Computed tomography of the head and brain performed only after intravenous contrast is given, with no non-contrast images in the same study.
- Medicare
- $148.30
- Work RVU
- 1.1
- 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 stating why contrast is needed, such as tumor or infection
- Renal function or contrast allergy screening when the facility requires it
- Contrast agent, dose, and route in the technologist record
- Report confirming the study was post-contrast only
- Reason MRI was not used when that is part of the payer's criteria
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 ↓
70460 is a head CT done with contrast only. It is less common than the non-contrast scan because most head imaging starts without contrast to look for blood. When contrast is needed for a tumor, infection, or abscess question, many clinicians go to MRI instead.
In orthopedic care, the code mostly shows up in oncology and infection cases. A patient with a known primary cancer and a new pathologic fracture may need staging that includes the brain. A spine patient with a post-op infection and new neurologic signs might also get a contrast head CT if MRI is not possible because of hardware or a pacemaker.
The common billing mistake is coding 70460 when the study actually included pre-contrast images. Read the report. If it describes images before and after contrast, the right code is 70470. In an office or freestanding imaging center, the contrast agent usually goes on the claim as its own HCPCS supply code. In the hospital, the facility reports it. Confirm the payer's rule before the claim goes out.
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 (1.1) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (4.44) adds practice overhead and malpractice, and is what drives the Medicare payment below.
| Work RVU | 1.1 |
| Practice expense RVU | 3.25 |
| Malpractice RVU | 0.09 |
| Total RVU | 4.44 |
| Medicare national rate | $148.30 |
| 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 | $148.30 |
HOPD (APC 5571) Hospital outpatient department | $179.20 |
Common denial reasons
The recurring reasons claims for CPT 70460 get rejected.
Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓
- Report shows pre and post contrast images, so 70470 was the correct code
- Diagnosis does not support the need for contrast
- Prior authorization not obtained for a commercial plan
- Contrast supply code on the professional claim when the hospital supplied the agent
- Professional component billed without modifier 26 in a facility setting
Frequently asked questions
Source · Generated from the editorial pipeline, verified against 3 cited references ↓
01When should 70460 be used instead of 70470?
02Does 70460 need prior authorization?
03Can contrast be billed separately with 70460?
Sources & references
Editorial content was developed using the following public sources.
Mira Scribe
When a surgeon needs brain imaging for a cancer or infection patient, Mira Scribe records the indication and any reason MRI is off the table, which supports the contrast order.
See how Mira captures CPT 70460 documentation