Plain radiographs of the skull with fewer than four views, used to look for fracture, lesion, or foreign body.
- Medicare
- $35.74
- Work RVU
- 0.18
- Global, days
- Region
- Other
Documentation requirements
What must appear in the operative or office note to support the claim.
Source · Editorial brief grounded in 2 cited references ↓
- Number and type of views taken
- Clinical indication
- Signed interpretation report
- Ordering provider
- Comparison to prior imaging if available
Applicable modifiers
Modifiers commonly billed with this code.
Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual
What this code covers
Source · Editorial summary grounded in 2 cited references ↓
70250 covers a limited skull x-ray series of fewer than four views. 70260 is the complete study with four or more views. CT has replaced plain skull films for most head trauma, so this code is used far less than it once was.
Ortho practices rarely order skull films. They may come up in a trauma clinic for a facial or skull injury alongside an extremity fracture, or in a practice that screens for lytic lesions in a myeloma or metastatic workup. If the practice owns the x-ray equipment and a physician reads the films, bill the global code. If the reading is done elsewhere, split it with modifier 26 for the reading and TC for the technical component.
The report needs to state the number of views, because that decides 70250 versus 70260. Payers expect a clinical reason, not a screening order.
RVU & reimbursement
Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.
Source · CMS Physician Fee Schedule, RVU26A · January 2026
Work RVU vs. total RVU
The work RVU (0.18) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (1.07) adds practice overhead and malpractice, and is what drives the Medicare payment below.
| Work RVU | 0.18 |
| Practice expense RVU | 0.87 |
| Malpractice RVU | 0.02 |
| Total RVU | 1.07 |
| Medicare national rate | $35.74 |
| Global period | days |
Payment by site of service
Medicare pays different rates by setting. HOPD typically pays substantially more than ASC for the same procedure.
Source · CMS OPPS Addendum B·ASC HCPCS payment rates·2026
| Setting | Medicare rate (national) |
|---|---|
Office (PFS non-facility) Procedure performed in physician's office | $35.74 |
HOPD (APC 5522) Hospital outpatient department | $106.81 |
Common denial reasons
The recurring reasons claims for CPT 70250 get rejected.
Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓
- Views documented support the complete code or fewer
- No signed interpretation
- Global billed when reading was done by another provider
- Screening indication without symptoms
- Duplicate billing with CT on the same day without support
Frequently asked questions
Source · Generated from the editorial pipeline, verified against 2 cited references ↓
01What is the difference between 70250 and 70260?
02Can an orthopedic practice bill 70250?
03When are modifiers 26 and TC used with skull x-rays?
Sources & references
Editorial content was developed using the following public sources.
- 01CMS Physician Fee Schedule 2026
- 02cms.govhttps://www.cms.gov/medicare/payment/fee-schedules/physician
Mira Scribe
Mira Scribe notes record why the imaging was ordered, so the indication on the claim matches the clinical story.
See how Mira captures CPT 70250 documentation