Billing code 70472: Cerebral perfusion CTMedicare rate & RVUs in Virginia
Reports contrast-enhanced cerebral CT perfusion analysis when performed with CT and CTA, commonly during imaging evaluation of suspected acute stroke.
Medicare pays $153.54–$180.82 for 70472 in the office in Virginia, from Virginia to Dc + Md/Va Suburbs. 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 70472 covers
This service adds cerebral perfusion analysis to contrast-enhanced head imaging that includes CT and CTA. Perfusion processing produces maps of cerebral blood flow and related measures that can help clinicians assess suspected acute ischemic stroke and impaired brain perfusion. A radiologist typically interprets the study in a hospital or imaging facility; acquisition and postprocessing require the appropriate CT equipment and staff.
Report 70472 only with its designated primary procedure, not as a stand-alone perfusion service. The record should support contrast-enhanced perfusion acquisition, the associated CT and CTA imaging, postprocessing, and the interpreting physician’s findings. CMS treats it as an add-on paid within the primary procedure’s global period. The diagnostic test may be billed globally, or its interpretation with modifier 26 and its technical service with modifier TC; billing without either modifier represents the global service.
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 70472 pays more and less in Virginia
| Payment locality | Office | Facility |
|---|---|---|
| Dc + Md/Va Suburbs | $180.82 | Unavailable |
| Virginia | $153.54 | Unavailable |
How the 70472 rate is calculated
Each of 70472’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 · 70472
RVUs × geographic indexes × conversion factor
Work0.77
0.77 RVUs× 1.000 GPCI
Practice expense3.85
3.85 RVUs× 1.000 GPCI
Malpractice0.06
0.06 RVUs× 1.000 GPCI
Adjusted RVUs
4.6800
Conversion factor
$33.4009
Medicare rate
$156.32
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 70472
The CMS indicators that decide how 70472 is paid alongside other services.
CMS payment indicators · 70472
Cerebral perfusion CT
| Rule | CMS value | What it means |
|---|---|---|
| Global period | ZZZ | Add-on code: falls within the primary procedure’s global period. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| 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
70472 without 26 · national office
$156.32
Cerebral perfusion CT
70472-26 · Professional component
$36.41
Pays only the interpretation and report.
70472 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 70473Ct cere prfu aly c+wo ct/cta
- Both codes report cerebral perfusion analysis, but 70472 is the variant with CT and CTA, while 70473 is the variant without CT and/or CTA.
- 70450Head CT
- 70450 reports a noncontrast head CT. It does not represent the contrast-enhanced cerebral perfusion analysis reported by 70472.
- 70496Ct angiography head
- 70496 reports CT angiography of the head. It is not a cerebral perfusion analysis code and does not replace 70472 when perfusion analysis is performed.
70472 billing questions
How does 70472 differ from 70473?
70472 is the cerebral perfusion analysis variant that includes CT and CTA. 70473 is the related variant without CT and/or CTA; select according to the imaging actually performed and the code descriptor.
Can 70472 be billed by itself?
No. CMS identifies it as an add-on code, so it must be reported with its designated primary procedure.
Can the radiologist and imaging facility bill separate components?
Yes. The interpreting physician may report modifier 26, and the entity providing the equipment and staff may report modifier TC. Without either modifier, the claim represents the global service.
What documentation supports reporting 70472?
Document the contrast-enhanced cerebral perfusion acquisition, the CT and CTA imaging, the perfusion postprocessing, and the interpretation. The record should also identify the associated primary procedure.
How does CMS treat the add-on payment period?
CMS pays 70472 within the global period of its primary procedure. Report it only in conjunction with that primary service.
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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