MRI of one or both temporomandibular joints to evaluate the disc, condyle, and surrounding soft tissue.
- Medicare
- $259.19
- Work RVU
- 1.44
- 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 ↓
- Jaw symptoms and exam findings
- Conservative treatment tried before imaging
- Clinical question for the study
- Signed interpretation
- Prior authorization number
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 ↓
70336 covers MRI of the temporomandibular joint. It is reported once whether one or both joints are scanned, since both are usually imaged in the same session. MRI is the standard test for TMJ disc displacement, joint effusion, and condylar changes.
Ortho practices rarely order TMJ MRI, but it can come up in rheumatology-heavy practices with inflammatory arthritis that involves the jaw, or with jaw trauma alongside other fractures. Practices with their own MRI bill the global code. Otherwise the reading physician bills with 26 and the facility bills TC.
Most commercial plans require prior authorization for MRI, and some carve out TMJ treatment from medical coverage entirely. Document the jaw symptoms, exam findings, and the conservative treatment tried, such as splints or anti-inflammatories, before the scan was ordered.
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 (1.44) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (7.76) adds practice overhead and malpractice, and is what drives the Medicare payment below.
| Work RVU | 1.44 |
| Practice expense RVU | 6.23 |
| Malpractice RVU | 0.09 |
| Total RVU | 7.76 |
| Medicare national rate | $259.19 |
| 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 | $259.19 |
HOPD (APC 5523) Hospital outpatient department | $243.77 |
Common denial reasons
The recurring reasons claims for CPT 70336 get rejected.
Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓
- No prior authorization
- Plan excludes TMJ services
- Billed twice for bilateral joints
- Conservative care not documented
- No signed interpretation
- Global billed by a provider who only read the study
Frequently asked questions
Source · Generated from the editorial pipeline, verified against 2 cited references ↓
01Is 70336 billed once for both TMJs?
02Does TMJ MRI need prior authorization?
03Which modifiers split 70336 between facility and reader?
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 the symptoms, exam, and failed conservative treatment behind an MRI order, which is what prior authorization reviewers check first.
See how Mira captures CPT 70336 documentation