Imaging · Other

70488

Facial bone and sinus CT performed in one session with a non-contrast series followed by a series after intravenous contrast.

3 sources ↓

Medicare
$184.04
Work RVU
1.24
Global, days
Region
Other
Drawn from CMS

Documentation requirements

What must appear in the operative or office note to support the claim.

Source · Editorial brief grounded in 3 cited references ↓

  • Order explaining why both phases are needed
  • Contrast agent, dose, and injection time
  • Report describing both the pre and post contrast images
  • Reason documented if the contrast phase was stopped
  • Authorization matching the two-phase code

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 ↓

70488 is the two-phase facial CT: images without contrast, then images with contrast, in the same session. It is used for tumors, complex infections, and some vascular questions in the face.

For orthopedic practices it is a reconciliation code, not a billing code. You might see it in the chart of a cancer patient with bone metastases or a patient with a head and neck tumor who also has a pathologic fracture. Radiology owns the code.

The errors are predictable. Some systems generate 70486 and 70487 when both phases run, which is an unbundle that payer edits will stop. Report 70488 once. If the contrast phase was cancelled, drop to 70486 and make sure the report explains it. Prior authorization from a radiology benefit manager should name 70488 itself, because an approval for one phase does not carry over to the two-phase code.

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 (1.24) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (5.51) adds practice overhead and malpractice, and is what drives the Medicare payment below.

Work RVU 1.24
Practice expense RVU 4.18
Malpractice RVU 0.09
Total RVU 5.51
Medicare national rate $184.04
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

SettingMedicare rate (national)
Office (PFS non-facility)
Procedure performed in physician's office
$184.04
HOPD (APC 5571)
Hospital outpatient department
$179.20

Common denial reasons

The recurring reasons claims for CPT 70488 get rejected.

Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓

  • 70486 and 70487 billed together instead of 70488
  • Only one phase performed
  • Authorization obtained for a single-phase code
  • Diagnosis does not support contrast
  • Professional and technical components billed incorrectly

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 3 cited references ↓

01Can 70486 and 70487 be billed together?
No. A facial CT with both phases is reported as 70488.
02What if the contrast phase was not completed?
Bill 70486 and document why contrast was not given.
03Is 70488 used for facial fractures?
Rarely. Fractures are imaged without contrast, which is 70486.

Sources & references

Editorial content was developed using the following public sources.

  1. 01CMS Physician Fee Schedule 2026
  2. 02
    cms.gov
    https://www.cms.gov/medicare/payment/fee-schedules/physician
  3. 03
    cms.gov
    https://www.cms.gov/medicare/coding-billing/national-correct-coding-initiative-ncci-edits

Mira Scribe

Mira Scribe keeps the surgeon's note focused on orthopedic findings and referrals, so imaging performed for other specialties is clearly attributed in the record.

See how Mira captures CPT 70488 documentation

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