Computed tomography of the facial bones and sinuses done only after intravenous contrast, used when infection, abscess, or a mass is suspected.
- Medicare
- $151.64
- 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 the reason for contrast, such as abscess or mass
- Contrast agent and dose
- Report confirming post-contrast images only
- Kidney function or allergy screening per protocol
- Prior authorization number for commercial plans
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 ↓
70487 is a facial and sinus CT done with contrast only. Contrast is added when the question is infection, abscess, or tumor rather than fracture. Bone detail does not need contrast, so trauma imaging uses 70486 instead.
This code rarely touches orthopedic billing. The likely overlap is a patient with a known malignancy being staged, or a patient with a deep facial infection who also has a septic joint or osteomyelitis your surgeon is treating. Radiology bills it.
The errors are the same as the other contrast pairs. If the report shows images before and after contrast, the code is 70488, not 70487. If contrast was never given, it is 70486. Make sure the charge matches the report, because a mismatch between the billed code and the radiology narrative is an easy audit finding.
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 (4.54) adds practice overhead and malpractice, and is what drives the Medicare payment below.
| Work RVU | 1.1 |
| Practice expense RVU | 3.35 |
| Malpractice RVU | 0.09 |
| Total RVU | 4.54 |
| Medicare national rate | $151.64 |
| 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 | $151.64 |
HOPD (APC 5571) Hospital outpatient department | $179.20 |
Common denial reasons
The recurring reasons claims for CPT 70487 get rejected.
Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓
- Report shows a two-phase study that should be 70488
- Contrast not given, so 70486 was correct
- Diagnosis supports a fracture study, not a contrast study
- Missing authorization
- Global billed by a hospital-based radiologist
Frequently asked questions
Source · Generated from the editorial pipeline, verified against 3 cited references ↓
01What is the difference between 70486 and 70487?
02When is 70488 used instead of 70487?
03Does 70487 require prior authorization?
Sources & references
Editorial content was developed using the following public sources.
Mira Scribe
When an infection patient has findings outside the surgeon's field, Mira Scribe records the referral and the concern in plain language, which helps the receiving service justify its own imaging.
See how Mira captures CPT 70487 documentation