CPT 70472
Global ZZZ ActiveCt cere prfu alys c+w/ct/cta
CPT 70472 Billing & Documentation Guide
CPT code 70472 (Ct cere prfu alys c+w/ct/cta) is classified under Radiology with a global period indicator of ZZZ. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 0.77, a non-facility practice expense RVU of 3.85, and a malpractice RVU of 0.06, a total non-facility RVU of 4.68 and facility RVU of 4.68. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $162.16, though rates vary from $137.21 to $215.05 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 70472, 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 current NCCI edits before bundling with related codes.
Payment Status & Global Period
Active code (paid under MPFS)
Add-on code (global concept does not apply)
MUE Limit (Medically Unlikely Edits)
Submitting more than 1 units of 70472 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 70472
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 0.77 | 0.77 |
| Practice Expense RVU | 3.85 | 3.85 |
| Malpractice RVU | 0.06 | 0.06 |
| Total RVU | 4.68 | 4.68 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 70472
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 | $179.89 | $179.89 | $168.17 - $215.05 | 29 |
| Florida | $158.64 | $158.64 | $151.67 - $164.65 | 3 |
| Georgia | $150.83 | $150.83 | $142.81 - $158.85 | 2 |
| Illinois | $153.89 | $153.89 | $146.26 - $161.52 | 4 |
| Michigan | $149.29 | $149.29 | $145.39 - $153.19 | 2 |
| North Carolina | $146.98 | $146.98 | $146.98 - $146.98 | 1 |
| New York | $173.12 | $173.12 | $149.29 - $183.98 | 5 |
| Ohio | $145.14 | $145.14 | $145.14 - $145.14 | 1 |
| Pennsylvania | $154.05 | $154.05 | $145.66 - $162.44 | 2 |
| Texas | $154.32 | $154.32 | $144.6 - $163.6 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
Frequently Asked Questions, CPT 70472
What does CPT code 70472 mean? +
CPT code 70472 represents: Ct cere prfu alys c+w/ct/cta. It's in the Radiology category with a global period of ZZZ.
What is the Medicare reimbursement for CPT 70472? +
The 2026 Medicare national average non-facility payment for CPT 70472 is $162.16. Rates range from $137.21 to $215.05 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 70472? +
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 70472? +
No NCCI PTP edits currently on file for this code.
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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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