Non-contrast computed tomography of the facial bones and sinuses, typically used to map facial fractures or chronic sinus disease.
- Medicare
- $128.26
- 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 naming the facial bones or sinuses
- Mechanism of injury or sinus symptoms
- Separate report when performed with a head CT
- Description of fracture findings with laterality
- Indication for repeat imaging if a second scan is done
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 ↓
70486 is a facial bone and sinus CT without contrast. It is the go-to study for facial fractures and for sinus disease. In trauma it shows the mandible, maxilla, zygoma, and orbital rims.
Orthopedic surgeons do not treat facial fractures, so this code belongs to radiology, ENT, oral surgery, or plastics. It matters to an ortho practice in polytrauma: a motorcycle crash patient may have a tibial plateau fracture and a zygoma fracture, and the facial CT will be on the same encounter. Know whose code it is so it does not end up on your surgeon's charge ticket.
The main error is overlap. A maxillofacial CT usually includes the orbits, so billing 70480 on top is a duplicate unless a separate study was done. When a head CT and a facial CT are both performed in a trauma panel, both can be billed because they are separate anatomic studies, but they need separate orders and reports. Some payers want modifier 59 or XU on the second code if an edit fires.
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 (3.84) adds practice overhead and malpractice, and is what drives the Medicare payment below.
| Work RVU | 0.83 |
| Practice expense RVU | 2.95 |
| Malpractice RVU | 0.06 |
| Total RVU | 3.84 |
| Medicare national rate | $128.26 |
| 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 | $128.26 |
HOPD (APC 5522) Hospital outpatient department | $106.81 |
Common denial reasons
The recurring reasons claims for CPT 70486 get rejected.
Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓
- Billed with 70480 for the same scan
- No separate order when billed with 70450
- Diagnosis does not support facial imaging
- Prior authorization missing for outpatient sinus CT
- Professional component billed without modifier 26
Frequently asked questions
Source · Generated from the editorial pipeline, verified against 3 cited references ↓
01Can a head CT and facial bone CT be billed on the same day?
02Does 70486 include the orbits?
03Who bills 70486 in a trauma admission?
Sources & references
Editorial content was developed using the following public sources.
Mira Scribe
For polytrauma consults, Mira Scribe notes which injuries the orthopedic surgeon is treating, so imaging and procedures for other services stay off the ortho claim.
See how Mira captures CPT 70486 documentation