How much does Medicare pay for CPT 70491?

Medicare allowed an average of $81.73 per service and paid $61.48 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $470.54, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 70491?

Ct scan of soft tissue of neck with contrast. It was billed 222,427 times to 211,426 Medicare beneficiaries by 6,307 providers in 2024.

Does 70491 pay differently in an office than a hospital?

Yes. The allowed amount averaged $115.93 in an office setting and $63.30 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 70491 most?

Diagnostic Radiology, with 203,913 services from 5,690 clinicians. Next are Independent Diagnostic Testing Facility (IDTF), Interventional Radiology, Hematology-Oncology.

CPT 70491

Ct scan of soft tissue of neck with contrast

$81.73Medicare-allowed amount per service, averaged across 222,427 services

Providers submitted

$470.54

Asking price, not received

Medicare allowed

$81.73

The fee schedule figure

Medicare paid

$61.48

Balance is patient coinsurance

Providers submitted an average of $470.54 for this code and Medicare allowed $81.73 — 5.8× 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 $61.48 (75%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $115.93
Hospital / facility: $63.30

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. 77,918 services were billed in an office setting and 144,509 in a facility.

Services: 222,427
Beneficiaries: 211,426
Providers billing it: 6,307
Total allowed: $18,178,959

What Medicare pays for CPT 70491

Across 222,427 services billed by 6,307 providers to 211,426 beneficiaries, Medicare allowed an average of $81.73 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 70491

Specialty	Services	Beneficiaries	Avg allowed	Providers
Diagnostic Radiology	203,913	194,797	$78.94	5,690
Independent Diagnostic Testing Facility (IDTF)	7,175	6,494	$144.98	229
Interventional Radiology	3,939	3,719	$72.88	126
Hematology-Oncology	2,332	1,988	$96.51	99
Nuclear Medicine	1,251	1,119	$109.89	20
Radiation Oncology	1,068	846	$98.22	33
Medical Oncology	826	694	$94.46	35
Internal Medicine	425	406	$95.31	19
Otolaryngology	416	388	$126.01	24
Undefined Physician type	389	322	$106.47	4
Family Practice	208	187	$109.03	10
Physician Assistant	118	118	$110.64	1
Pediatric Medicine	96	89	$115.26	3
Neurology	50	49	$62.63	2
Emergency Medicine	48	46	$96.78	3

70491 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
Texas	22,556	$79.55	$58.50	482
California	16,214	$89.09	$60.76	478
Florida	15,415	$101.63	$76.47	396
New York	12,586	$94.16	$62.83	279
Massachusetts	10,009	$74.13	$51.22	212
Illinois	9,467	$76.54	$55.17	294
Pennsylvania	8,681	$76.50	$55.25	267
North Carolina	7,870	$76.27	$58.27	228
Minnesota	7,067	$91.55	$66.47	258
Tennessee	6,976	$83.44	$66.37	170
Virginia	6,835	$80.56	$60.63	169
Ohio	6,761	$66.45	$49.60	186
Missouri	6,491	$64.86	$49.39	185
Michigan	6,015	$67.61	$49.02	188
Arizona	5,242	$91.95	$68.36	135
Maryland	5,158	$111.11	$78.50	149
Georgia	5,123	$76.23	$56.94	169
Washington	4,581	$84.07	$58.18	137
New Jersey	4,166	$109.96	$74.74	123
Arkansas	4,144	$81.96	$67.00	101
South Carolina	3,891	$83.20	$65.06	120
Colorado	3,809	$82.68	$58.10	134
Wisconsin	3,570	$71.01	$52.59	113
Indiana	3,435	$66.14	$49.86	117
Kansas	2,770	$69.81	$54.33	79
Alabama	2,641	$78.26	$61.82	92
Iowa	2,458	$71.67	$56.11	64
Connecticut	2,302	$80.07	$57.25	70
Oklahoma	2,200	$67.05	$50.96	83
Kentucky	2,198	$72.38	$54.58	82
Oregon	2,126	$69.47	$51.32	62
Nebraska	1,961	$65.46	$50.73	67
Mississippi	1,953	$67.36	$51.99	66
Louisiana	1,808	$69.43	$53.96	77
Utah	1,747	$74.79	$55.31	49
Delaware	1,304	$72.64	$53.57	28
New Hampshire	1,230	$64.01	$46.08	41
Idaho	959	$62.78	$46.66	29
Nevada	898	$97.45	$74.09	37
District of Columbia	866	$81.32	$56.00	18
West Virginia	837	$69.67	$51.88	44
New Mexico	791	$91.66	$68.14	28
Maine	761	$72.53	$50.33	31
Montana	724	$67.90	$49.18	25
North Dakota	668	$63.51	$46.51	23
South Dakota	630	$63.01	$44.84	18
Rhode Island	518	$84.56	$57.67	27
Alaska	513	$115.00	$68.78	17
Hawaii	465	$79.90	$59.33	20
Wyoming	420	$77.83	$56.54	19
Vermont	402	$62.00	$45.17	13
XX	88	$77.86	$62.63	2
Puerto Rico	55	$93.81	$73.91	2
AA	31	$62.36	$43.73	2
ZZ	27	$60.50	$48.38	1
AP	14	$62.88	$47.82	1

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
70486Ct scan of face without contrast$61.51
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.