Billing code 70491: CT neckMedicare rate & RVUs

Medicare pays $183.37 for 70491 nationally in the office. Local office rates run $162.84–$246.73.

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

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.

Where 70491 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

70491 rates by state

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

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.

Payment rules and modifiers for 70491

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

What modifiers do to the payment

When to use modifier 26

70491 compared with similar codes

How to choose

70490Neck CT

Choose 70490 for a soft tissue neck CT without contrast; choose 70491 when contrast is used.

70492CT neck

70492 represents a neck CT performed both without and with contrast. 70491 is for the contrast-only protocol.

70498Ct angiography neck

70498 is CT angiography of the neck, focused on vascular structures; 70491 evaluates neck soft tissues.

70460Head CT

70460 is a contrast-enhanced CT of the head or brain. 70491 applies when the documented study covers the soft tissues of the neck.

Codes related to 70491

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