CPT 70496 Fee Schedule
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.
| Key Fact | Detail |
|---|---|
| Service Type | • Radiology Procedures • Diagnostic Radiology (Diagnostic Imaging) Procedures |
| Common Place of Service | • 23 - Emergency Room • 21 - Inpatient Hospital |
| Common Modifiers | • None • 26 - Professional component • TC - Technical component |
| Complexity Level | Moderate |
National average reimbursement for CPT 70496 by major payers:
$341.25
$444.72
$431.79
$520.01
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 70496 | ||||||
United | 70496 | $945.58 | 1801938048 - SWEDISH FIRST HILL DIAGNOSTIC IMAGING, LLC | 208378242 - (WA) SWEDISH FIRST HILL DIAGNOSTIC IMAGING LLC | WA | Diagnostic Radiology Physician (2085R0202X) |
United | 70496 | $383.86 | 1275596926 - EDWARD SULLIVAN | 630581180 - (AL) UROLOGY CENTERS OF ALABAMA PC | AL | Diagnostic Radiology Physician (2085R0202X) |
United | 70496 | $625.46 | 1972563971 - KURT TECH | 822768899 - BEAUMONT MEDICAL GROUP - HOSPITAL-BASED SERVICES | MI | Diagnostic Radiology Physician (2085R0202X) |
United | 70496 | $276.70 | 1255320727 - NORTHEAST RADIOLOGY PC | 133910669 - ALYESKA IMAGING CENTER INC / NORTHEAST RADIOLOGY / NORTHEAST RADIOLOGY OF CONNECTICUT LLC | NY | Diagnostic Radiology Physician (2085R0202X) |
United | 70496 | $482.16 | 1326156282 - JAMES HILL | 820301061 - (ID) BOISE RADIOLOGY GROUP PLLC | ID | Diagnostic Radiology Physician (2085R0202X) |
United | 70496 | $548.75 | 1417905522 - DANIEL LUCAS | 850278235 - NOR-LEA HOSPITAL DISTRICT | AZ | Body Imaging Physician (2085B0100X) |
United | 70496 | $1122.63 | 1124018890 - FRANCINE JACOBSON | 42312909 - MASS GENERAL BRIGHAM INCORPORATED | VA | Diagnostic Radiology Physician (2085R0202X) |
United | 70496 | $918.76 | 1023338282 - ROBERT HOSKER | 411293970 - RANGE REGIONAL HEALTH SERVICES | MN | Diagnostic Radiology Physician (2085R0202X) |
United | 70496 | $1094.82 | 1578636304 - BERNDT SCHMIT | 522220700 - MEDICAL FACULTY ASSOCIATES INC | TX | Diagnostic Radiology Physician (2085R0202X) |
United | 70496 | $267.01 | 1841683281 - PECONIC BAY MEDICAL SERVICES, P.C. | 472151802 - (NY) PECONIC BAY MEDICAL SERVICES PC | NY | Diagnostic Radiology Physician (2085R0202X) |
United | 70496 | $194.96 | 1972590438 - JOHN LYONS | 273004594 | NJ | Diagnostic Radiology Physician (2085R0202X) |
United | 70496 | $700.85 | 1306378245 - CORY MALONE | 956419205 - (CA) SANSUM CLINIC | MO | Diagnostic Radiology Physician (2085R0202X) |
United | 70496 | $331.48 | 1326033366 - JENNIFER KIM | 463166765 - (ME) RADIOLOGY ALLIANCE OF MAINE LLC | MN | Diagnostic Radiology Physician (2085R0202X) |
United | 70496 | $764.77 | 1235451659 - PETER HARRI | 582030692 - EMORY UNIVERSITY | GA | Diagnostic Radiology Physician (2085R0202X) |
United | 70496 | $361.61 | 1790891596 - SINA HAZNECI | 341933718 - NORTHERN OHIO MEDICAL SPECIALISTS, LLC | OH | Diagnostic Radiology Physician (2085R0202X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 70496 vs. Other Diagnostic Radiology (Diagnostic Imaging) Procedures Codes
The CPT 70496 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 70496 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.
| Code | Complexity | Description |
|---|---|---|
| 70481 | Moderate | Ct,Orbit,Sella,Fossa,Ear;W/Contrast |
| 70482 | Moderate | Computerized Axial Tomography Orbit Sella Or Posterior Fossa Or Outer Middle Or Inner Ear; Without Contrast Material Followed By Contrast Material(S) And Further Sections |
| 70496 | Moderate | Computed Tomographic Angiography Head With Contrast Material(S) Including Noncontrast Images If Performed And Image Postprocessing Essing |
| 70498 | Moderate | Computed Tomographic Angiography Neck With Contrast Material(S) Including Noncontrast Images If Performed And Image Postprocessing Essing |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 70496. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 70496 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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