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See a sample rate comparisonCPT 76536 Fee Schedule
Medicare rates as of October 2026
CPT 76536 is classified under Radiology Procedures, in the Diagnostic Ultrasound Procedures subgroup.
Ultrasound Of Head And Neck, Ultrasound (Images With Sound Waves) Of The Thyroid Parathyroid Or Parotid Glands. These Glands Are In The Neck And Mouth.
| Key Fact | Detail |
|---|---|
| Service Type | Radiology Procedures Diagnostic Ultrasound Procedures |
| Common Place of Service | 11 - Office 22 - On Campus Outpatient Hospital |
| Common Modifiers | 26 - Professional component TC - Technical component |
| Complexity Level | Low |
| Medicare Fee Schedule | $108.55 national non-facility rate (2026) · View Medicare rates for 76536 |
| Medicaid Fee Schedule | $88.37 median of the 8 states in the free preview · View Medicaid rates for 76536 |
National average reimbursement for CPT 76536 by major payers:
$133.82
BCBS / Anthem
$133.14
UnitedHealthcare
$143.49
Aetna
$161.35
Cigna
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 76536.
CPT 76536
5 of 25 sample ratesHigher to lower in this preview
Percy Genyk
Hunterdon Cardiovascular Associates, P.A.
$200.75Published rateGeorge Kartalian, Jr.
Town Center Orthopaedic Associates, P.C.
$120.50Published rateJason Liou
Town Center Orthopaedic Associates, P.C.
$101.84Published rateGenevieve Matthews
Radu Codel, Md, PC
$40.54Published rateAlan Roth
Kew Gardens Family Physicians LLP
$19.52Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 76536 vs. Other Diagnostic Ultrasound Procedures Codes
The table lists codes related to 76536. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| 76506-CPT | Low | Echo Exam Of Head, Echoencephalography Real Time With Image Documentation Gray Scale For Determination Of Ventricular Size Delineation Of Cerebral Contents And Detection Of Fluid Masses Or Other Intracranial Abnormalities Including A Mode Encephalography As Secondary Component Where Indicated |
| 76536-CPT | Low | Ultrasound Of Head And Neck, Ultrasound (Images With Sound Waves) Of The Thyroid Parathyroid Or Parotid Glands. These Glands Are In The Neck And Mouth. |
| 76800-CPT | Low | Echography, Spinal Canal & Contents |
| 76882-CPT | Low | Us Lmtd Jt Fcl Evl Nvasc Xtr, Ultrasound Limited Joint Or Focal Evaluation Of Other Nonvascular Extremity Structure S Eg Joint Space Peri Articular Tendon S Muscle S Nerve S Other Soft Tissue Structure S Or Soft Tissue Mass Es Real Time With Image Documentation |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 76536. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 76536 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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Frequently Asked Questions
CPT stands for Current Procedural Terminology. CPT codes are standardized numerical codes used by medical professionals to report medical, surgical, and diagnostic services and procedures to entities like insurance companies. They are essential for accurate billing and processing of claims.
The cost of a medical procedure can vary significantly based on your location, the specific provider, and your insurance plan. To get an estimate for a specific CPT code and your location, we recommend checking Payerprice. Payerprice offers a fee schedule lookup tool where you can search with a CPT code and your specific location to get pricing information.
EOB stands for Explanation of Benefits. It's a statement from your health insurance company that explains what medical treatments and services were paid for on your behalf. It's not a bill, but it details the services received, the amount billed by the provider, the amount your insurer paid, and your remaining responsibility (like deductibles, co-pays, or co-insurance).
If you believe there's an error on your medical bill, the first step is to contact the healthcare provider's billing department to clarify or correct the issue. If the issue isn't resolved, you can contact your insurance company to review the claim. Always keep detailed records of all communications.
Insurance coverage for a specific procedure depends on your individual policy, including your benefits, deductibles, co-pays, and whether the procedure is deemed medically necessary. The best way to determine coverage is to contact your insurance provider directly and provide them with the CPT code for the procedure in question. You can also research typical costs using tools like Payerprice to understand potential out-of-pocket expenses even if covered.