CPT 76498 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 | • 11 - Office • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • 26 - Professional component • TC - Technical component |
| Complexity Level | Moderate |
National average reimbursement for CPT 76498 by major payers:
$284.66
$309.99
$317.71
$209.08
| 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 76498 | ||||||
United | 76498 | $227.17 | 1760513980 - INOVA HEALTH CARE SERVICES, INOVA FAIR OAKS HOSPITAL | 540620889 - INOVA HEALTH CARE SERVICES | VA | General Acute Care Hospital (282N00000X) |
United | 76498 | $80.90 | 1922310200 - VHS HURON VALLEY-SINAI HOSPITAL INC, HURON VALLEY-SINAI HOSPITAL | 272844563 | MI | General Acute Care Hospital (282N00000X) |
United | 76498 | $182.02 | 1710499462 - HMH HOSPITALS CORPORATION, RIVERVIEW MEDICAL CENTER | 221487576 - HACKENSACK MERIDIAN HEALTH INC | NJ | General Acute Care Hospital (282N00000X) |
United | 76498 | $182.02 | 1770569832 - RARITAN BAY MEDICAL CENTER | 221487576 - HACKENSACK MERIDIAN HEALTH INC | NJ | General Acute Care Hospital (282N00000X) |
United | 76498 | $80.90 | 1326022732 - VHS ACQUISITION SUBSIDIARY NUMBER 1 INC, ABRAZO SCOTTSDALE CAMPUS | 621861138 - (AZ) VHS ACQUISITION SUBSIDIARY NUMBER 1 INC | AZ | General Acute Care Hospital (282N00000X) |
United | 76498 | $73.43 | 1386779031 - ADVOCATE LUTHERAN GENERAL | 362169147 - ADVOCATE HEALTH AND HOSPITALS CORPORATION | IL | General Acute Care Hospital (282N00000X) |
United | 76498 | $83.86 | 1255384533 - COLUMBIA MEDICAL CENTER OF LEWISVILLE SUBSIDIARY LP, MEDICAL CITY LEWISVILLE | 621682210 - (TX) COLUMBIA MEDICAL CENTER OF LEWISVILLE SUBSIDIARY LP | TX | General Acute Care Hospital (282N00000X) |
United | 76498 | $119.72 | 1144695081 - HH HEALTH SYSTEM, ATHENS LIMESTONE HOSPITAL | 475531420 | AL | General Acute Care Hospital (282N00000X) |
United | 76498 | $179.71 | 1720371487 - SIBLEY MEMORIAL HOSPITAL | 530196602 - (DC) LUCY WEBB HAYNES NATIONAL TRAINING SCHOOL FOR DEACONESSES AND MISSION | DC | General Acute Care Hospital (282N00000X) |
United | 76498 | $124.23 | 1972904738 - NORTHERN VIRGINIA COMMUNITY HOSPITAL LLC, STONESPRINGS HOSPITAL CENTER | 43665595 - (VA) NORTHERN VIRGINIA COMMUNITY HOSPITAL LLC | VA | General Acute Care Hospital (282N00000X) |
United | 76498 | $68.76 | 1215996632 - PARK PLACE SURGERY CENTER, LLC, PARK PLACE SURGICAL HOSPITAL | 721404092 - (LA) PARK PLACE SURGERY CENTER LLC | LA | General Acute Care Hospital (282N00000X) |
United | 76498 | $182.02 | 1588631311 - SURGICAL SPECIALTY CENTER OF BATON ROUGE, LLC, SURGICAL SPECIALTY CENTER OF BATON ROUGE | 263120962 - (LA) SURGICAL SPECIALTY CENTER OF BATON ROUGE, LLC | LA | General Acute Care Hospital (282N00000X) |
United | 76498 | $179.57 | 1861479545 - MAURY REGIONAL HOSPITAL, MAURY REGIONAL MEDICAL CENTER | 626002623 - MAURY REGIONAL HOSPITAL | TN | General Acute Care Hospital (282N00000X) |
United | 76498 | $80.90 | 1538522412 - TENET HOSPITALS LIMITED, THE HOSPITALS OF PROVIDENCE TRANSMOUNTAIN CAMPUS | 954537720 | TX | General Acute Care Hospital (282N00000X) |
United | 76498 | $105.59 | 1821019571 - FLORIDA HOSPITAL WATERMAN INC, ADVENTHEALTH WATERMAN | 593140669 - (FL) FLORIDA HOSPITAL WATERMAN INC | FL | General Acute Care Hospital (282N00000X) |
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 76498 vs. Other Diagnostic Radiology (Diagnostic Imaging) Procedures Codes
The CPT 76498 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 76498 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 |
|---|---|---|
| 76498-CPT | Moderate | Unlisted Magnetic Resonance Procedure (Eg, Diagnostic, Interventional) |
| 76499-CPT | High | Unlisted Diagnostic Radiologic Procedure |
| 76700-CPT | Low | Ultrasound Abdominal |
| 76706-CPT | Low | Ultrasound Abdominal Aorta Real Time With Image Documentation Screening Study For Abdominal Aortic Aneurysm (Aaa) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 76498. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 76498 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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