CT Chest price: Medicare anchor and facility lever
Anchor for CT Chest - CPT 71250
$130.87
Professional (26) $50.38 plus technical (TC) $80.50.
Hospital OPPS facility anchor, this code billed alone: $106.81 (APC 5522, Level 2 Imaging without Contrast; national unadjusted, before wage-index adjustment).
Composite APC 8005: $226.07 (multi-study only, national unadjusted).
Chest CT without contrast, CPT 71250, has two close neighbors in the code set: the contrast study, 71260, and the without-then-with study. For price purposes, the questions are whether contrast will be used and which setting performs it.
CPT code
71250
Computed tomography, thorax, diagnostic; without contrast material
CPT 71250 is chest CT without contrast. With contrast is 71260 and without followed by with is 71270. A screening lung study may use a different code. Confirm the ordered code before you shop.
The codes this visit can be billed under
| CPT | PFS office or global | PFS facility (professional) | Global period | Hospital single-service APC | Minimum Medicare copay at hospital |
|---|---|---|---|---|---|
| 71250 (this page) | $130.87 | $130.87 | not a surgical global | $106.81 (APC 5522) | $21.37 |
| 71260 | $164.33 | $164.33 | not a surgical global | $179.20 (APC 5571) | $35.84 |
Billed alone in a hospital, 71250 maps to CY2026 APC 5522 at $106.81, with a minimum unadjusted copayment of $21.37. With contrast (71260) maps to APC 5571 at $179.20, and its global anchor is $164.33 against $130.87 for the plain study.
The composite anchor at the top of this page, APC 8005 at $226.07, applies only when two or more qualifying CT studies are billed on one claim. A single chest CT billed alone uses the single-service APC shown here. CMS Addendum B lists 71250 and 71260 with status indicator Q3.
The CMS fee schedule splits the 71250 global anchor into a professional component of $50.38 for the radiologist's reading and a technical component of {pfs.tc:71250} for the scan itself. For 71260 the technical component is {pfs.tc:71260}, so most of the step up in the global anchor for contrast is on the technical side. A hospital bills the technical side as its facility payment; an imaging center bills the global amount.
For a Medicare patient billed by a hospital, the minimum unadjusted facility copayment is $21.37 for 71250 alone and $35.84 for 71260. These are national unadjusted figures before wage-index adjustment.
Inside and outside the 71250 anchor
Covered by the anchor
- Scanner time and image acquisition
- Radiologist interpretation and written report (professional component, modifier 26)
- Standard image storage and transmission to the ordering clinician
Billed outside it
- Contrast material when a different code is ordered
- Sedation, when used
- The ordering visit, labs, and follow-up visit
- A separate CT abdomen or pelvis billed the same day
Why prices vary for CPT 71250
Chest CT without contrast maps to the CT without-contrast composite in a hospital and to a single global amount at an imaging center. The hospital facility payment is billed on top of the professional fee, while the imaging center folds the technical component into one global payment. Setting is the first question to ask for this code.
Ask for the cash price for CPT 71250 at a freestanding imaging center and at the hospital outpatient department, and confirm the quote covers the same code in both places.
Questions specific to Chest CT
- Which chest CT code is on the order: 71250, or a different chest CT code with its own anchor?
- Could contrast be added, changing the code to 71260 or 71270?
- Is the reading included in the quote?
- If other CT scans are done on the same day, will composite billing apply?
- For a Medicare patient billed by a hospital, what copayment applies to the facility line, and is the radiologist's coinsurance billed separately?
CT Chest: billing questions
Does contrast change the chest CT price?
Yes. With contrast the code is 71260 and maps to a higher hospital APC, and the fee schedule anchor rises as well.
Is every chest CT billed under 71250?
No. 71250 is chest CT without contrast; with contrast is 71260, and other chest CT studies use other codes with their own anchors. Ask the scheduler which code the order uses before comparing prices.
What is the technical component of a chest CT?
It is the equipment, supplies and technologist side of the scan, separate from the radiologist's reading. For 71250 the CY2026 Michigan Locality 01 technical component is {pfs.tc:71250}, and for 71260 it is {pfs.tc:71260}. Ask whether a quote includes the reading or only the scan.
Why might a hospital estimate and an imaging center estimate for the same chest CT differ in structure?
A hospital outpatient department is paid under the outpatient payment system for the scan and a physician fee for the reading, while an imaging center usually bills one global amount. Ask each for the all-in price for the same code.