CPT code 70490: Neck CT, without contrast2026 Medicare rate & RVUs in California

CT of the neck’s soft tissues without contrast, reported when the diagnostic question calls for cross-sectional imaging without contrast material.

CMS RVU26DEffective Oct 1, 202629 payment localities57.2K Medicare services in 2024

Medicare pays $159.21–$199.49 for 70490 in the office in California, from Chico, CA to San Benito County, CA. Which amount applies depends on the service address.

$159.21–$199.49Office (non-facility)
—Hospital or facility

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

Your location

Medicare pays by the payment locality where the service is performed.

On this page 9 sections
  1. Rate in California
  2. What 70490 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. Sources

What 70490 covers

This study uses computed tomography to produce cross-sectional images of the neck’s soft tissues without contrast material. Radiologists interpret examinations performed in hospital imaging departments, outpatient centers, and other diagnostic imaging settings. Clinical questions may involve a neck mass, cervical lymph nodes, or other soft-tissue findings; the ordering clinician selects the protocol based on the diagnostic question and the patient’s circumstances.

Report 70490 when the examination covers the soft tissues of the neck and is performed without contrast. The order and imaging report should support the anatomic area examined and the noncontrast technique. Use 70491 for a neck soft-tissue CT with contrast, or 70492 when both without- and with-contrast imaging is performed. CMS recognizes separately priced professional and technical components: modifier 26 identifies the interpretation, modifier TC the equipment and staff, and no modifier represents the global service. When multiple diagnostic imaging procedures are reported, the imaging multiple-procedure reduction applies to both the professional and technical components.

This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.

Where 70490 pays more and less in California

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

29 payment localities

$159.21 to $199.49

$159.21$179.35$199.49
One dot per payment locality, office / nonfacility. Hover a dot to see the locality; select it to open that rate.

29 of 29 payment localities

70490 office and facility rates by payment locality
Payment localityOfficeFacility
Bakersfield, CA$159.48Unavailable
Chico, CA$159.21Unavailable
El Centro, CA$159.22Unavailable
Fresno, CA$159.21Unavailable
Hanford, CA$159.21Unavailable
Los Angeles, CA$169.70Unavailable
Madera, CA$159.21Unavailable
Marin County, CA$195.29Unavailable
Merced, CA$159.21Unavailable
Modesto, CA$159.21Unavailable

How the 70490 rate is calculated

Each of 70490’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.

How the rate is built · 70490

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.25

1.25 RVUs× 1.000 GPCI

Practice expense3.15

3.15 RVUs× 1.000 GPCI

Malpractice0.08

0.08 RVUs× 1.000 GPCI

Adjusted RVUs

4.4800

Conversion factor

$33.4009

Medicare rate

$149.64

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

Payment rules and modifiers for 70490

The CMS indicators that decide how 70490 is paid alongside other services.

CMS payment indicators · 70490

Neck CT, without contrast

RuleCMS valueWhat it means
Global periodXXXThe global surgery concept doesn’t apply.
Multiple procedures4Diagnostic imaging reduction applies to the technical component (and professional component) of additional services.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical1Diagnostic test with separate professional (26) and technical (TC) components.

What modifiers do to the payment

Modifier 26 · payment effect

With and without the modifier

70490 without 26 · national office

$149.64

Neck CT, without contrast

70490-26 · Professional component

$59.12

Pays only the interpretation and report.

When to use modifier 26

70490 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 70490

    Neck CT, without contrast1.25 wRVU

    $149.64

  • 70491

    CT neck, with contrast1.35 wRVU

    $183.37+$33.73

  • 70492

    CT neck, without and with contrast1.58 wRVU

    $219.78+$70.14

  • 70498

    Neck CTA, cervical arteries1.71 wRVU

    $273.89+$124.25

How to choose

70491CT neckWith contrast
Choose 70491 when contrast is administered for the neck soft-tissue CT; 70490 is for imaging without contrast.
70492CT neckWithout and with contrast
Choose 70492 when the neck is imaged both without and with contrast. 70490 covers the noncontrast examination only.
70498Neck CTACervical arteries
70498 is CT angiography of the neck for vascular evaluation; 70490 is a noncontrast CT of neck soft tissues.

70490 billing questions

When should 70490 be chosen over 70491?

Use 70490 for a neck soft-tissue CT performed without contrast. Use 70491 when contrast is administered for the examination.

How does 70490 differ from 70492?

70492 represents a neck soft-tissue CT performed both without and with contrast. 70490 represents the noncontrast examination only.

Can the professional and technical services be billed separately?

Yes. Modifier 26 identifies the professional interpretation, and modifier TC identifies the technical service, including equipment and staff. Billing without a modifier represents the global service.

What documentation supports reporting 70490?

The order and imaging report should identify the neck soft tissues as the imaged area and support that the examination was performed without contrast.

How does the multiple-procedure reduction affect this code?

When multiple diagnostic imaging procedures are reported, the CMS imaging multiple-procedure reduction applies to the professional and technical components of 70490.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.

CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027

Show the CMS file lines behind this rate
RVUs for 70490PPRRVU2026_Oct_nonQPP.csv, line 7,814 (RVU26D)

Open CMS sourceHow we calculate rates

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