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CPT code 70491: CT neck, with contrast2026 Medicare rate & RVUs in Washington, DC area

Contrast-enhanced CT of the soft tissues of the neck, reported to evaluate masses, adenopathy, infection, or other nonvascular neck abnormalities.

CMS RVU26DEffective Oct 1, 2026One payment locality290.8K Medicare services in 2024

In Washington, DC area, Medicare pays $210.22 for 70491 in the office.

$210.22Office (non-facility)
Not available in this settingHospital or facility
+14.6%vs the national office rate ($183.37)

Check a contract rate as a % of Medicare · 70491 nationwide

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

We’ll open 70491 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Washington, DC area
  2. What 70491 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 70491 covers

This study uses computed tomography with contrast to depict soft tissues of the neck, including structures such as the pharynx, larynx, thyroid region, and cervical lymph nodes. It is commonly ordered to assess a neck mass, enlarged nodes, or suspected deep neck infection. A technologist acquires the images, and a radiologist or other qualified physician interprets them in a hospital, imaging center, or office setting.

Select this code when the documented examination covers the soft tissues of the neck and uses contrast; use a different code for a noncontrast study or one performed both without and with contrast. The order, imaging record, and interpretation should support the examined region, contrast protocol, and clinical question. The service may be billed globally, or the professional interpretation with modifier 26 and the technical service with modifier TC. CMS applies the diagnostic imaging multiple procedure reduction to both the technical and professional 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 Washington, DC area compares for 70491

Across 109 of 109 payment localities, the office rate for 70491 runs from $162.84 in Arkansas to $246.73 in San Benito County, CA. Washington, DC area pays $210.22. The RVUs are the same everywhere; the geographic indexes change the dollars.

70491 in Washington, DC area vs other payment areas
  1. Washington, DC area · this page$210.22
  2. Los Angeles, CA · California$208.96−$1.26
  3. Miami, FL · Florida$193.51−$16.71
  4. Chicago, IL · Illinois$188.26−$21.96
  5. Manhattan, NY · New York$209.93−$0.29
  6. Alaska · Alaska$213.36+$3.14
  7. Alabama · Alabama$165.16−$45.06

Other areas in District of Columbia first, then benchmark localities. Bars start at $0.

Every other payment area

70491 in every other Medicare payment locality
Payment localityOfficeFacility
ArkansasArkansas$162.84—
ArizonaArizona$178.74—
Bakersfield, CACalifornia$196.04—
Chico, CACalifornia$195.73—
El Centro, CACalifornia$195.74—
Fresno, CACalifornia$195.73—
Hanford, CACalifornia$195.73—
Madera, CACalifornia$195.73—

70491 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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.

$162.84

$221.23

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
70491 office rate range by state
State / territoryOffice rate rangeLocalities
AK$213.361
AL$165.161
AR$162.841
AZ$178.741
CA$195.73–$246.7329
CO$191.911
CT$195.321
DC$210.221
DE$181.671
FL$178.93–$193.513
GA$169.34–$186.272
GU$200.641
HI$200.641
IA$170.061
ID$170.961
IL$173.29–$189.664
IN$171.951
KS$168.891
KY$168.101
LA$167.69–$175.802
MA$190.65–$211.132
MD$185.20–$210.223
ME$171.41–$181.042
MI$171.99–$180.702
MN$185.181
MO$164.63–$176.883
MS$163.781
MT$183.361
NC$173.221
ND$181.591
NE$171.091
NH$188.541
NJ$197.91–$208.062
NM$172.751
NV$183.001
NY$175.71–$214.405
OH$171.631
OK$168.231
OR$181.94–$198.342
PA$172.11–$190.312
PR$184.811
RI$188.371
SC$172.641
SD$181.371
TN$169.671
TX$170.98–$190.968
UT$174.951
VA$180.19–$210.222
VI$184.811
VT$180.531
WA$190.41–$215.782
WI$175.611
WV$166.951
WY$182.591

See 70491 in every payment locality

How the 70491 rate is calculated

Each of 70491’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 · 70491

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.35

1.35 RVUs× 1.000 GPCI

Practice expense4.05

4.05 RVUs× 1.000 GPCI

Malpractice0.09

0.09 RVUs× 1.000 GPCI

Adjusted RVUs

5.4900

Conversion factor

$33.4009

Medicare rate

$183.37

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

The exact Washington, DC area inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

7,817

Code
70491
Physician work
1.35
Practice expense
4.05
Malpractice
0.09

GPCI2026.csv

39

Locality
Washington, DC area
Physician work
1.054
Practice expense
1.178
Malpractice
1.113
Office calculation for 70491 in Washington, DC area
ComponentRVULocality factorAdjusted
Physician work1.35× 1.0541.4229
Practice expense4.05× 1.1784.7709
Malpractice0.09× 1.1130.1002
Total RVUs6.2940
Conversion factor× 33.4009

Office rate, Washington, DC area$210.22

Office: (1.35 × 1.054 + 4.05 × 1.178 + 0.09 × 1.113) × $33.4009 = $210.22

Open 70491 in the RVU calculator

Payment rules and modifiers for 70491

The CMS indicators that decide how 70491 is paid alongside other services.

CMS payment indicators · 70491

CT neck, with 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

70491 without 26 · national office

$183.37

CT neck, with contrast

70491-26 · Professional component

$63.46

Pays only the interpretation and report.

When to use modifier 26

Codes related to 70491

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 70491
CodeHow it relatesOffice range, Washington, DC area
Used instead
70490Neck CT, without contrastSame soft tissue neck CT region, performed without contrast.$170.92
70498Neck CTA, cervical arteriesCT angiography of the neck for a vascular imaging question.No office rate
Same family
70492CT neck, without and with contrastSoft tissue neck CT performed both without and with contrast.$252.14

How 70491 has changed in Washington, DC area

70491 · Office / nonfacility

$210.22

Effective 2026-10-01

The base rate is $0.39 higher than on 2025-10-01, moving from $209.83 to $210.22 (0.2%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

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

  1. January 1, 2026

    RVU26A

    $209.83changed to$210.22

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.38 changed to 1.35
    • Practice expense RVU 4.14 changed to 4.05
    • Malpractice RVU 0.08 changed to 0.09
    • Work GPCI 1.057 changed to 1.054
    • Practice expense GPCI 1.192 changed to 1.178
    • Malpractice GPCI 1.168 changed to 1.113

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $218.70changed to$209.83

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 4.20 changed to 4.14
    • Malpractice RVU 0.09 changed to 0.08

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $215.14changed to$218.70

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $228.80changed to$215.14

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 4.27 changed to 4.20
    • Work GPCI 1.056 changed to 1.057
    • Practice expense GPCI 1.214 changed to 1.192
    • Malpractice GPCI 1.231 changed to 1.168

  5. January 1, 2023

    RVU23A

    $237.42changed to$228.80

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 4.29 changed to 4.27
    • Malpractice RVU 0.08 changed to 0.09
    • Work GPCI 1.054 changed to 1.056
    • Practice expense GPCI 1.236 changed to 1.214
    • Malpractice GPCI 1.294 changed to 1.231

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $243.66changed to$237.42

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 4.41 changed to 4.29
    • Malpractice RVU 0.06 changed to 0.08

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $242.75changed to$243.66

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 4.25 changed to 4.41
    • Malpractice RVU 0.07 changed to 0.06
    • Work GPCI 1.049 changed to 1.054
    • Practice expense GPCI 1.221 changed to 1.236
    • Malpractice GPCI 1.277 changed to 1.294

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $240.19changed to$242.75

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 4.24 changed to 4.25
    • Malpractice RVU 0.09 changed to 0.07
    • Work GPCI 1.045 changed to 1.049
    • Practice expense GPCI 1.205 changed to 1.221
    • Malpractice GPCI 1.261 changed to 1.277

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $241.66changed to$240.19

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 4.28 changed to 4.24

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $280.02changed to$241.66

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 5.18 changed to 4.28
    • Work GPCI 1.048 changed to 1.045
    • Malpractice GPCI 1.271 changed to 1.261

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $278.68changed to$280.02

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 5.16 changed to 5.18
    • Work GPCI 1.051 changed to 1.048
    • Malpractice GPCI 1.280 changed to 1.271

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $278.36changed to$278.68

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 5.14 changed to 5.16
    • Malpractice RVU 0.08 changed to 0.09

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $276.97changed to$278.36

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $290.46changed to$276.97

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 5.46 changed to 5.14
    • Work GPCI 1.050 changed to 1.051
    • Practice expense GPCI 1.202 changed to 1.205
    • Malpractice GPCI 1.205 changed to 1.280

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $318.49changed to$290.46

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 6.53 changed to 5.46
    • Work GPCI 1.049 changed to 1.050
    • Practice expense GPCI 1.198 changed to 1.202
    • Malpractice GPCI 1.130 changed to 1.205

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $318.49

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$210.22Not available in this settingRVU26D
2026-07-01$210.22Not available in this settingRVU26C
2026-04-01$210.22Not available in this settingRVU26B
2026-01-01$210.22Not available in this settingRVU26A
2025-10-01$209.83Not available in this settingRVU25D
2025-07-01$209.83Not available in this settingRVU25C
2025-04-01$209.83Not available in this settingRVU25B
2025-01-01$209.83Not available in this settingRVU25A
2024-10-01$218.70Not available in this settingRVU24D
2024-07-01$218.70Not available in this settingRVU24C
2024-04-01$218.70Not available in this settingRVU24B
2024-03-09$218.70Not available in this settingRVU24AR
2024-01-01$215.14Not available in this settingRVU24A
2023-10-01$228.80Not available in this settingRVU23D
2023-07-01$228.80Not available in this settingRVU23C
2023-04-01$228.80Not available in this settingRVU23B
2023-01-01$228.80Not available in this settingRVU23A
2022-10-01$237.42Not available in this settingRVU22D
2022-07-01$237.42Not available in this settingRVU22C
2022-04-01$237.42Not available in this settingRVU22B
2022-01-01$237.42Not available in this settingRVU22A
2021-10-01$243.66Not available in this settingRVU21D
2021-07-01$243.66Not available in this settingRVU21C
2021-04-01$243.66Not available in this settingRVU21B
2021-01-01$243.66Not available in this settingRVU21A
2020-10-01$242.75Not available in this settingRVU20D
2020-07-01$242.75Not available in this settingRVU20C
2020-04-01$242.75Not available in this settingRVU20B
2020-01-01$242.75Not available in this settingRVU20A
2019-10-01$240.19Not available in this settingRVU19D
2019-07-01$240.19Not available in this settingRVU19C
2019-04-01$240.19Not available in this settingRVU19B
2019-01-01$240.19Not available in this settingRVU19A
2018-10-01$241.66Not available in this settingRVU18D
2018-07-01$241.66Not available in this settingRVU18C
2018-04-01$241.66Not available in this settingRVU18B
2018-01-01$241.66Not available in this settingRVU18AR1
2017-10-01$280.02Not available in this settingRVU17D
2017-07-01$280.02Not available in this settingRVU17C
2017-04-01$280.02Not available in this settingRVU17B
2017-01-01$280.02Not available in this settingRVU17A
2016-10-01$278.68Not available in this settingRVU16D
2016-07-01$278.68Not available in this settingRVU16C
2016-04-01$278.68Not available in this settingRVU16B
2016-01-01$278.68Not available in this settingRVU16A
2015-10-01$278.36Not available in this settingRVU15D
2015-07-01$278.36Not available in this settingRVU15C
2015-04-01$276.97Not available in this settingRVU15B
2015-01-01$276.97Not available in this settingRVU15A
2014-10-01$290.46Not available in this settingRVU14D
2014-07-01$290.46Not available in this settingRVU14C
2014-04-01$290.46Not available in this settingRVU14B
2014-01-01$290.46Not available in this settingRVU14A
2013-10-01$318.49Not available in this settingRVU13D
2013-07-01$318.49Not available in this settingRVU13C
2013-04-01$318.49Not available in this settingRVU13B
2013-01-01$318.49Not available in this settingRVU13AR

Price 70491 for an earlier date of service

Where the Washington, DC area rate applies

Washington, DC area is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in District of Columbia. Some span more than one payment area; confirm with the service ZIP.

  • Washington

Browse all communities in District of Columbia

70491 billing questions

How does this differ from 70490?

70491 is for a soft tissue neck CT performed with contrast. 70490 describes the corresponding study without contrast.

When should 70492 be used instead?

Use 70492 when the neck CT is performed both without and with contrast. A study performed with contrast only is reported with 70491.

Can the interpretation and image acquisition be billed separately?

Yes. Report the professional interpretation with modifier 26 and the technical service with modifier TC; billing without either modifier represents the global service.

Does the multiple procedure reduction affect this code?

CMS applies the diagnostic imaging multiple procedure reduction to the technical and professional components. This can affect either component when it is billed separately.

How does this differ from a neck CT angiography?

70491 evaluates neck soft tissues with contrast. 70498 is for CT angiography of the neck when the examination is directed at blood vessels.

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 70491PPRRVU2026_Oct_nonQPP.csv, line 7,817 (RVU26D)
Geographic factors for Washington, DC areaGPCI2026.csv, line 39 (RVU26D)

Open CMS sourceHow we calculate rates

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