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 |
| Medicare Fee Schedule | View Medicare rates for 76016 |
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 | $79.40 | 1932362126 - ALLYSON PARNES | 870622942 - (UT) UTAH IMAGING ASSOCIATES, INC. | FL | Diagnostic Radiology Physician (2085R0202X) |
United | 76016 | $72.22 | 1861469132 - SHERVIN KARIMPOUR | 363097297 - NORTHWESTERN MEMORIAL HEALTHCARE | FL | Radiation Oncology Physician (2085R0001X) |
United | 76016 | $72.83 | 1205183415 - GRETHE MORTENSON | 860665872 - (AZ) NEONATAL SPECIALISTS LTD | OR | Nurse Practitioner (363L00000X) |
United | 76016 | $115.95 | 1023123544 - DERRICK GLYMPH | 562070036 - DUKE UNIVERSITY HEALTH SYSTEM INC | NC | Certified Registered Nurse Anesthetist (367500000X) |
United | 76016 | $67.48 | 1619087590 - MIGUEL ARENAS | 300394179 - (AZ) MIGUEL A ARENAS MD PC | AZ | Gastroenterology Physician (207RG0100X) |
United | 76016 | $39.25 | 1851357040 - ALEXIS ISAACS | 650913389 | CO | Critical Care Neonatal Nurse Practitioner (363LN0005X) |
United | 76016 | $33.22 | 1023123544 - DERRICK GLYMPH | 562070036 - DUKE UNIVERSITY HEALTH SYSTEM INC | NC | Certified Registered Nurse Anesthetist (367500000X) |
United | 76016 | $75.44 | 1720095805 - DONALSONVILLE HOSPITAL INC | 580973772 - (GA) DONALSONVILLE HOSPITAL INC | GA | Rural Acute Care Hospital (282NR1301X) |
United | 76016 | $64.76 | 1568876977 - RASHPAL SANDHU | 611654232 - (NY) WESTERN NEW YORK MEDICAL PRACTICE PC | NY | Diagnostic Radiology Physician (2085R0202X) |
United | 76016 | $45.00 | 1225147234 - BASIM KAHLEIFEH | 10632125 - (KY) PEDIATRIX MEDICAL GROUP OF KENTUCKY PSC | KY | Obstetrics & Gynecology Physician (207V00000X) |
United | 76016 | $78.76 | 1497275853 - ALEXANDER TRAN MD PA | 821967465 - (TX) ALEXANDER TRAN MD PA | TX | General Acute Care Hospital (282N00000X) |
United | 76016 | $73.55 | 1760498588 - PIEDMONT NEWTON HOSPITAL, INC., NEWTON MEDICAL CENTER | 814475074 - (GA) PIEDMONT NEWTON HOSPITAL INC | GA | General Acute Care Hospital (282N00000X) |
United | 76016 | $80.12 | 1124080668 - DAVID EPSTEIN | 590704934 - WATSON CLINIC LLP | FL | Vascular & Interventional Radiology Physician (2085R0204X) |
United | 76016 | $36.36 | 1801883780 - TANNER MEDICAL CENTER, INC, TANNER HEALTH SYSTEM | 581790149 - (GA) TANNER MEDICAL CENTER INC | GA | General Acute Care Hospital (282N00000X) |
United | 76016 | $25.77 | 1619087590 - MIGUEL ARENAS | 300394179 - (AZ) MIGUEL A ARENAS MD PC | AZ | Gastroenterology Physician (207RG0100X) |
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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