Billing code 70190: Orbit X-rayMedicare rate & RVUs in Illinois
Reports plain-film imaging focused on the eye sockets, such as evaluation of suspected orbital injury, with separate professional and technical billing options.
Medicare pays $34.56–$38.10 for 70190 in the office in Illinois, from Rest Of Illinois to Suburban Chicago. Which amount applies depends on the service address.
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 9 sections
What 70190 covers
This service is plain-film imaging focused on the bony structures surrounding the eyes. It may be ordered for suspected orbital injury, including trauma, and is typically performed by a radiologic technologist in an imaging department or office. A radiologist or other qualified practitioner interprets the images. The order and report should make clear that the orbits, rather than the facial bones generally or the eye itself, were the imaging target.
Report the global service when one billing entity provides both image acquisition and interpretation. Modifier 26 identifies the professional interpretation, while modifier TC identifies the technical work, equipment, and staff; CMS separately prices both modifiers. For bilateral imaging, CMS pays each side separately at 100%. The record should support the clinical indication, the imaged side or sides, the images obtained, and the interpretation. Select a different radiographic code when the study is specifically for foreign-body screening, facial bones, or another adjacent structure.
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 70190 pays more and less in Illinois
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
4 payment localities
$34.56 to $38.10
| Payment locality | Office | Facility |
|---|---|---|
| Chicago | $37.80 | Unavailable |
| East St. Louis | $35.07 | Unavailable |
| Rest Of Illinois | $34.56 | Unavailable |
| Suburban Chicago | $38.10 | Unavailable |
How the 70190 rate is calculated
Each of 70190’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 · 70190
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 0.20Practice expense 0.88Malpractice 0.02
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 70190
The CMS indicators that decide how 70190 is paid alongside other services.
CMS payment indicators · 70190
Orbit X-ray
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 3 | Each side paid at 100% (no 150% cap). |
| 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
70190 without 26 · national office
$36.74
Orbit X-ray
70190-26 · Professional component
$10.35
Pays only the interpretation and report.
70190 compared with similar codes
Compare codes
70190 vs 70030 vs 70140 vs 70150 vs 70170: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 70030Eye X-ray
- 70190 images the bony orbits; 70030 is for radiographic screening of the eye for a foreign body.
- 70140Facial bone X-ray
- Choose 70190 for an orbital study. Choose 70140 when the ordered examination targets facial bones.
- 70150Facial bone X-ray
- 70150 is for a facial-bone examination, while 70190 is focused on the eye sockets.
- 70170X-ray exam of tear duct
- 70170 evaluates the lacrimal drainage system radiographically; 70190 images the bony orbits.
70190 billing questions
When should 70190 be chosen instead of 70030?
Use 70190 when the study images the bony orbits. Code 70030 is for radiographic screening of the eye for a foreign body.
How are the professional and technical services reported?
Use modifier 26 for the interpretation and modifier TC for the technical service. Billing without either modifier represents the global service.
How is bilateral orbital imaging paid?
CMS pays each side separately at 100% when imaging is performed bilaterally. Document which sides were imaged.
Should facial-bone imaging be included in 70190?
Choose the code that reflects the ordered and performed study. Use a facial-bone radiography code when the examination targets the facial skeleton rather than the orbits.
What documentation supports reporting 70190?
Retain the order and imaging report showing the clinical indication, orbital target, side or sides examined, and interpretation.
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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