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 |
| Medicare Fee Schedule | View Medicare rates for 76498 |
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 | $106.63 | 1710943881 - WHITE RIVER HEALTH SYSTEM, INC., WHITE RIVER MEDICAL CENTER | 710411459 - WHITE RIVER HEALTH SYSTEM INC | AR | 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 | $80.90 | 1538522412 - TENET HOSPITALS LIMITED, THE HOSPITALS OF PROVIDENCE TRANSMOUNTAIN CAMPUS | 954537720 | TX | General Acute Care Hospital (282N00000X) |
United | 76498 | $83.86 | 1902857766 - COLUMBIA MEDICAL CENTER OF LAS COLINAS INC, MEDICAL CITY LAS COLINAS | 621650582 - (TX) COLUMBIA MEDICAL CENTER OF LAS COLINAS INC | TX | General Acute Care Hospital (282N00000X) |
United | 76498 | $156.38 | 1851927669 - NORTHWEST SAHUARITA HOSPITAL LLC, NORTHWEST MEDICAL CENTER SAHUARITA | 384088744 - (AZ) NORTHWEST SAHUARITA HOSPITAL LLC | AZ | General Acute Care Hospital (282N00000X) |
United | 76498 | $80.90 | 1962472431 - COASTAL CAROLINA MEDICAL CENTER, INC., COASTAL CAROLINA HOSPITAL | 934580630 | SC | General Acute Care Hospital (282N00000X) |
United | 76498 | $235.82 | 1013382860 - LARKIN COMMUNITY HOSPITAL PALM SPRINGS CAMPUS, LLC | 475625607 | FL | General Acute Care Hospital (282N00000X) |
United | 76498 | $83.86 | 1659323772 - COLUMBIA PLAZA MEDICAL CENTER OF FORT WORTH SUBSIDIARY LP, MEDICAL CITY FORT WORTH | 621682202 - (TX) COLUMBIA PLAZA MEDICAL CENTER OF FORT WORTH SUBSIDIARY LP | TX | General Acute Care Hospital (282N00000X) |
United | 76498 | $159.61 | 1194770404 - MADISON HMA LLC, MERIT HEALTH MADISON | 30400182 - (MS) MADISON HMA LLC | MS | General Acute Care Hospital (282N00000X) |
United | 76498 | $129.44 | 1134278435 - SCOTT REGIONAL MEDICAL CENTER, INC., OCHSNER SCOTT REGIONAL | 260792328 - (MS) SCOTT REGIONAL MEDICAL CENTER INC | MS | Critical Access Hospital (282NC0060X) |
United | 76498 | $80.90 | 1457382483 - AMISUB OF SOUTH CAROLINA, INC., PIEDMONT MEDICAL CENTER | 953561198 - (SC) AMISUB OF SOUTH CAROLINA INC | SC | General Acute Care Hospital (282N00000X) |
United | 76498 | $235.82 | 1013382860 - LARKIN COMMUNITY HOSPITAL PALM SPRINGS CAMPUS, LLC | 475625607 | FL | General Acute Care Hospital (282N00000X) |
United | 76498 | $70.69 | 1437177664 - TALLAHASSEE MEMORIAL HEALTHCARE INC | 591917016 - TALLAHASSEE MEMORIAL HEALTHCARE INC | FL | General Acute Care Hospital (282N00000X) |
United | 76498 | $80.90 | 1841844735 - EMERUS BHS SA THOUSAND OAKS, LLC, BAPTIST NEIGHBORHOOD HOSPITAL KELLY | 452497248 - (TX) EMERUS BHS SA THOUSAND OAKS LLC | TX | General Acute Care Hospital (282N00000X) |
United | 76498 | $80.90 | 1841843455 - HCN EP HORIZON CITY, LLC, THE HOSPITALS OF PROVIDENCE EMERGENCY ROOM MONTWOOD | 813935393 - (TX) HCN EP HORIZON CITY LLC | TX | 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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