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See a sample rate comparisonCPT 76080 Fee Schedule
Last Verified: September 2026
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.
Radiologic Examination Absces, Radiologic Examination Abscess Fistula Or Sinus Tractstudy Radiological Supervision And Interpretation
| 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 |
| Medicare Fee Schedule | View Medicare rates for 76080 |
| Medicaid Fee Schedule | View Medicaid rates for 76080 |
National average reimbursement for CPT 76080 by major payers:
$73.06
$70.60
$76.07
$87.22
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CPT 76080
5 of 25 sample ratesHigher to lower in this preview
Aron Mednick
New York University
$198.36Published rateVictor Laregina
St Peters Hospital
$97.58Published rateJoseph Dryer
Spinecare
$63.04Published rateChristopher Raio
Samaritan Emergency Medical Services PC
$40.40Published rateSyed Shah
New York University
$30.01Published rate
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See a sample payer proposalCPT 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 Procedur, Fluoroscopy (Separate Procedure) Up To 1 Hour Physician Or Other Qualified Health Care Professionaltime Other Than 71023 Or 71034 (Eg Cardiac Fluo Roscopy) |
| 76010-CPT | Low | X-Ray Of Child To Find Object, X-Rays Taken Of A Childs Digestive Tract From Nose To Rectum. The Images Are Taken To Find A Foreign Object. |
| 76080-CPT | Low | Radiologic Examination Absces, Radiologic Examination Abscess Fistula Or Sinus Tractstudy Radiological Supervision And Interpretation |
| 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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