CPT code 70491: CT neck, with contrast2026 Medicare rate & RVUs in North Dakota
Contrast-enhanced CT of the soft tissues of the neck, reported to evaluate masses, adenopathy, infection, or other nonvascular neck abnormalities.
In North Dakota, Medicare pays $181.59 for 70491 in the office.
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.
On this page 11 sections
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 North Dakota 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. North Dakota pays $181.59. The RVUs are the same everywhere; the geographic indexes change the dollars.
- North Dakota · this page$181.59
- Los Angeles, CA · California$208.96+$27.37
- Washington, DC area · District of Columbia$210.22+$28.63
- Miami, FL · Florida$193.51+$11.92
- Chicago, IL · Illinois$188.26+$6.67
- Manhattan, NY · New York$209.93+$28.34
- Alaska · Alaska$213.36+$31.77
Other areas in North Dakota first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $165.16 | — |
| 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 | — |
| Merced, CACalifornia | $195.73 | — |
| Modesto, CACalifornia | $195.73 | — |
| Napa, CACalifornia | $227.75 | — |
| Oxnard, CACalifornia | $208.12 | — |
| Redding, CACalifornia | $195.73 | — |
| Rest of CaliforniaCalifornia | $195.73 | — |
| Riverside, CACalifornia | $196.73 | — |
| Sacramento, CACalifornia | $205.65 | — |
| Salinas, CACalifornia | $204.88 | — |
| San Diego, CACalifornia | $209.86 | — |
| Marin County, CACalifornia | $241.49 | — |
| San Francisco, CACalifornia | $241.39 | — |
| San Benito County, CACalifornia | $246.73 | — |
| Santa Clara County, CACalifornia | $246.31 | — |
| San Luis Obispo, CACalifornia | $201.55 | — |
| Santa Cruz, CACalifornia | $212.01 | — |
| Santa Maria, CACalifornia | $205.69 | — |
| Santa Rosa, CACalifornia | $214.17 | — |
| Stockton, CACalifornia | $195.73 | — |
| Vallejo, CACalifornia | $227.60 | — |
| Visalia, CACalifornia | $195.73 | — |
| Yuba City, CACalifornia | $195.73 | — |
| ColoradoColorado | $191.91 | — |
| ConnecticutConnecticut | $195.32 | — |
| DelawareDelaware | $181.67 | — |
| Fort Lauderdale, FLFlorida | $187.56 | — |
| Rest of FloridaFlorida | $178.93 | — |
| Atlanta, GAGeorgia | $186.27 | — |
| Rest of GeorgiaGeorgia | $169.34 | — |
| Hawaii, Guam, HIHawaii | $200.64 | — |
| IowaIowa | $170.06 | — |
| IdahoIdaho | $170.96 | — |
| East St. Louis, ILIllinois | $175.60 | — |
| Rest of IllinoisIllinois | $173.29 | — |
| Suburban Chicago, ILIllinois | $189.66 | — |
| IndianaIndiana | $171.95 | — |
| KansasKansas | $168.89 | — |
| KentuckyKentucky | $168.10 | — |
| New Orleans, LALouisiana | $175.80 | — |
| Rest of LouisianaLouisiana | $167.69 | — |
| Metropolitan Boston, MAMassachusetts | $211.13 | — |
| Rest of MassachusettsMassachusetts | $190.65 | — |
| Baltimore area, MDMaryland | $194.68 | — |
| Rest of MarylandMaryland | $185.20 | — |
| Rest of MaineMaine | $171.41 | — |
| Southern Maine, MEMaine | $181.04 | — |
| Detroit, MIMichigan | $180.70 | — |
| Rest of MichiganMichigan | $171.99 | — |
| MinnesotaMinnesota | $185.18 | — |
| Metropolitan Kansas City, MOMissouri | $175.05 | — |
| Metropolitan St. Louis, MOMissouri | $176.88 | — |
| Rest of MissouriMissouri | $164.63 | — |
| MississippiMississippi | $163.78 | — |
| MontanaMontana | $183.36 | — |
| North CarolinaNorth Carolina | $173.22 | — |
| NebraskaNebraska | $171.09 | — |
| New HampshireNew Hampshire | $188.54 | — |
| Northern New JerseyNew Jersey | $208.06 | — |
| Rest of New JerseyNew Jersey | $197.91 | — |
| New MexicoNew Mexico | $172.75 | — |
| NevadaNevada | $183.00 | — |
| NYC suburbs and Long Island, NYNew York | $214.40 | — |
| Poughkeepsie and northern NYC suburbs, NYNew York | $198.88 | — |
| Queens, NYNew York | $212.21 | — |
| Rest of New YorkNew York | $175.71 | — |
| OhioOhio | $171.63 | — |
| OklahomaOklahoma | $168.23 | — |
| Portland, OROregon | $198.34 | — |
| Rest of OregonOregon | $181.94 | — |
| Metropolitan Philadelphia, PAPennsylvania | $190.31 | — |
| Rest of PennsylvaniaPennsylvania | $172.11 | — |
| Puerto RicoPuerto Rico | $184.81 | — |
| Rhode IslandRhode Island | $188.37 | — |
| South CarolinaSouth Carolina | $172.64 | — |
| South DakotaSouth Dakota | $181.37 | — |
| TennesseeTennessee | $169.67 | — |
| Austin, TXTexas | $190.96 | — |
| Beaumont, TXTexas | $170.98 | — |
| Brazoria, TXTexas | $181.85 | — |
| Dallas, TXTexas | $182.81 | — |
| Fort Worth, TXTexas | $181.50 | — |
| Galveston, TXTexas | $182.27 | — |
| Houston, TXTexas | $183.92 | — |
| Rest of TexasTexas | $176.18 | — |
| UtahUtah | $174.95 | — |
| VirginiaVirginia | $180.19 | — |
| Virgin Islands, VIUnited States Virgin Islands | $184.81 | — |
| VermontVermont | $180.53 | — |
| Rest of WashingtonWashington | $190.41 | — |
| King County, WAWashington | $215.78 | — |
| WisconsinWisconsin | $175.61 | — |
| West VirginiaWest Virginia | $166.95 | — |
| WyomingWyoming | $182.59 | — |
70491 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.
$162.84
$221.23
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 | $213.36 | 1 |
| AL | $165.16 | 1 |
| AR | $162.84 | 1 |
| AZ | $178.74 | 1 |
| CA | $195.73–$246.73 | 29 |
| CO | $191.91 | 1 |
| CT | $195.32 | 1 |
| DC | $210.22 | 1 |
| DE | $181.67 | 1 |
| FL | $178.93–$193.51 | 3 |
| GA | $169.34–$186.27 | 2 |
| GU | $200.64 | 1 |
| HI | $200.64 | 1 |
| IA | $170.06 | 1 |
| ID | $170.96 | 1 |
| IL | $173.29–$189.66 | 4 |
| IN | $171.95 | 1 |
| KS | $168.89 | 1 |
| KY | $168.10 | 1 |
| LA | $167.69–$175.80 | 2 |
| MA | $190.65–$211.13 | 2 |
| MD | $185.20–$210.22 | 3 |
| ME | $171.41–$181.04 | 2 |
| MI | $171.99–$180.70 | 2 |
| MN | $185.18 | 1 |
| MO | $164.63–$176.88 | 3 |
| MS | $163.78 | 1 |
| MT | $183.36 | 1 |
| NC | $173.22 | 1 |
| ND | $181.59 | 1 |
| NE | $171.09 | 1 |
| NH | $188.54 | 1 |
| NJ | $197.91–$208.06 | 2 |
| NM | $172.75 | 1 |
| NV | $183.00 | 1 |
| NY | $175.71–$214.40 | 5 |
| OH | $171.63 | 1 |
| OK | $168.23 | 1 |
| OR | $181.94–$198.34 | 2 |
| PA | $172.11–$190.31 | 2 |
| PR | $184.81 | 1 |
| RI | $188.37 | 1 |
| SC | $172.64 | 1 |
| SD | $181.37 | 1 |
| TN | $169.67 | 1 |
| TX | $170.98–$190.96 | 8 |
| UT | $174.95 | 1 |
| VA | $180.19–$210.22 | 2 |
| VI | $184.81 | 1 |
| VT | $180.53 | 1 |
| WA | $190.41–$215.78 | 2 |
| WI | $175.61 | 1 |
| WV | $166.95 | 1 |
| WY | $182.59 | 1 |
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
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 North Dakota 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
84
- Locality
- North Dakota
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.406
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.35 | × 1.000 | 1.3500 |
| Practice expense | 4.05 | × 1.000 | 4.0500 |
| Malpractice | 0.09 | × 0.406 | 0.0365 |
| Total RVUs | 5.4365 | ||
| Conversion factor | × 33.4009 | ||
Office rate, North Dakota$181.59
Office: (1.35 × 1 + 4.05 × 1 + 0.09 × 0.406) × $33.4009 = $181.59
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
| 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
70491 without 26 · national office
$183.37
CT neck, with contrast
70491-26 · Professional component
$63.46
Pays only the interpretation and report.
How 70491 has changed in North Dakota
70491 · Office / nonfacility
$181.59
Effective 2026-10-01
The base rate is $1.70 higher than on 2025-10-01, moving from $179.89 to $181.59 (0.9%).
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
$179.89changed to$181.59
- 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
- Malpractice GPCI 0.517 changed to 0.406
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$187.29changed to$179.89
- 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.
March 9, 2024
RVU24AR
$184.24changed to$187.29
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$192.91changed to$184.24
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 4.27 changed to 4.20
- Malpractice GPCI 0.474 changed to 0.517
January 1, 2023
RVU23A
$197.41changed to$192.91
- 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
- Malpractice GPCI 0.431 changed to 0.474
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$202.93changed to$197.41
- 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.
January 1, 2021
RVU21A
$204.41changed to$202.93
- 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
- Malpractice GPCI 0.485 changed to 0.431
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$204.29changed to$204.41
- 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
- Malpractice GPCI 0.540 changed to 0.485
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$205.51changed to$204.29
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 4.28 changed to 4.24
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$237.20changed to$205.51
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 5.18 changed to 4.28
- Malpractice GPCI 0.547 changed to 0.540
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$235.95changed to$237.20
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 5.16 changed to 5.18
- Malpractice GPCI 0.554 changed to 0.547
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$235.88changed to$235.95
- 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.
July 1, 2015
RVU15C
$234.71changed to$235.88
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$246.56changed to$234.71
- Conversion factor 35.8228 changed to 35.7547
- Practice expense RVU 5.46 changed to 5.14
- Malpractice GPCI 0.536 changed to 0.554
Held through RVU15B.
January 1, 2014
RVU14A
$270.53changed to$246.56
- Conversion factor 34.0230 changed to 35.8228
- Practice expense RVU 6.53 changed to 5.46
- Malpractice GPCI 0.517 changed to 0.536
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: $270.53
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $181.59 | Not available in this setting | RVU26D |
| 2026-07-01 | $181.59 | Not available in this setting | RVU26C |
| 2026-04-01 | $181.59 | Not available in this setting | RVU26B |
| 2026-01-01 | $181.59 | Not available in this setting | RVU26A |
| 2025-10-01 | $179.89 | Not available in this setting | RVU25D |
| 2025-07-01 | $179.89 | Not available in this setting | RVU25C |
| 2025-04-01 | $179.89 | Not available in this setting | RVU25B |
| 2025-01-01 | $179.89 | Not available in this setting | RVU25A |
| 2024-10-01 | $187.29 | Not available in this setting | RVU24D |
| 2024-07-01 | $187.29 | Not available in this setting | RVU24C |
| 2024-04-01 | $187.29 | Not available in this setting | RVU24B |
| 2024-03-09 | $187.29 | Not available in this setting | RVU24AR |
| 2024-01-01 | $184.24 | Not available in this setting | RVU24A |
| 2023-10-01 | $192.91 | Not available in this setting | RVU23D |
| 2023-07-01 | $192.91 | Not available in this setting | RVU23C |
| 2023-04-01 | $192.91 | Not available in this setting | RVU23B |
| 2023-01-01 | $192.91 | Not available in this setting | RVU23A |
| 2022-10-01 | $197.41 | Not available in this setting | RVU22D |
| 2022-07-01 | $197.41 | Not available in this setting | RVU22C |
| 2022-04-01 | $197.41 | Not available in this setting | RVU22B |
| 2022-01-01 | $197.41 | Not available in this setting | RVU22A |
| 2021-10-01 | $202.93 | Not available in this setting | RVU21D |
| 2021-07-01 | $202.93 | Not available in this setting | RVU21C |
| 2021-04-01 | $202.93 | Not available in this setting | RVU21B |
| 2021-01-01 | $202.93 | Not available in this setting | RVU21A |
| 2020-10-01 | $204.41 | Not available in this setting | RVU20D |
| 2020-07-01 | $204.41 | Not available in this setting | RVU20C |
| 2020-04-01 | $204.41 | Not available in this setting | RVU20B |
| 2020-01-01 | $204.41 | Not available in this setting | RVU20A |
| 2019-10-01 | $204.29 | Not available in this setting | RVU19D |
| 2019-07-01 | $204.29 | Not available in this setting | RVU19C |
| 2019-04-01 | $204.29 | Not available in this setting | RVU19B |
| 2019-01-01 | $204.29 | Not available in this setting | RVU19A |
| 2018-10-01 | $205.51 | Not available in this setting | RVU18D |
| 2018-07-01 | $205.51 | Not available in this setting | RVU18C |
| 2018-04-01 | $205.51 | Not available in this setting | RVU18B |
| 2018-01-01 | $205.51 | Not available in this setting | RVU18AR1 |
| 2017-10-01 | $237.20 | Not available in this setting | RVU17D |
| 2017-07-01 | $237.20 | Not available in this setting | RVU17C |
| 2017-04-01 | $237.20 | Not available in this setting | RVU17B |
| 2017-01-01 | $237.20 | Not available in this setting | RVU17A |
| 2016-10-01 | $235.95 | Not available in this setting | RVU16D |
| 2016-07-01 | $235.95 | Not available in this setting | RVU16C |
| 2016-04-01 | $235.95 | Not available in this setting | RVU16B |
| 2016-01-01 | $235.95 | Not available in this setting | RVU16A |
| 2015-10-01 | $235.88 | Not available in this setting | RVU15D |
| 2015-07-01 | $235.88 | Not available in this setting | RVU15C |
| 2015-04-01 | $234.71 | Not available in this setting | RVU15B |
| 2015-01-01 | $234.71 | Not available in this setting | RVU15A |
| 2014-10-01 | $246.56 | Not available in this setting | RVU14D |
| 2014-07-01 | $246.56 | Not available in this setting | RVU14C |
| 2014-04-01 | $246.56 | Not available in this setting | RVU14B |
| 2014-01-01 | $246.56 | Not available in this setting | RVU14A |
| 2013-10-01 | $270.53 | Not available in this setting | RVU13D |
| 2013-07-01 | $270.53 | Not available in this setting | RVU13C |
| 2013-04-01 | $270.53 | Not available in this setting | RVU13B |
| 2013-01-01 | $270.53 | Not available in this setting | RVU13AR |
Where the North Dakota rate applies
North Dakota is a Medicare payment area, not a city. Our Census mapping connects it to 406 cities and communities in North Dakota. Some span more than one payment area; confirm with the service ZIP.
- Abercrombie
- Adams
- Alamo
- Alexander
- Alice
- Almont
- Alsen
- Ambrose
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
Fee sheets
Put 70491 and the rest of your codes on one sheet
Your codes at your locality, with payer contracts beside Medicare.
Build my fee sheet