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SpecialistBase2026 Compliant

CPT 71250

2026 Billing Guide

CT Thorax w/o Contrast

Reimbursement

$146.29

Threshold

N/A

2026 Status

Active

What is CPT Code 71250?

CPT 71250 is defined as: Computed tomography of the thorax (Chest CT) without the use of intravenous contrast material. This diagnostic imaging procedure provides detailed cross-sectional views of the lungs, heart, mediastinum, pleura, and chest wall. It is commonly used for evaluating pulmonary nodules, detecting interstitial lung disease, or assessing trauma when contrast is contraindicated or unnecessary for the clinical question.

This code is primarily used for Specialist services. It falls under the category of Radiology / Diagnostic Radiology and is valid for the 2026 calendar year according to the CMS Physician Fee Schedule.

2026 RVU Components

Relative Value Units (Non-Facility)

Standard Formula Applied

Work RVU

1.1

Physician Effort

PE (Non-Fac)

3.2

Practice Expense

Malpractice

0.08

Risk Factor

Total RVU

4.38

Note: [(Work RVU * Work GPCI) + (PE RVU * PE GPCI) + (MP RVU * MP GPCI)] * Conversion Factor

2026 CMS Policy Intelligence

efficiency adjustment

Subject to -2.5% Efficiency Adjustment. CMS has devalued the Work RVU based on the assumption that automated protocols and faster scanners have reduced physician interpretive time.

indirect pe cut

For hospital-based billing (POS 22), the indirect Practice Expense component is reduced by 50% relative to office-based settings in 2026.

conversion factor

Payment utilizes the 2026 Non-QP baseline of $33.40.

Administrative Framework

Place of Service

11 (Office)22 (Outpatient Hospital)23 (Emergency Room)

NCCI Exclusions

Do not bill with:71260712707127599211-99215

Key Modifiers

26Professional component. Used for the physician's interpretation and report.
59Distinct procedural service. Use if billing multiple CTs on different body areas on the same day.

Operational Requirements

order requirement

Must have a written order from a physician or QHP stating the clinical indication and medical necessity for a non-contrast study.

supervision

Requires 'General Supervision' (physician must be available but not necessarily in the room).

technical standards

Images must be of diagnostic quality and archived in a permanent digital format (PACS).

report content

Final signed report must include clinical history, technique (including dose reduction protocols), findings, and a clear impression.

Compliance Checklist

Detailed time tracking (cumulative for the month).
Specific clinical decision-making documentation.
Electronic care plan availability and access log.

Audit Defense

No specific audit defense elements defined.

2026 Update

Work RVUs reduced by mandatory 2.5% efficiency cut for non-time-based diagnostic imaging.

Common Clinical Scenarios

No clinical examples provided.

Target Specialties & Utilization

RadiologyPulmonologyOncology

Typical Clinical Indications (ICD-10)

R91.1 (Solitary pulmonary nodule)J18.9 (Pneumonia, unspecified)J84.10 (Pulmonary fibrosis, unspecified)

Frequently Asked Questions

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CPT Code 71250 for CT Thorax w/o Contrast - 2026 Reimbursement & Rules