Data Platform
Sign InTry for Free

CPT 76642 Fee Schedule

Last Verified: February 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.

Ultrasound, Breast, Unilateral, Real Time With Image Documentation, Including Axilla When Performed; Limited
Key FactDetail
Service Type

Radiology Procedures

Diagnostic Ultrasound Procedures

Common Place of Service

22 - On Campus Outpatient Hospital

11 - Office

Common Modifiers

None

LT - Left side of body

26 - Professional component

Complexity LevelLow
Medicare Fee ScheduleView Medicare rates for 76642

National average reimbursement for CPT 76642 by major payers:

bcbs

$116.46

uhc

$104.69

aetna

$109.59

cigna

$137.95

Preview provider-level rates for...
For billing codeCPT 76642
PayerCodeRateNPITax IDStateSpecialty

Select a payer to view fee schedule data

Choose a payer from the options above to see rates for CPT 76642

United
76642$351.801790096592 - RAHUL SAWLANI330675245VADiagnostic Radiology Physician (2085R0202X)
United
76642$17.891225271174 - RONALD WALSH131740127 - (NY) ST JOSEPHS HOSPITAL YONKERSNYBlood Banking & Transfusion Medicine Physician (207ZB0001X)
United
76642$88.981952798837 - ROCHELLE NAGALES NAGAMOS223487984 - SUMMIT MEDICAL GROUP, P.A.NYAnatomic Pathology & Clinical Pathology Physician (207ZP0102X)
United
76642$66.371376578369 - BRUCE URBAN204881619 - UNIVERSITY HOSPITALS HEALTH SYSTEM INCVADiagnostic Radiology Physician (2085R0202X)
United
76642$29.491346473071 - KISHAN PATEL454574670 - (NY) COMPLETE NEUROLOGICAL CARE PCNYNeurology Physician (2084N0400X)
United
76642$24.491528555117 - CHRISTOPHER BONDOC454574670 - (NY) COMPLETE NEUROLOGICAL CARE PCNYNeurology Physician (2084N0400X)
United
76642$54.491750914057 - SAMUEL APATA845061667 - (TX) GOODWILL DIAGNOSTIC SERVICES LLCTXDiagnostic Ultrasound Physician (2085U0001X)
United
76642$88.981417215468 - CHRISTOPHER BATCHELOR223487984 - SUMMIT MEDICAL GROUP, P.A.NJInternal Medicine Physician (207R00000X)
United
76642$134.271225077308 - CARLOS HAMILTON815443236 - (TX) INTERVENTIONAL PARTNERS, PLLC DBA STRIDE HEALTHCARE, PLLCTXVascular & Interventional Radiology Physician (2085R0204X)
United
76642$125.441881950012 - ALFREDO ECHEVERRIA300791563TXRadiation Oncology Physician (2085R0001X)
United
76642$74.911558456855 - NAVID HOMAYOUNI562616090DCNuclear Radiology Physician (2085N0904X)
United
76642$75.501760671317 - STANLEY NG463321096NYInternal Medicine Physician (207R00000X)
United
76642$111.151326305483 - ZACHARY ROEDER953365198 - SAN ANTONIO RADIOLOGICAL MEDICALVADiagnostic Radiology Physician (2085R0202X)
United
76642$34.041215068796 - ANDREW GOMES832497678 - (TX) NIRP LAREDO PLLCTXVascular & Interventional Radiology Physician (2085R0204X)
United
76642$105.051780116764 - EVERARDO FLORES760453250 - (TX) BAPTIST PHYSICIAN NETWORKTXDiagnostic Radiology Physician (2085R0202X)
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist
United
99202$100.0012345678901234567890CACardiologist

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 76642 vs. Other Diagnostic Ultrasound Procedures Codes

The CPT 76642 code is part of the Radiology Procedures services used for Diagnostic Ultrasound 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 76642 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.

CodeComplexityDescription
76641-CPTLowUltrasound, Breast, Unilateral, Real Time With Image Documentation, Including Axilla When Performed; Complete
76642-CPTLowUltrasound, Breast, Unilateral, Real Time With Image Documentation, Including Axilla When Performed; Limited
76700-CPTLowUltrasound Abdominal
76705-CPTLowEchogr,Abd,B-Scan/Real Time,Doc;Ltd

What is a fee schedule?

A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 76642. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 76642 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.

FREE SAMPLE MARKET COMPARISON

Let's review your payer contracts side-by-side with the market.

Bring your top codes (like CPT 76642) and we'll show you how you compare in 15 minutes or less.