Non-contrast CT focused on a small region of the skull: the orbits, the sella, the posterior fossa, or the outer, middle, or inner ear.
- Medicare
- $158.32
- Work RVU
- 1.25
- Global, days
- Region
- Other
Documentation requirements
What must appear in the operative or office note to support the claim.
Source · Editorial brief grounded in 3 cited references ↓
- Order naming the specific region, such as orbits or temporal bone
- Clinical reason, such as orbital trauma or hearing loss after head injury
- Report that addresses the targeted region
- Separate orders and reports when billed with another head or face CT
- Mechanism of injury for trauma cases
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 3 cited references ↓
70480 is a targeted CT of a small skull region without contrast. The covered areas are the orbits, the sella turcica, the posterior fossa, and the ear structures. It is used for orbital fractures, foreign bodies in the eye, temporal bone fractures, and some skull base questions.
An orthopedic practice almost never orders it. You may see it on a polytrauma patient whose face or temporal bone was involved in the same accident as the fractures your surgeon is fixing. Radiology and the facility bill it. Your practice's job is to keep it off your claims and to know it exists when reconciling a trauma admission.
The frequent error is picking the wrong head code. A full head CT is 70450, not 70480, and a facial bone CT is 70486. If the radiologist reads the orbits as part of a maxillofacial study, that is still one code, not two. Billing 70480 alongside 70486 for the same scan will usually fail an edit or an audit unless the two studies were separately ordered and performed.
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 (1.25) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (4.74) adds practice overhead and malpractice, and is what drives the Medicare payment below.
| Work RVU | 1.25 |
| Practice expense RVU | 3.4 |
| Malpractice RVU | 0.09 |
| Total RVU | 4.74 |
| Medicare national rate | $158.32 |
| 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 | $158.32 |
HOPD (APC 5522) Hospital outpatient department | $106.81 |
Common denial reasons
The recurring reasons claims for CPT 70480 get rejected.
Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓
- Billed with 70486 for a single facial scan
- Wrong code chosen when a full head CT was performed
- Diagnosis does not match the targeted region
- No separate order for a second CT billed the same day
- Global billed in a facility setting
Frequently asked questions
Source · Generated from the editorial pipeline, verified against 3 cited references ↓
01What areas does CPT 70480 cover?
02Can 70480 and 70486 be billed together?
03Is 70480 used for orbital fractures?
Sources & references
Editorial content was developed using the following public sources.
Mira Scribe
In trauma consults, Mira Scribe records which injuries belong to orthopedics and which were handed to other services, which keeps the surgeon's charges clean.
See how Mira captures CPT 70480 documentation