Summary & Overview
CPT 70450: CT Scan of Head or Brain Without Contrast
CPT code 70450 is a widely used billing code for computed tomography (CT) scans of the head or brain performed without contrast material. This diagnostic imaging procedure is essential in evaluating patients with neurological symptoms, head trauma, or suspected brain disorders. The code is recognized nationally and is a cornerstone in radiology services, particularly in outpatient hospital settings where rapid assessment is critical.
Major payers covering this procedure include Aetna, Blue Cross Blue Shield, Cigna Health, Medicare, and UnitedHealthcare. The publication provides a comprehensive overview of payer coverage, reimbursement benchmarks, and policy updates relevant to this code. Readers will gain insights into clinical indications, typical sites of service, and the role of this procedure in diagnostic radiology. The summary also highlights related codes and modifiers commonly used in billing, offering a clear understanding of how 70450 fits within broader radiology coding practices.
This article is designed for healthcare professionals, administrators, and policy analysts seeking up-to-date information on national trends, payer policies, and clinical context for CT head scans without contrast. It serves as a resource for understanding the significance of 70450 in medical billing and its impact on patient care and healthcare operations.
CPT Code Overview
CPT code 70450 represents a computed tomography (CT) scan of the head or brain performed without contrast material. This procedure is classified under radiology and is commonly utilized to evaluate neurological conditions, trauma, or other abnormalities in the brain. The typical site of service for this procedure is an outpatient hospital setting (Place of Service 22), where advanced imaging technology is available for prompt and accurate diagnosis.
Clinical & Coding Specifications
Clinical Context
A patient presents to the outpatient hospital with symptoms such as acute headache, confusion, or loss of consciousness following a minor head injury. The clinician suspects a neurological issue, such as a traumatic subdural hemorrhage or cerebral infarction, and orders a computed tomography (CT) scan of the head or brain without contrast. The radiology department performs the procedure, and the images are interpreted by a diagnostic radiologist or neuroradiologist. The results assist in diagnosing conditions like intracranial bleeding, stroke, or other brain disorders.
Coding Specifications
-
Modifiers:
- Modifier
26: Used when billing for the professional component (interpretation and report) of the CT scan. - Modifier
TC: Used when billing for the technical component (equipment, supplies, and technician) of the CT scan.
- Modifier
-
Provider Taxonomies:
| Taxonomy Code | Specialty Name |
|---|---|
2085R0202X | Radiology, Diagnostic Radiology |
2085N0700X | Radiology, Neuroradiology |
2085B0100X | Radiology, Body Imaging |
- These taxonomies represent providers specializing in diagnostic radiology, neuroradiology, and body imaging, all of whom may perform or interpret CT scans of the head or brain.
Related Diagnoses
-
S06.5X9A: Traumatic subdural hemorrhage, unspecified, initial encounter- Relevant for patients with head trauma, as CT imaging is essential for detecting intracranial bleeding.
-
G93.9: Disorder of brain, unspecified- Used when a patient presents with neurological symptoms and the cause is unclear; CT imaging helps rule out structural abnormalities.
-
R51: Headache- CT scans are often ordered to exclude serious causes of headache, such as hemorrhage or mass lesions.
-
R55: Syncope and collapse- Imaging may be performed to assess for neurological causes of sudden loss of consciousness.
-
I63.9: Cerebral infarction, unspecified- CT imaging is critical in the evaluation of suspected stroke to differentiate between ischemic and hemorrhagic events.
Related CPT Codes
-
70460: CT, head or brain; with contrast material(s)- Used when a CT scan of the head or brain is performed with contrast. This may be ordered if initial non-contrast imaging is inconclusive or if specific pathology requires contrast enhancement.
-
70470: CT, head or brain; without contrast material, followed by contrast material(s) and further sections- Used when both non-contrast and contrast-enhanced CT scans are performed in the same session, often for comprehensive evaluation.
-
70551: MRI, brain (including brain stem); without contrast material- MRI is an alternative imaging modality for brain evaluation, often used when CT findings are unclear or when more detailed imaging is needed.
-
70553: MRI, brain (including brain stem); without contrast material, followed by contrast material(s) and further sequences- Used for MRI studies that include both non-contrast and contrast-enhanced sequences, providing a thorough assessment of brain pathology.
-
These codes are related to
70450as alternatives or adjuncts in the diagnostic workflow for neurological conditions.70460and70470are commonly used together with70450when contrast imaging is required.70551and70553are MRI alternatives for further evaluation.
National Reimbursement Benchmarks
Nationally, the mean rate for CPT code 70450 is highest among commercial payers, with Blue Cross Blue Shield, Cigna, and UnitedHealth Group all averaging above $126.00. The BUCA average (commercial composite) stands at $117.24, while Medicare's mean rate is significantly lower at $73.82. This highlights a substantial gap between commercial and government reimbursement levels for this service.
Rate dispersion, measured by the difference between the 75th and 25th percentiles, varies across payers. Cigna exhibits the widest spread at $84.17, indicating greater variability in contracted rates. In contrast, Aetna has the tightest range at $44.79, suggesting more consistent reimbursement levels. The table and chart below present the full breakdown of national benchmarks for each payer.
Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.