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See a sample rate comparisonCPT 76872 Fee Schedule
Last Verified: September 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 Scan Of Pelvis, Ultrasound (Sound Waves) Taken By Inserting A Hand-Held Device Into The Rectum.
| Key Fact | Detail |
|---|---|
| Service Type | Radiology Procedures Diagnostic Ultrasound Procedures |
| Common Place of Service | 11 - Office 24 - Ambulatory Surgical Center |
| Common Modifiers | None 26 - Professional component TC - Technical component |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 76872 |
| Medicaid Fee Schedule | View Medicaid rates for 76872 |
National average reimbursement for CPT 76872 by major payers:
$202.80
$165.25
$166.78
$238.15
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CPT 76872
5 of 25 sample ratesHigher to lower in this preview
Phillip Chapman
$559.21Published rateWilliam Anderson
The Everett Clinic, PLLC
$296.08Published ratePacific Medical Specialty Group
$159.88Published rateAnthony Law
Emory University
$85.45Published rateAndrew S Edwards Md PLLC, Walla Walla Eye Center
Andrew S. Edwards, M.D., P.C.
$34.29Published rate
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See a sample payer proposalCPT 76872 vs. Other Diagnostic Ultrasound Procedures Codes
The CPT 76872 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 76872 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 |
|---|---|---|
| 76830-CPT | Low | Vaginal Ultrasound, Ultrasound (Sound Wave Images) Of The Reproductive System Taken By Inserting A Hand-Held Probe Into The Vagina. |
| 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 76872. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 76872 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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