CPT CODERadiologyStatus A

CPT Code 70472Complete Billing & Coding Guide (2026)Ct cere prfu alys c+w/ct/cta

Reviewed by AAPC-Certified Coders2026 Medicare Fee ScheduleCMS + AMA Sources
Medicare Payment
$156
Non-facility · National avg
Facility
$156
Total RVU
4.68
Global
ZZZ
Payment
$156
non-facility
Work RVU
0.77
physician effort
Global Period
ZZZ
post-op days
Bundling Edits
0
none found

About CPT 70472

CPT 70472 is a Current Procedural Terminology code in the Radiology category maintained by the American Medical Association. The CMS short descriptor reads "Ct cere prfu alys c+w/ct/cta". For the full AMA long descriptor and clinical guidance, refer to the current CPT code manual.

Add-on codes cannot be billed alone and inherit their global period from the primary procedure. Payer scrubbers will reject add-on codes submitted without a valid base code on the same claim.

Pro Tip

Verify the current CMS National Physician Fee Schedule and any local Medicare Administrative Contractor LCDs before billing 70472. Commercial payer medical policies can impose additional bundling, prior authorization, or documentation requirements beyond national rules.

Code Properties

Global Period
ZZZ
Add-on code (global period matches base procedure)
Status Indicator
A
Active. Payment under Medicare PFS.
Conversion Factor
$33.4009
CMS national rate
Effective Date
2026-04-01
per CMS publication

RVU Breakdown

Every CPT code’s Medicare payment is calculated from three Relative Value Unit components: physician work, practice expense, and malpractice. Together they multiply by the conversion factor to produce the payment amount.

RVU Composition
4.68 total RVU
0.77
3.85
Work RVU
0.77 · 16%
Physician time + skill
Practice Expense
3.85 · 82%
Office & equipment
Malpractice
0.06 · 1%
Liability insurance
Non-Facility
Private office · urgent care · ambulatory
Most billed
$156.32
4.68 RVU × $33.4009 CF
Facility
Hospital · ASC · nursing home
$156.32
4.68 RVU × $33.4009 CF

Payment = Total RVU × Conversion Factor ($33.4009) × Geographic Adjustment (GPCI). National averages shown. Actual payment varies by locality.

Medicare Payment by State

Medicare adjusts payment by locality based on GPCI (Geographic Practice Cost Index). Higher cost-of-living areas like California and New York pay more. Rural states pay less. Top 12 states shown.

DC
$181
CA
$180
AK
$177
WA
$175
NJ
$174
NY
$173
HI
$173
MA
$173
CT
$167
CO
$164
OR
$163
MD
$162

Showing top 12 of 53 states. Full locality data available in CMS PFS Locality file.

Applicable Modifiers

Modifiers commonly paired with 70472 based on its category. Apply only when the clinical circumstance warrants. Incorrect modifier use is a top audit target.

26
Professional component — physician interpretation/report only (no technical component)
When to use · When the physician only interprets/reads a diagnostic test performed by another entity (e.g., reading an echo performed at a hospital).
33
Preventive services — when the primary purpose is delivery of an evidence-based service per USPSTF A or B recommendation
When to use · Screening services (colonoscopy, mammography, etc.) to indicate the primary purpose is preventive. Waives cost-sharing under ACA.
76
Repeat procedure or service by same physician
When to use · When the same physician repeats the exact same procedure on the same day (e.g., repeat EKG after treatment, repeat X-ray after reduction).
77
Repeat procedure by another physician
When to use · When a different physician repeats the same procedure on the same day.
91
Repeat clinical diagnostic laboratory test on the same day for the same patient
When to use · When the same lab test is repeated on the same day for clinical reasons (not equipment malfunction).
GA
Waiver of liability statement issued as required by payer policy (ABN on file)
When to use · Medicare: when an Advance Beneficiary Notice (ABN) has been signed by the patient for services that may not be covered.
GY
Item or service statutorily excluded or does not meet the definition of any Medicare benefit
When to use · Service is never covered by Medicare (e.g., cosmetic procedures). May bill patient directly.
GZ
Item or service expected to be denied as not reasonable and necessary — no ABN on file
When to use · When a service is expected to be denied by Medicare and no ABN was obtained. Provider cannot bill the patient.
AR Recovery Note

Component split modifiers (26 professional, TC technical) are the most under-applied modifiers in diagnostic billing. Practices that bill global on services where they only provided the read silently invite refund requests. We split components correctly at submission.

Supporting ICD-10 Diagnoses

These diagnosis codes commonly support medical necessity for CPT 70472. Using the correct ICD-10 prevents CARC 50 denials. Payer rejects when the diagnosis doesn’t support the procedure.

1
CMS LCD: Billing and Coding: Computed Tomography Cerebral Perfusion Analysis (CTP)
CMS LCD
G43.401See ICD-10-CM tabular index
G43.409See ICD-10-CM tabular index
G43.411See ICD-10-CM tabular index
G43.419See ICD-10-CM tabular index
G45.1See ICD-10-CM tabular index
G46.0See ICD-10-CM tabular index
G81.01See ICD-10-CM tabular index
G81.02See ICD-10-CM tabular index
G81.03See ICD-10-CM tabular index
G81.04See ICD-10-CM tabular index
G81.91See ICD-10-CM tabular index
G81.92See ICD-10-CM tabular index
AR Recovery Note

Imaging CO-50 denials trace to medical-policy criteria mismatches. Cardiac MRI, cardiac CT, nuclear cardiology, and advanced imaging all face strict commercial payer policies. We pre-verify the indication against the payer's policy before submission, not after the denial.

Free 90-Day AR Recovery Audit

Find the revenue leakage in your 70472 claims.

Wrong modifier, missing documentation, bundling without justification, stale ICD-10 linkage: these are the silent revenue killers on Radiology claims. Our AAPC-certified team audits your last 90 days of 70472 claims, surfaces the recoverable dollars, and appeals them. Free, no obligation.

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FAQ

Everything about CPT 70472

What does CPT code 70472 cover?

CPT 70472 is a Current Procedural Terminology code in the Radiology category maintained by the American Medical Association. The CMS short descriptor reads "Ct cere prfu alys c+w/ct/cta". For the full AMA long descriptor and clinical guidance, refer to the current CPT code manual.

What is the Medicare payment for CPT 70472?

The national average Medicare payment for CPT 70472 is approximately $156.32 in a non-facility setting and $156.32 in a facility setting. Actual payment varies by locality based on GPCI adjustments. Total RVU is 4.68 with a conversion factor of $33.4009.

What is the global period for CPT 70472?

CPT 70472 is an add-on code (indicator ZZZ). Its global period matches the base procedure it's billed with. Cannot be billed alone. Must be paired with a primary code per CPT guidelines.

CMS Medicare Physician Fee ScheduleNCCI Edits · Current QuarterAMA CPT Code Set

CPT codes and descriptions are copyright of the American Medical Association. RVU values reflect current CMS publications. Actual payment varies by locality. Commercial payer rates vary by contract.

Free 90-Day AR Recovery Audit

We audit your last 90 days of claims and surface the revenue leakage: wrong modifiers, missed bundling appeals, ICD-10 specificity gaps. AAPC-certified coders. 2.49% of collections. No setup fees.