Head and brain CT done in two passes during one session, first without intravenous contrast and then again after contrast is injected.
- Medicare
- $173.02
- Work RVU
- 1.24
- 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 indication for both non-contrast and contrast images
- Contrast agent, dose, and time of injection
- Report describing both series
- Note explaining a cancelled contrast phase if it was not given
- Screening for kidney function or contrast allergy per facility protocol
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 ↓
70470 covers a head CT with both a non-contrast series and a contrast series in the same session. It replaces the combination of 70450 and 70460. You never bill those two together.
For an orthopedic or spine practice, this code comes up in the same situations as the contrast-only scan: metastatic disease workup, suspected intracranial infection, or a patient who cannot have MRI. A spine surgeon evaluating a patient with myelopathy symptoms and a pacemaker may need brain imaging to rule out a central cause before attributing the symptoms to the cervical cord.
What trips people up is unbundling. Some charge masters fire one charge per series, which produces 70450 plus 70460 on the claim. Payer edits flag that pair. Fix it at the charge level so the claim goes out as one 70470. Also watch for the case where contrast was ordered but never given. If only the non-contrast series was done, the code drops to 70450, and the report should say why contrast was cancelled.
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 (1.24) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (5.18) adds practice overhead and malpractice, and is what drives the Medicare payment below.
| Work RVU | 1.24 |
| Practice expense RVU | 3.85 |
| Malpractice RVU | 0.09 |
| Total RVU | 5.18 |
| Medicare national rate | $173.02 |
| 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 | $173.02 |
HOPD (APC 5571) Hospital outpatient department | $179.20 |
Common denial reasons
The recurring reasons claims for CPT 70470 get rejected.
Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓
- 70450 and 70460 billed on the same claim instead of 70470
- Contrast phase not performed but 70470 still billed
- Prior authorization approved for a different CT code
- Diagnosis does not explain the need for contrast
- Missing modifier 26 for the professional read in a facility
Frequently asked questions
Source · Generated from the editorial pipeline, verified against 3 cited references ↓
01What CPT code is used for a head CT with and without contrast?
02What if the contrast phase was cancelled?
03Does prior authorization for 70450 cover 70470?
Sources & references
Editorial content was developed using the following public sources.
Mira Scribe
Mira Scribe documents the neurologic findings and any MRI contraindication during the visit, so the reason for a two-phase head CT is already in the note when the order goes out.
See how Mira captures CPT 70470 documentation