Computed tomography of the head and brain performed without any intravenous contrast, the standard first scan after head trauma or a sudden neurologic change.
- Medicare
- $106.55
- Work RVU
- 0.83
- 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 ↓
- Order with the clinical reason, such as head strike, loss of consciousness, or new confusion
- Anticoagulation status when relevant to the bleed risk
- Mechanism of injury for trauma cases
- Signed radiology report with findings and impression
- Time of the scan when repeat imaging is done the same day
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 ↓
70450 is a non-contrast head CT. It is the scan the emergency department runs on almost every fall patient who hit their head, and it is the first test for suspected bleeding.
Orthopedic practices see it most in trauma and geriatric fracture care. An older patient with a hip fracture after a fall often gets a head CT in the ED before the orthopedic consult. On the inpatient side, a post-op patient on anticoagulation who becomes confused may get one too. The ordering provider is usually the ED physician or hospitalist, and radiology bills the read. If your surgeon orders it on the floor, the order needs a symptom-based diagnosis, not just the fracture code.
Two rules cause most problems. First, do not bill 70450 with 70460 on the same day for the same patient. If the study was done without contrast and then with contrast, the correct single code is 70470. Second, professional and technical components split cleanly. A hospital-based radiologist bills with modifier 26, and the facility bills the technical side.
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 (0.83) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (3.19) adds practice overhead and malpractice, and is what drives the Medicare payment below.
| Work RVU | 0.83 |
| Practice expense RVU | 2.3 |
| Malpractice RVU | 0.06 |
| Total RVU | 3.19 |
| Medicare national rate | $106.55 |
| 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 | $106.55 |
HOPD (APC 5522) Hospital outpatient department | $106.81 |
Common denial reasons
The recurring reasons claims for CPT 70450 get rejected.
Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓
- Billed together with 70460 instead of reporting 70470
- Diagnosis limited to the orthopedic injury with no head or neuro symptom
- Repeat same-day scan billed without modifier 76 or 77
- Global billed by a radiologist reading in a hospital setting
- Missing signed interpretation
Frequently asked questions
Source · Generated from the editorial pipeline, verified against 3 cited references ↓
01Can you bill 70450 and 70460 together?
02What diagnosis supports a head CT after a fall?
03Does an orthopedic surgeon bill 70450?
Sources & references
Editorial content was developed using the following public sources.
Mira Scribe
Mira Scribe captures the head strike, loss of consciousness, and anticoagulant use in the orthopedic consult note, which gives the head CT a clear reason on the chart.
See how Mira captures CPT 70450 documentation