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See a sample rate comparisonCPT 70190 Fee Schedule
Last Verified: September 2026
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
X-Ray; Optic Foramina
| Key Fact | Detail |
|---|---|
| Service Type | Radiology Procedures Diagnostic Radiology (Diagnostic Imaging) Procedures |
| Common Place of Service | 11 - Office None |
| Common Modifiers | None 26 - Professional component TC - Technical component |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 70190 |
| Medicaid Fee Schedule | View Medicaid rates for 70190 |
National average reimbursement for CPT 70190 by major payers:
$45.07
$42.87
$42.30
$53.62
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CPT 70190
5 of 25 sample ratesHigher to lower in this preview
Christopher Raio
Mercy Medical Center
$59.35Published rateChristopher Raio
Mercy Medical Center
$42.68Published rateBrianne Snider
Northern Arizona Healthcare Corporation
$27.43Published rateChristopher Raio
Mercy Medical Center
$14.36Published rateGregory Duhon
Northern Arizona Healthcare Corporation
$11.55Published rate
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See a sample payer proposalCPT 70190 vs. Other Diagnostic Radiology (Diagnostic Imaging) Procedures Codes
The CPT 70190 code is part of the Radiology Procedures services used for Diagnostic Radiology (Diagnostic Imaging) Procedures. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 70190 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 70190. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 70190 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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