CPT 76098 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 • 11 - Office |
| Common Modifiers | • None • 26 - Professional component • LT - Left side of body |
| Complexity Level | Low |
National average reimbursement for CPT 76098 by major payers:
$45.63
$36.76
$41.46
$49.68
| 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 76098 | ||||||
United | 76098 | $1357.06 | 1922139120 - INOVA HEALTH CARE SERVICES, INOVA MOUNT VERNON HOSPITAL | 540620889 - INOVA HEALTH CARE SERVICES | VA | General Acute Care Hospital (282N00000X) |
United | 76098 | $5.78 | 1447376652 - NORTH HOUSTON X-RAY,INC, NORTH HOUSTON X-RAY & IMAGING CENTER | 760574907 - (TX) NORTH HOUSTON XRAYINC | TX | Radiology Clinic/Center (261QR0200X) |
United | 76098 | $1236.18 | 1710491253 - NJMHMC, LLC, HUDSON REGIONAL HOSPITAL | 812857619 - (NJ) NJMHMC LLC | NJ | General Acute Care Hospital (282N00000X) |
United | 76098 | $963.15 | 1215981303 - VICKSBURG HEALTHCARE LLC, MERIT HEALTH RIVER REGION | 621752111 - (MS) VICKSBURG HEALTHCARE LLC | MS | General Acute Care Hospital (282N00000X) |
United | 76098 | $18.70 | 1720574296 - SHANNEN WHIDDON | 593238640 - H LEE MOFFITT CANCER CTR & RES INST LIFE TIME CANCER SCRN CTR INC | FL | Family Nurse Practitioner (363LF0000X) |
United | 76098 | $963.15 | 1023061405 - AFFINITY HOSPITAL LLC, GRANDVIEW MEDICAL CENTER | 203391873 | AL | General Acute Care Hospital (282N00000X) |
United | 76098 | $421.85 | 1033165501 - METHODIST HOSPITALS OF DALLAS, METHODIST RICHARDSON MEDICAL CENTER | 750800661 - METHODIST HOSPITALS OF DALLAS | TX | General Acute Care Hospital (282N00000X) |
United | 76098 | $12.85 | 1053334441 - TEXARKANA PET/CT IMAGING INSTITUTE, L.P. | 721513569 - (TX) TEXARKANA PETCT IMAGING INSTITUTE LP | TX | Radiology Clinic/Center (261QR0200X) |
United | 76098 | $21.98 | 1356420038 - LAURA DOEPKE | 593238640 - H LEE MOFFITT CANCER CTR & RES INST LIFE TIME CANCER SCRN CTR INC | FL | Diagnostic Radiology Physician (2085R0202X) |
United | 76098 | $1110.32 | 1205164928 - CAHRMC LLC, RICE MEDICAL CENTER | 270565499 | TX | Critical Access Hospital (282NC0060X) |
United | 76098 | $15.69 | 1861918815 - PROFESSIONAL RADIOLOGY PLLC | 472177210 - (TX) PROFESSIONAL RADIOLOGY PLLC | TX | Radiology Clinic/Center (261QR0200X) |
United | 76098 | $1678.06 | 1851686059 - SWEDISH HEALTH SERVICES, SWEDISH/ISSAQUAH | 910433740 - (WA) SWEDISH HEALTH SERVICES | WA | General Acute Care Hospital (282N00000X) |
United | 76098 | $859.53 | 1386746592 - KENNEDY UNIVERSITY HOSPITAL INC. | 221773439 - (NJ) KENNEDY UNIVERSITY HOSPITAL INC | NJ | General Acute Care Hospital (282N00000X) |
United | 76098 | $795.97 | 1578504056 - MERCY HOSPITAL SPRINGFIELD, MERCY HOSPITAL SPRINGFIELD | 440552485 - MERCY HOSPITAL SPRINGFIELD | MO | General Acute Care Hospital (282N00000X) |
United | 76098 | $18.70 | 1952045635 - EMILY WHICHELLO | 593238640 - H LEE MOFFITT CANCER CTR & RES INST LIFE TIME CANCER SCRN CTR INC | FL | Anesthesiologist Assistant (367H00000X) |
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 |
Want to see your competitors' rates?
Start your trial today to unlock complete access to provider rates and fee schedules in your area.
Here's what you can do with PayerPrice
Renegotiate your managed care contracts
Benchmark your current rates against market averages to identify opportunities for rate optimization.
Prospect for new business using fee schedules
Access every provider's negotiated rates for every billing code in your market to inform your prospecting strategies.
Integrate real-time payer data into your workflows
Automatically keep fee schedules up-to-date without adding yet another log-in to your insurance systems. Connect via API or SQL.
PayerPrice shows you the exact negotiated rates that insurers publish under federal transparency rules.
We display the raw data directly from insurers' files, giving you the same information they make public. Learn more about Price Transparency.
CPT 76098 vs. Other Diagnostic Radiology (Diagnostic Imaging) Procedures Codes
The CPT 76098 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 76098 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 76098. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 76098 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.
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 76098) and we'll show you how you compare in 15 minutes or less.