How much does Medicare pay for CPT 70486?

Medicare allowed an average of $61.51 per service and paid $46.25 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $377.68, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 70486?

Ct scan of face without contrast. It was billed 457,630 times to 445,790 Medicare beneficiaries by 13,292 providers in 2024.

Does 70486 pay differently in an office than a hospital?

Yes. The allowed amount averaged $106.47 in an office setting and $38.68 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 70486 most?

Diagnostic Radiology, with 367,726 services from 11,113 clinicians. Next are Otolaryngology, Independent Diagnostic Testing Facility (IDTF), Interventional Radiology.

CPT 70486

Ct scan of face without contrast

$61.51Medicare-allowed amount per service, averaged across 457,630 services

Providers submitted

$377.68

Asking price, not received

Medicare allowed

$61.51

The fee schedule figure

Medicare paid

$46.25

Balance is patient coinsurance

Providers submitted an average of $377.68 for this code and Medicare allowed $61.51 — 6.1× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $46.25 (75%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $106.47
Hospital / facility: $38.68

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 154,150 services were billed in an office setting and 303,480 in a facility.

Services: 457,630
Beneficiaries: 445,790
Providers billing it: 13,292
Total allowed: $28,148,821

What Medicare pays for CPT 70486

Across 457,630 services billed by 13,292 providers to 445,790 beneficiaries, Medicare allowed an average of $61.51 per service. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 70486

Specialty	Services	Beneficiaries	Avg allowed	Providers
Diagnostic Radiology	367,726	361,953	$50.61	11,113
Otolaryngology	61,259	56,218	$116.70	1,282
Independent Diagnostic Testing Facility (IDTF)	11,077	10,614	$114.20	290
Interventional Radiology	8,024	7,987	$45.26	310
Oral Surgery (Dentist only)	1,756	1,600	$64.81	51
Physician Assistant	1,615	1,525	$83.00	44
Nurse Practitioner	880	842	$98.90	33
Allergy/ Immunology	677	633	$114.63	21
Dentist	602	595	$106.68	11
Nuclear Medicine	560	555	$51.33	18
Internal Medicine	516	511	$73.33	20
Maxillofacial Surgery	513	476	$55.89	20
Radiation Oncology	510	460	$53.86	15
Ophthalmology	331	328	$134.66	1
Family Practice	315	290	$83.67	13

70486 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
California	42,498	$74.07	$49.38	1,188
Florida	39,473	$75.04	$56.35	960
Texas	38,953	$67.64	$51.44	1,057
New York	28,064	$64.92	$43.21	670
Illinois	20,593	$60.25	$43.68	567
Pennsylvania	16,556	$47.25	$33.88	531
North Carolina	14,424	$57.57	$44.05	457
Minnesota	13,834	$53.85	$38.94	484
Georgia	13,416	$69.16	$52.60	398
Virginia	12,548	$51.32	$37.11	348
Tennessee	12,196	$58.98	$46.54	385
Maryland	11,932	$72.17	$49.75	280
Ohio	11,909	$44.78	$33.41	420
Massachusetts	11,564	$48.10	$33.04	341
New Jersey	11,170	$71.01	$47.78	314
Missouri	10,886	$48.09	$36.86	330
Arizona	10,480	$67.43	$50.82	250
Michigan	9,808	$43.03	$31.34	327
Colorado	9,603	$61.26	$43.01	261
South Carolina	9,480	$66.58	$52.64	270
Alabama	9,407	$58.14	$47.37	287
Indiana	7,630	$52.96	$40.50	244
Washington	7,192	$57.71	$39.69	226
Louisiana	6,734	$59.22	$46.95	240
Kansas	6,721	$66.43	$53.83	160
Wisconsin	6,384	$51.43	$37.98	239
Mississippi	6,131	$66.32	$54.66	150
Oklahoma	5,363	$49.80	$38.29	164
Connecticut	4,548	$51.41	$36.09	155
Arkansas	4,270	$46.35	$36.74	137
Kentucky	4,115	$48.04	$36.79	147
Nevada	3,863	$74.44	$56.03	112
Nebraska	3,804	$47.29	$36.95	110
Iowa	3,772	$48.57	$37.35	131
Oregon	3,419	$56.68	$41.12	118
Utah	3,152	$66.02	$51.48	114
West Virginia	2,315	$42.94	$31.13	85
District of Columbia	2,008	$62.07	$42.70	48
New Hampshire	1,951	$40.94	$29.29	80
Rhode Island	1,749	$54.72	$38.18	63
Idaho	1,676	$52.63	$40.09	56
Maine	1,674	$53.99	$37.33	38
Montana	1,638	$77.37	$56.86	58
New Mexico	1,598	$53.52	$39.34	54
Delaware	1,524	$50.73	$36.53	36
Hawaii	1,048	$54.23	$38.24	40
North Dakota	1,030	$50.84	$37.57	36
Alaska	912	$80.91	$50.60	30
Wyoming	748	$67.89	$51.28	29
Vermont	683	$38.87	$27.44	19
South Dakota	621	$44.41	$32.96	25
Puerto Rico	346	$56.38	$41.82	15
AA	83	$37.99	$29.71	2
AP	43	$41.39	$26.43	2
XX	36	$39.87	$25.72	1
Guam	33	$40.14	$27.83	2

Related codes

70450Ct scan head or brain without contrast$40.22
70498Ct scan of blood vessels of neck$80.79
70496Ct scan of blood vessels of head$84.13
70491Ct scan of soft tissue of neck$81.73
70480Ct scan of cranial cavity without contrast$109.74
70470Ct scan of head or brain before and after contrast$83.98
70490Ct scan of soft tissue of neck without contrast$78.66
70492Ct scan of soft tissue of neck before and after contrast$150.79
70487Ct scan of face$57.47
70460Ct scan head or brain$68.11

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.