CPT 70260
Global XXX ActiveX-ray exam of skull
CPT 70260 Billing & Documentation Guide
CPT code 70260 (X-ray exam of skull) is classified under Radiology with a global period indicator of XXX. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 0.27, a non-facility practice expense RVU of 1.02, and a malpractice RVU of 0.02, a total non-facility RVU of 1.31 and facility RVU of 1.31. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $45.33, though rates vary from $38.63 to $59.5 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 70260, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 70260 with related codes; this code has 5 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
No global period (E/M and other non-procedural services)
MUE Limit (Medically Unlikely Edits)
Submitting more than 1 units of 70260 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 70260
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 0.27 | 0.27 |
| Practice Expense RVU | 1.02 | 1.02 |
| Malpractice RVU | 0.02 | 0.02 |
| Total RVU | 1.31 | 1.31 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 70260
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $50.02 | $50.02 | $46.87 - $59.5 | 29 |
| Florida | $44.5 | $44.5 | $42.59 - $46.17 | 3 |
| Georgia | $42.33 | $42.33 | $40.2 - $44.46 | 2 |
| Illinois | $43.25 | $43.25 | $41.17 - $45.25 | 4 |
| Michigan | $41.95 | $41.95 | $40.88 - $43.02 | 2 |
| North Carolina | $41.23 | $41.23 | $41.23 - $41.23 | 1 |
| New York | $48.36 | $48.36 | $41.85 - $51.34 | 5 |
| Ohio | $40.8 | $40.8 | $40.8 - $40.8 | 1 |
| Pennsylvania | $43.18 | $43.18 | $40.92 - $45.44 | 2 |
| Texas | $43.23 | $43.23 | $40.64 - $45.67 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 70260
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 70260 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 36591 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 36592 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 70250 | Column 1 (primary), can be billed with modifier | No | HCPCS/CPT procedure code definition |
| 96523 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 77075 | Column 2 (secondary), bundled into primary | Yes | Standards of medical/surgical practice |
Frequently Asked Questions, CPT 70260
What does CPT code 70260 mean? +
CPT code 70260 represents: X-ray exam of skull. It's in the Radiology category with a global period of XXX.
What is the Medicare reimbursement for CPT 70260? +
The 2026 Medicare national average non-facility payment for CPT 70260 is $45.33. Rates range from $38.63 to $59.5 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 70260? +
Radiology codes rely heavily on the professional/technical split: modifier 26 (professional component only) and TC (technical component only). Also common: 50 (bilateral imaging), 76 (repeat by same physician), 77 (repeat by different physician), and LT/RT for laterality.
What bundling edits apply to CPT 70260? +
This code has 5 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on June 1, 2026.
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