CPT 76016 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 |
| Complexity Level | Moderate |
National average reimbursement for CPT 76016 by major payers:
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| 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 76016 | ||||||
United | 76016 | $25.79 | 1205183415 - GRETHE MORTENSON | 861385436 | OR | Nurse Practitioner (363L00000X) |
United | 76016 | $109.75 | 1932124997 - DANIEL KNIGHT | 426005842 - (IA) JEFFERSON COUNTY HOSPITAL | IL | Emergency Medicine Physician (207P00000X) |
United | 76016 | $50.97 | 1962435792 - HOUSTON HOSPITALS INC, HOUSTON MEDICAL CENTER | 711045290 - (GA) HOUSTON HOSPITALS INC | GA | General Acute Care Hospital (282N00000X) |
United | 76016 | $60.63 | 1427055821 - NORTHEAST GEORGIA MEDICAL CENTER, INC. | 581177261 - (GA) GAINESVILLE RADIOLOGY GROUP | GA | General Acute Care Hospital (282N00000X) |
United | 76016 | $72.00 | 1205183415 - GRETHE MORTENSON | 251857035 | OR | Nurse Practitioner (363L00000X) |
United | 76016 | $78.76 | 1497275853 - ALEXANDER TRAN MD PA | 821967465 - (TX) ALEXANDER TRAN MD PA | TX | General Acute Care Hospital (282N00000X) |
United | 76016 | $54.29 | 1619932894 - PAUL FISHER | 273426141 - (TN) UT LE BONHEUR PEDIATRIC SPECIALISTS INC | NY | Pediatric Radiology Physician (2085P0229X) |
United | 76016 | $55.59 | 1851319628 - DANIEL DAHL | 900730395 | AZ | Anesthesiology Physician (207L00000X) |
United | 76016 | $61.18 | 1487684122 - UNION COUNTY HOSPITAL AUTHORITY, UNION GENERAL HOSPITAL | 586025393 - (GA) UNION COUNTY HOSPITAL AUTHORITY | GA | General Acute Care Hospital (282N00000X) |
United | 76016 | $60.13 | 1154324184 - TERRI WILLIAMS-WEEKES | 873928715 - (MA) TMC RADIOLOGY CRA LLC | NY | Pediatric Radiology Physician (2085P0229X) |
United | 76016 | $117.91 | 1205183415 - GRETHE MORTENSON | 860665872 - (AZ) NEONATAL SPECIALISTS LTD | OR | Nurse Practitioner (363L00000X) |
United | 76016 | $79.40 | 1932362126 - ALLYSON PARNES | 870622942 - (UT) UTAH IMAGING ASSOCIATES, INC. | FL | Diagnostic Radiology Physician (2085R0202X) |
United | 76016 | $87.59 | 1619932894 - PAUL FISHER | 263064869 - (NE) NEBRASKA PEDIATRIC PRACTICE INC | NY | Pediatric Radiology Physician (2085P0229X) |
United | 76016 | $42.88 | 1497789515 - CLARKE MORTON | 205521741 - SOUTHERN ILLINOIS MEDICAL SERVICES NFP | VA | Emergency Medicine Physician (207P00000X) |
United | 76016 | $103.97 | 1144647272 - ABIEYUWA EWEKA | 853861695 - MUSC COMMUNITY PHYSICIANS | IA | Vascular & Interventional Radiology Physician (2085R0204X) |
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 76016 vs. Other Diagnostic Radiology (Diagnostic Imaging) Procedures Codes
The CPT 76016 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 76016 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 |
|---|---|---|
| 76016-CPT | Moderate | Mr Safety Determination By A Physician Or Other Qualified Health Care Professional Responsible For The Safety Of The Mr Proc Incl Review Of Implant Mr Conditions For Exam |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 76016. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 76016 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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