic film can push the case back. The dentist or oral surgeon usually takes and bills the film. Your practice just needs the result in the chart.
The trip-ups are coverage. Medicare and most commercial plans do not pay for routine dental imaging. A panoramic film billed to medical insurance needs a diagnosis that ties it to a medical problem, such as a suspected jaw fracture or a mass. Billed with a routine dental diagnosis, it will deny. Pre-op dental clearance for a joint replacement is not one of Medicare's recognized dental exceptions, so expect that film to fall to the patient or the dental plan.
RVU & reimbursement
Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.
Source · CMS Physician Fee Schedule, RVU26A · January 2026
Work RVU vs. total RVU
The work RVU (0.2) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (0.58) adds practice overhead and malpractice, and is what drives the Medicare payment below.
| Work RVU | 0.2 |
| Practice expense RVU | 0.36 |
| Malpractice RVU | 0.02 |
| Total RVU | 0.58 |
| Medicare national rate | $19.37 |
| Global period | days |
Payment by site of service
Medicare pays different rates by setting. HOPD typically pays substantially more than ASC for the same procedure.
Source · CMS OPPS Addendum B·ASC HCPCS payment rates·2026
| Setting | Medicare rate (national) |
|---|---|
Office (PFS non-facility) Procedure performed in physician's office | $19.37 |
HOPD (APC 5521) Hospital outpatient department | $88.91 |
Common denial reasons
The recurring reasons claims for CPT 70355 get rejected.
Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓
- Routine dental diagnosis billed to a medical payer
- Medicare dental exclusion applied because no medical necessity is shown
- Global billed by a provider who did not own the equipment (should be 26 only)
- No written report on file when records are requested
- Duplicate claim when the dentist and the referring office both bill
Frequently asked questions
Source · Generated from the editorial pipeline, verified against 3 cited references ↓
01Is CPT 70355 covered by Medicare?
02Can an orthopedic surgeon order a panoramic x-ray before joint replacement?
03What is the difference between 70355 and a dental panoramic code?
Sources & references
Editorial content was developed using the following public sources.
Mira Scribe
When a surgeon asks for dental clearance before a joint replacement, Mira Scribe records the reason in the note, so the order carries a medical indication instead of a bare request for a dental film.
See how Mira captures CPT 70355 documentation