Computed tomography, maxillofacial area; without contrast material

CPT 70486 is the billing code for "Computed tomography, maxillofacial area; without contrast material". For CT maxillofacial area without contrast

Medicare pays approximately $126.15 for CPT 70486 (national average). Actual payment varies by geographic location due to GPCI adjustments. Hospital and commercial insurance rates are typically 2-4x higher than Medicare rates.

CPT 70486 has a total RVU of 8.90, broken down as: Work RVU 1.00, Practice Expense RVU 7.80, and Malpractice RVU 0.10. RVUs (Relative Value Units) determine Medicare reimbursement rates.

Key documentation requirements for CPT 70486 include: Indication for CT maxillofacial; Without contrast; Findings and interpretation; Comparison to prior studies if available. Missing or incomplete documentation is a leading cause of claim denials for this code.

Bundling considerations for CPT 70486: Includes CT maxillofacial without contrast. Includes interpretation and report Use an NCCI bundling checker to verify specific code combinations before billing.

Common modifiers for CPT 70486 include: 26 (Professional component only (interpretation)), TC (Technical component only (equipment/staff)), 59 (Distinct procedural service if performed separately). Modifiers indicate special circumstances and can affect reimbursement or prevent claim denials.

The typical time requirement for CPT 70486 is 15-20 minutes typical procedure time. Time-based codes require documentation of the actual time spent providing the service.