CPT 76080 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 | • 22 - On Campus Outpatient Hospital • 21 - Inpatient Hospital |
| Common Modifiers | • None • 26 - Professional component • TC - Technical component |
| Complexity Level | Low |
National average reimbursement for CPT 76080 by major payers:
$73.06
$70.60
$76.07
$89.16
| 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 76080 | ||||||
United | 76080 | $26.70 | 1790002350 - KRISTOPHER DAY | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | RI | Surgery Physician (208600000X) |
United | 76080 | $40.40 | 1184856965 - DANIEL BUCHNEA | 111986351 - NEW YORK COMMUNITY HOSPITAL OF BROOKLYN INC | NY | Critical Care Medicine (Internal Medicine) Physician (207RC0200X) |
United | 76080 | $91.21 | 1467420877 - MIKHAIL KOGAN | 135562308 - NEW YORK UNIVERSITY | NY | Pain Medicine (Anesthesiology) Physician (207LP2900X) |
United | 76080 | $150.73 | 1073502985 - CHU CHEN | 42484572 - MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC. | MA | Pediatrics Physician (208000000X) |
United | 76080 | $63.98 | 1811000177 - CHARLESTON RADIOLOGISTS PA | 570634747 - CHARLESTON RADIOLOGISTS, P.A. | SC | Diagnostic Radiology Physician (2085R0202X) |
United | 76080 | $198.36 | 1013997279 - DORA PINKHASOVA | 135562308 - NEW YORK UNIVERSITY | NY | Neurology Physician (2084N0400X) |
United | 76080 | $88.30 | 1346629334 - ARTUR IVCHENKO | 111986351 - NEW YORK COMMUNITY HOSPITAL OF BROOKLYN INC | NY | Surgery Physician (208600000X) |
United | 76080 | $84.38 | 1861650780 - CHILDRENS NATIONAL MEDICAL CENTER | 530196580 - CHILDRENS HOSPITAL | DC | Children's Hospital (282NC2000X) |
United | 76080 | $47.89 | 1346629334 - ARTUR IVCHENKO | 111986351 - NEW YORK COMMUNITY HOSPITAL OF BROOKLYN INC | NY | Surgery Physician (208600000X) |
United | 76080 | $198.36 | 1467689554 - ARON MEDNICK | 135562308 - NEW YORK UNIVERSITY | NY | Internal Medicine Physician (207R00000X) |
United | 76080 | $63.98 | 1811000177 - CHARLESTON RADIOLOGISTS PA | 570634747 - CHARLESTON RADIOLOGISTS, P.A. | SC | Diagnostic Radiology Physician (2085R0202X) |
United | 76080 | $39.40 | 1407365554 - SYED SHAH | 135562308 - NEW YORK UNIVERSITY | NY | Internal Medicine Physician (207R00000X) |
United | 76080 | $32.21 | 1184856965 - DANIEL BUCHNEA | 111986351 - NEW YORK COMMUNITY HOSPITAL OF BROOKLYN INC | NY | Critical Care Medicine (Internal Medicine) Physician (207RC0200X) |
United | 76080 | $139.22 | 1811000177 - CHARLESTON RADIOLOGISTS PA | 570634747 - CHARLESTON RADIOLOGISTS, P.A. | SC | Single Specialty Group (193400000X) |
United | 76080 | $53.67 | 1386715621 - ST. PETER'S HOSPITALOF THE CITY OF ALBANY, ST. PETER'S FAMILY HEALTH CENTER | 141348692 - (NY) ST PETERS HOSPITAL | NY | Obstetrics & Gynecology Physician (207V00000X) |
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 76080 vs. Other Diagnostic Radiology (Diagnostic Imaging) Procedures Codes
The CPT 76080 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 76080 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 76080. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 76080 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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