Billing code 70490: Neck CTMedicare rate & RVUs in Washington
CT of the neck’s soft tissues without contrast, reported when the diagnostic question calls for cross-sectional imaging without contrast material.
Medicare pays $155.12–$175.12 for 70490 in the office in Washington, from Rest Of Washington to Seattle (King Cnty). 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 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 in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | $155.12 | Unavailable |
| Seattle (King Cnty) | $175.12 | Unavailable |
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.
How the rate is built · 70490
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 1.25Practice expense 3.15Malpractice 0.08
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 70490
The CMS indicators that decide how 70490 is paid alongside other services.
CMS payment indicators · 70490
Neck CT
| 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
70490 without 26 · national office
$149.64
Neck CT
70490-26 · Professional component
$59.12
Pays only the interpretation and report.
70490 compared with similar codes
Compare codes
70490 vs 70491 vs 70492 vs 70498: national Medicare rates
Swap in your local Medicare rate.
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.
70490 billing questions
When should 70490 be chosen over 70491?
Use 70490 for a neck soft-tissue CT performed without contrast. Use 70491 when contrast is administered for the examination.
How does 70490 differ from 70492?
70492 represents a neck soft-tissue CT performed both without and with contrast. 70490 represents the noncontrast examination only.
Can the professional and technical services be billed separately?
Yes. Modifier 26 identifies the professional interpretation, and modifier TC identifies the technical service, including equipment and staff. Billing without a modifier represents the global service.
What documentation supports reporting 70490?
The order and imaging report should identify the neck soft tissues as the imaged area and support that the examination was performed without contrast.
How does the multiple-procedure reduction affect this code?
When multiple diagnostic imaging procedures are reported, the CMS imaging multiple-procedure reduction applies to the professional and technical components of 70490.
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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