Billing code 70490: Neck CTMedicare rate & RVUs

Medicare pays $149.64 for 70490 nationally in the office. Local office rates run $133.51–$199.49.

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

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

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

109 of 109 payment localities

70490 rates by state

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

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.

Payment rules and modifiers for 70490

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

What modifiers do to the payment

When to use modifier 26

70490 compared with similar codes

How to choose

70491CT neck

Choose 70491 when contrast is administered for the neck soft-tissue CT; 70490 is for imaging without contrast.

70492CT neck

Choose 70492 when the neck is imaged both without and with contrast. 70490 covers the noncontrast examination only.

70498Ct angiography neck

70498 is CT angiography of the neck for vascular evaluation; 70490 is a noncontrast CT of neck soft tissues.

Codes related to 70490

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

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

Open CMS sourceHow we calculate rates