CPT 71260
Global XXX ActiveCt thorax dx c+
CPT 71260 Billing & Documentation Guide
CPT code 71260 (Ct thorax dx c+) is classified under Radiology with a global period indicator of XXX. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 1.13, a non-facility practice expense RVU of 3.77, and a malpractice RVU of 0.09, a total non-facility RVU of 4.99 and facility RVU of 4.99. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $172.5, though rates vary from $147.46 to $225.08 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 71260, 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 71260 with related codes; this code has 10 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 2 units of 71260 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 71260
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 1.13 | 1.13 |
| Practice Expense RVU | 3.77 | 3.77 |
| Malpractice RVU | 0.09 | 0.09 |
| Total RVU | 4.99 | 4.99 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 71260
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 | $189.73 | $189.73 | $178.01 - $225.08 | 29 |
| Florida | $169.94 | $169.94 | $162.64 - $176.43 | 3 |
| Georgia | $161.53 | $161.53 | $153.65 - $169.4 | 2 |
| Illinois | $165.29 | $165.29 | $157.41 - $172.66 | 4 |
| Michigan | $160.22 | $160.22 | $156.1 - $164.33 | 2 |
| North Carolina | $157.15 | $157.15 | $157.15 - $157.15 | 1 |
| New York | $184.1 | $184.1 | $159.48 - $195.46 | 5 |
| Ohio | $155.74 | $155.74 | $155.74 - $155.74 | 1 |
| Pennsylvania | $164.64 | $164.64 | $156.18 - $173.09 | 2 |
| Texas | $164.71 | $164.71 | $155.12 - $173.71 | 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 71260
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 71260 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 01922 | Column 1 (primary), can be billed with modifier | No | Anesthesia service included in surgical procedure |
| 0558T | Column 1 (primary), can be billed with modifier | Yes | CPT Manual or CMS manual coding instruction |
| 0708T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 0709T | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 36000 | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 36005 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 36011 | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 36406 | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 36410 | Column 1 (primary), can be billed with modifier | Yes | Standards of medical/surgical practice |
| 36591 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
Frequently Asked Questions, CPT 71260
What does CPT code 71260 mean? +
CPT code 71260 represents: Ct thorax dx c+. It's in the Radiology category with a global period of XXX.
What is the Medicare reimbursement for CPT 71260? +
The 2026 Medicare national average non-facility payment for CPT 71260 is $172.5. Rates range from $147.46 to $225.08 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 71260? +
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 71260? +
This code has 10 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 May 31, 2026.
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