CPT code 70490: Neck CT, without contrast2026 Medicare rate & RVUs in Puerto Rico
CT of the neck’s soft tissues without contrast, reported when the diagnostic question calls for cross-sectional imaging without contrast material.
In Puerto Rico, Medicare pays $150.75 for 70490 in the office.
Check a contract rate as a % of Medicare · 70490 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
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.
How Puerto Rico compares for 70490
Across 109 of 109 payment localities, the office rate for 70490 runs from $133.51 in Arkansas to $199.49 in San Benito County, CA. Puerto Rico pays $150.75. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Puerto Rico · this page$150.75
- Los Angeles, CA · California$169.70+$18.95
- Washington, DC area · District of Columbia$170.92+$20.17
- Miami, FL · Florida$158.04+$7.29
- Chicago, IL · Illinois$153.91+$3.16
- Manhattan, NY · New York$170.92+$20.17
- Alaska · Alaska$176.15+$25.40
Other areas in Puerto Rico first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $135.32 | — |
| ArkansasArkansas | $133.51 | — |
| ArizonaArizona | $145.99 | — |
| Bakersfield, CACalifornia | $159.48 | — |
| Chico, CACalifornia | $159.21 | — |
| El Centro, CACalifornia | $159.22 | — |
| Fresno, CACalifornia | $159.21 | — |
| Hanford, CACalifornia | $159.21 | — |
| Madera, CACalifornia | $159.21 | — |
| Merced, CACalifornia | $159.21 | — |
| Modesto, CACalifornia | $159.21 | — |
| Napa, CACalifornia | $184.41 | — |
| Oxnard, CACalifornia | $168.95 | — |
| Redding, CACalifornia | $159.21 | — |
| Rest of CaliforniaCalifornia | $159.21 | — |
| Riverside, CACalifornia | $160.10 | — |
| Sacramento, CACalifornia | $167.05 | — |
| Salinas, CACalifornia | $166.42 | — |
| San Diego, CACalifornia | $170.29 | — |
| Marin County, CACalifornia | $195.29 | — |
| San Francisco, CACalifornia | $195.20 | — |
| San Benito County, CACalifornia | $199.49 | — |
| Santa Clara County, CACalifornia | $199.12 | — |
| San Luis Obispo, CACalifornia | $163.73 | — |
| Santa Cruz, CACalifornia | $171.89 | — |
| Santa Maria, CACalifornia | $167.03 | — |
| Santa Rosa, CACalifornia | $173.64 | — |
| Stockton, CACalifornia | $159.21 | — |
| Vallejo, CACalifornia | $184.28 | — |
| Visalia, CACalifornia | $159.21 | — |
| Yuba City, CACalifornia | $159.21 | — |
| ColoradoColorado | $156.29 | — |
| ConnecticutConnecticut | $159.13 | — |
| DelawareDelaware | $148.31 | — |
| Fort Lauderdale, FLFlorida | $153.16 | — |
| Rest of FloridaFlorida | $146.35 | — |
| Atlanta, GAGeorgia | $151.98 | — |
| Rest of GeorgiaGeorgia | $138.79 | — |
| Hawaii, Guam, HIHawaii | $162.93 | — |
| IowaIowa | $139.08 | — |
| IdahoIdaho | $139.81 | — |
| East St. Louis, ILIllinois | $143.93 | — |
| Rest of IllinoisIllinois | $141.99 | — |
| Suburban Chicago, ILIllinois | $154.83 | — |
| IndianaIndiana | $140.58 | — |
| KansasKansas | $138.21 | — |
| KentuckyKentucky | $137.73 | — |
| New Orleans, LALouisiana | $143.79 | — |
| Rest of LouisianaLouisiana | $137.42 | — |
| Metropolitan Boston, MAMassachusetts | $171.47 | — |
| Rest of MassachusettsMassachusetts | $155.34 | — |
| Baltimore area, MDMaryland | $158.62 | — |
| Rest of MarylandMaryland | $151.10 | — |
| Rest of MaineMaine | $140.21 | — |
| Southern Maine, MEMaine | $147.70 | — |
| Detroit, MIMichigan | $147.79 | — |
| Rest of MichiganMichigan | $140.83 | — |
| MinnesotaMinnesota | $150.81 | — |
| Metropolitan Kansas City, MOMissouri | $143.16 | — |
| Metropolitan St. Louis, MOMissouri | $144.59 | — |
| Rest of MissouriMissouri | $135.05 | — |
| MississippiMississippi | $134.31 | — |
| MontanaMontana | $149.63 | — |
| North CarolinaNorth Carolina | $141.62 | — |
| North DakotaNorth Dakota | $148.05 | — |
| NebraskaNebraska | $139.87 | — |
| New HampshireNew Hampshire | $153.62 | — |
| Northern New JerseyNew Jersey | $169.28 | — |
| Rest of New JerseyNew Jersey | $161.24 | — |
| New MexicoNew Mexico | $141.44 | — |
| NevadaNevada | $149.30 | — |
| NYC suburbs and Long Island, NYNew York | $174.48 | — |
| Poughkeepsie and northern NYC suburbs, NYNew York | $162.07 | — |
| Queens, NYNew York | $172.64 | — |
| Rest of New YorkNew York | $143.58 | — |
| OhioOhio | $140.50 | — |
| OklahomaOklahoma | $137.78 | — |
| Portland, OROregon | $161.30 | — |
| Rest of OregonOregon | $148.42 | — |
| Metropolitan Philadelphia, PAPennsylvania | $155.22 | — |
| Rest of PennsylvaniaPennsylvania | $140.86 | — |
| Rhode IslandRhode Island | $153.61 | — |
| South CarolinaSouth Carolina | $141.24 | — |
| South DakotaSouth Dakota | $147.86 | — |
| TennesseeTennessee | $138.82 | — |
| Austin, TXTexas | $155.52 | — |
| Beaumont, TXTexas | $139.98 | — |
| Brazoria, TXTexas | $148.44 | — |
| Dallas, TXTexas | $149.21 | — |
| Fort Worth, TXTexas | $148.19 | — |
| Galveston, TXTexas | $148.77 | — |
| Houston, TXTexas | $150.24 | — |
| Rest of TexasTexas | $144.01 | — |
| UtahUtah | $143.05 | — |
| VirginiaVirginia | $147.06 | — |
| Virgin Islands, VIUnited States Virgin Islands | $150.75 | — |
| VermontVermont | $147.26 | — |
| Rest of WashingtonWashington | $155.12 | — |
| King County, WAWashington | $175.12 | — |
| WisconsinWisconsin | $143.37 | — |
| West VirginiaWest Virginia | $137.00 | — |
| WyomingWyoming | $148.94 | — |
70490 rates by state
Office rate range in each state. Select a state to see its payment localities.
Explore a state
Local rates. Clear comparisons.
Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.
$133.51
$179.35
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $176.15 | 1 |
| AL | $135.32 | 1 |
| AR | $133.51 | 1 |
| AZ | $145.99 | 1 |
| CA | $159.21–$199.49 | 29 |
| CO | $156.29 | 1 |
| CT | $159.13 | 1 |
| DC | $170.92 | 1 |
| DE | $148.31 | 1 |
| FL | $146.35–$158.04 | 3 |
| GA | $138.79–$151.98 | 2 |
| GU | $162.93 | 1 |
| HI | $162.93 | 1 |
| IA | $139.08 | 1 |
| ID | $139.81 | 1 |
| IL | $141.99–$154.83 | 4 |
| IN | $140.58 | 1 |
| KS | $138.21 | 1 |
| KY | $137.73 | 1 |
| LA | $137.42–$143.79 | 2 |
| MA | $155.34–$171.47 | 2 |
| MD | $151.10–$170.92 | 3 |
| ME | $140.21–$147.70 | 2 |
| MI | $140.83–$147.79 | 2 |
| MN | $150.81 | 1 |
| MO | $135.05–$144.59 | 3 |
| MS | $134.31 | 1 |
| MT | $149.63 | 1 |
| NC | $141.62 | 1 |
| ND | $148.05 | 1 |
| NE | $139.87 | 1 |
| NH | $153.62 | 1 |
| NJ | $161.24–$169.28 | 2 |
| NM | $141.44 | 1 |
| NV | $149.30 | 1 |
| NY | $143.58–$174.48 | 5 |
| OH | $140.50 | 1 |
| OK | $137.78 | 1 |
| OR | $148.42–$161.30 | 2 |
| PA | $140.86–$155.22 | 2 |
| PR | $150.75 | 1 |
| RI | $153.61 | 1 |
| SC | $141.24 | 1 |
| SD | $147.86 | 1 |
| TN | $138.82 | 1 |
| TX | $139.98–$155.52 | 8 |
| UT | $143.05 | 1 |
| VA | $147.06–$170.92 | 2 |
| VI | $150.75 | 1 |
| VT | $147.26 | 1 |
| WA | $155.12–$175.12 | 2 |
| WI | $143.37 | 1 |
| WV | $137.00 | 1 |
| WY | $148.94 | 1 |
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
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.
The exact Puerto Rico inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
7,814
- Code
- 70490
- Physician work
- 1.25
- Practice expense
- 3.15
- Malpractice
- 0.08
GPCI2026.csv
91
- Locality
- Puerto Rico
- Physician work
- 1.000
- Practice expense
- 1.011
- Malpractice
- 0.985
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.25 | × 1.000 | 1.2500 |
| Practice expense | 3.15 | × 1.011 | 3.1846 |
| Malpractice | 0.08 | × 0.985 | 0.0788 |
| Total RVUs | 4.5134 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Puerto Rico$150.75
Office: (1.25 × 1 + 3.15 × 1.011 + 0.08 × 0.985) × $33.4009 = $150.75
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
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| Multiple procedures | 4 | Diagnostic imaging reduction applies to the technical component (and professional component) of additional services. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 1 | Diagnostic 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.
How 70490 has changed in Puerto Rico
70490 · Office / nonfacility
$150.75
Effective 2026-10-01
The base rate is $2.24 higher than on 2025-10-01, moving from $148.51 to $150.75 (1.5%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.
What changed, release by release
January 1, 2026
RVU26A
$148.51changed to$150.75
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 1.28 changed to 1.25
- Practice expense RVU 3.22 changed to 3.15
- Malpractice RVU 0.07 changed to 0.08
- Practice expense GPCI 1.007 changed to 1.011
- Malpractice GPCI 0.982 changed to 0.985
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$154.16changed to$148.51
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 3.25 changed to 3.22
- Malpractice RVU 0.08 changed to 0.07
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$151.65changed to$154.16
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$158.77changed to$151.65
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 3.30 changed to 3.25
- Practice expense GPCI 1.008 changed to 1.007
- Malpractice GPCI 0.984 changed to 0.982
October 1, 2023
RVU23D
$157.91changed to$158.77
- Practice expense GPCI 1.000 changed to 1.008
- Malpractice GPCI 1.000 changed to 0.984
January 1, 2023
RVU23A
$162.14changed to$157.91
- Conversion factor 34.6062 changed to 33.8872
- Practice expense GPCI 1.008 changed to 1.000
- Malpractice GPCI 0.986 changed to 1.000
Held through RVU23B, RVU23C.
January 1, 2022
RVU22A
$165.61changed to$162.14
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 3.38 changed to 3.30
- Malpractice RVU 0.06 changed to 0.08
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$168.01changed to$165.61
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 3.28 changed to 3.38
- Malpractice RVU 0.07 changed to 0.06
- Malpractice GPCI 0.988 changed to 0.986
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$167.66changed to$168.01
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 3.27 changed to 3.28
- Malpractice RVU 0.08 changed to 0.07
- Practice expense GPCI 1.007 changed to 1.008
- Malpractice GPCI 0.990 changed to 0.988
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$172.19changed to$167.66
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 3.40 changed to 3.27
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
No ratechanged to$172.19
Held through RVU18B, RVU18C, RVU18D.
January 1, 2014
RVU14A
$165.79changed toNo rate
Held through RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D, RVU16A, RVU16B, RVU16C, RVU16D, RVU17A, RVU17B, RVU17C, RVU17D.
January 1, 2013
RVU13AR
Earliest loaded release: $165.79
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $150.75 | Not available in this setting | RVU26D |
| 2026-07-01 | $150.75 | Not available in this setting | RVU26C |
| 2026-04-01 | $150.75 | Not available in this setting | RVU26B |
| 2026-01-01 | $150.75 | Not available in this setting | RVU26A |
| 2025-10-01 | $148.51 | Not available in this setting | RVU25D |
| 2025-07-01 | $148.51 | Not available in this setting | RVU25C |
| 2025-04-01 | $148.51 | Not available in this setting | RVU25B |
| 2025-01-01 | $148.51 | Not available in this setting | RVU25A |
| 2024-10-01 | $154.16 | Not available in this setting | RVU24D |
| 2024-07-01 | $154.16 | Not available in this setting | RVU24C |
| 2024-04-01 | $154.16 | Not available in this setting | RVU24B |
| 2024-03-09 | $154.16 | Not available in this setting | RVU24AR |
| 2024-01-01 | $151.65 | Not available in this setting | RVU24A |
| 2023-10-01 | $158.77 | Not available in this setting | RVU23D |
| 2023-07-01 | $157.91 | Not available in this setting | RVU23C |
| 2023-04-01 | $157.91 | Not available in this setting | RVU23B |
| 2023-01-01 | $157.91 | Not available in this setting | RVU23A |
| 2022-10-01 | $162.14 | Not available in this setting | RVU22D |
| 2022-07-01 | $162.14 | Not available in this setting | RVU22C |
| 2022-04-01 | $162.14 | Not available in this setting | RVU22B |
| 2022-01-01 | $162.14 | Not available in this setting | RVU22A |
| 2021-10-01 | $165.61 | Not available in this setting | RVU21D |
| 2021-07-01 | $165.61 | Not available in this setting | RVU21C |
| 2021-04-01 | $165.61 | Not available in this setting | RVU21B |
| 2021-01-01 | $165.61 | Not available in this setting | RVU21A |
| 2020-10-01 | $168.01 | Not available in this setting | RVU20D |
| 2020-07-01 | $168.01 | Not available in this setting | RVU20C |
| 2020-04-01 | $168.01 | Not available in this setting | RVU20B |
| 2020-01-01 | $168.01 | Not available in this setting | RVU20A |
| 2019-10-01 | $167.66 | Not available in this setting | RVU19D |
| 2019-07-01 | $167.66 | Not available in this setting | RVU19C |
| 2019-04-01 | $167.66 | Not available in this setting | RVU19B |
| 2019-01-01 | $167.66 | Not available in this setting | RVU19A |
| 2018-10-01 | $172.19 | Not available in this setting | RVU18D |
| 2018-07-01 | $172.19 | Not available in this setting | RVU18C |
| 2018-04-01 | $172.19 | Not available in this setting | RVU18B |
| 2018-01-01 | $172.19 | Not available in this setting | RVU18AR1 |
| 2017-10-01 | Additional calculation required | Not available in this setting | RVU17D |
| 2017-07-01 | Additional calculation required | Not available in this setting | RVU17C |
| 2017-04-01 | Additional calculation required | Not available in this setting | RVU17B |
| 2017-01-01 | Additional calculation required | Not available in this setting | RVU17A |
| 2016-10-01 | Additional calculation required | Not available in this setting | RVU16D |
| 2016-07-01 | Additional calculation required | Not available in this setting | RVU16C |
| 2016-04-01 | Additional calculation required | Not available in this setting | RVU16B |
| 2016-01-01 | Additional calculation required | Not available in this setting | RVU16A |
| 2015-10-01 | Additional calculation required | Not available in this setting | RVU15D |
| 2015-07-01 | Additional calculation required | Not available in this setting | RVU15C |
| 2015-04-01 | Additional calculation required | Not available in this setting | RVU15B |
| 2015-01-01 | Additional calculation required | Not available in this setting | RVU15A |
| 2014-10-01 | Additional calculation required | Not available in this setting | RVU14D |
| 2014-07-01 | Additional calculation required | Not available in this setting | RVU14C |
| 2014-04-01 | Additional calculation required | Not available in this setting | RVU14B |
| 2014-01-01 | Additional calculation required | Not available in this setting | RVU14A |
| 2013-10-01 | $165.79 | Not available in this setting | RVU13D |
| 2013-07-01 | $165.79 | Not available in this setting | RVU13C |
| 2013-04-01 | $165.79 | Not available in this setting | RVU13B |
| 2013-01-01 | $165.79 | Not available in this setting | RVU13AR |
Where the Puerto Rico rate applies
Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.
- Aceitunas
- Adjuntas
- Aguada
- Aguadilla
- Aguas Buenas
- Aguas Claras
- Aguilita
- Aibonito
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
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