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See a sample rate comparisonCPT 76870 is classified under Radiology Procedures, in the Diagnostic Ultrasound Procedures subgroup.
| Key Fact | Detail |
|---|---|
| Service Type | Radiology Procedures Diagnostic Ultrasound Procedures |
| Common Place of Service | 11 - Office 23 - Emergency Room |
| Common Modifiers | 26 - Professional component TC - Technical component |
| Complexity Level | Low |
| Medicare Fee Schedule | $98.53 national non-facility rate (2026) · View Medicare rates for 76870 |
| Medicaid Fee Schedule | $80.19 median of the 8 states in the free preview · View Medicaid rates for 76870 |
National average reimbursement for CPT 76870 by major payers:

$120.80
BCBS / Anthem

$119.94
UnitedHealthcare

$133.00
Aetna

$145.05
Cigna
Choose a payer to see a sample of rates for CPT 76870.
Rachel Voss
H Lee Moffitt Cancer Ctr & Res Inst Life Time Cancer Scrn Ctr Inc
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H Lee Moffitt Cancer Ctr & Res Inst Life Time Cancer Scrn Ctr Inc
Carla Moodie
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Arthur Parsee
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Corinne Steffen
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See a sample payer proposalCPT 76870 vs. Other Diagnostic Ultrasound Procedures Codes
The table lists codes related to 76870. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| 76700-CPT | Low | Ultrasound Abdominal |
| 76870-CPT | Low | Ultrasound Of Scrotum, An Ultrasound (Sound Waves) To Create An Image Of The Interior Of The Scrotum. |
| 76872-CPT | Moderate | Ultrasound Scan Of Pelvis, Ultrasound (Sound Waves) Taken By Inserting A Hand-Held Device Into The Rectum. |
| 76873-CPT | Moderate | Ultrasou Transrectal; Prostat Volum Study For Brachythera Treat, Ultrasound Transrectal; Prostate Volume Study For Brachytherapy Treat |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 76870. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 76870 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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The CPT 76870 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 76870 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. For specific details on reimbursement rates, documentation specifics, or to compare this code's fee schedule based on your location and specific payer, it is recommended to use Payerprice's fee schedule lookup tool, which allows searching with CPT codes and specific locations.