CPT 76010 Fee Schedule
Healthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | • Radiology Procedures • Diagnostic Radiology (Diagnostic Imaging) Procedures |
| Common Place of Service | • 23 - Emergency Room • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • 26 - Professional component • TC - Technical component |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 76010 |
National average reimbursement for CPT 76010 by major payers:
$37.79
$32.85
$35.90
$42.34
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 76010 | ||||||
United | 76010 | $30.59 | 1619315967 - DAVID SILVESTRE | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | PA | Critical Care Medicine (Internal Medicine) Physician (207RC0200X) |
United | 76010 | $46.20 | 1528350139 - BRANDON ABBOTT | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | NY | Hospitalist Physician (208M00000X) |
United | 76010 | $19.85 | 1710418959 - JERRIS-STEPHANIE OKONKWO | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | IA | Neurology Physician (2084N0400X) |
United | 76010 | $46.20 | 1205013919 - PATRICK MARTIN | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | FL | Critical Care Medicine (Internal Medicine) Physician (207RC0200X) |
United | 76010 | $30.59 | 1417340548 - KIRSTIN NELSON | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | WA | Registered Dietitian (133V00000X) |
United | 76010 | $15.60 | 1609919471 - JONATHAN MELLEN | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Gastroenterology Physician (207RG0100X) |
United | 76010 | $11.13 | 1134127301 - BAYCARE HOME CARE, INC. | 593582520 - (FL) BAYCARE HOME CARE INC | FL | Home Health Agency (251E00000X) |
United | 76010 | $29.22 | 1629070529 - GREGORY LINDERER | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | NV | Anesthesiology Physician (207L00000X) |
United | 76010 | $6.53 | 1891774519 - LEON HOME HEALTH, LLC, LEON AT HOME | 261288029 | FL | Home Health Agency (251E00000X) |
United | 76010 | $65.87 | 1336590934 - PATRICIA MELENDEZ MORENO | 751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PA | FL | Diagnostic Radiology Physician (2085R0202X) |
United | 76010 | $46.20 | 1720391279 - MUHAMMAD KHAN | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Neurology Physician (2084N0400X) |
United | 76010 | $30.59 | 1609950500 - MICHAEL REIDY | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | MT | Pulmonary Disease Physician (207RP1001X) |
United | 76010 | $46.20 | 1205153699 - COREY SONNETT | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Surgical Physician Assistant (363AS0400X) |
United | 76010 | $65.87 | 1902226301 - WILLIAM WARSHAUER | 751286819 - (TX) RADIOLOGY ASSOCIATES OF NORTH TEXAS, PA | TX | Diagnostic Radiology Physician (2085R0202X) |
United | 76010 | $26.85 | 1114926292 - JEFFREY BERG | 541383504 - TOWN CENTER ORTHOPAEDIC ASSOCIATES, P.C. | VA | Sports Medicine (Orthopaedic Surgery) Physician (207XX0005X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 76010 vs. Other Diagnostic Radiology (Diagnostic Imaging) Procedures Codes
The CPT 76010 code is part of the Radiology Procedures services used for Diagnostic Radiology (Diagnostic Imaging) Procedures. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 76010 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 76000-CPT | Low | Fluoroscopy (Separate Procedure) Up To 1 Hour Physician Or Other Qualified Health Care Professional Time (Desc Revised 1/1/2018) |
| 76010-CPT | Low | X-Ray From Nose To Rectum For F.B.,1 Fil |
| 76080-CPT | Low | Rad Exam Fistula Sinus Tract Study Rad S |
| 76098-CPT | Low | X-Ray Breast Surgical Specimen |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 76010. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 76010 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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