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See a sample rate comparisonHealthcare 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 Ultrasound Procedures |
| Common Place of Service | 21 - Inpatient Hospital 22 - On Campus Outpatient Hospital |
| Common Modifiers | None 26 - Professional component 59 - Distinct Procedural Service |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 76937 |
| Medicaid Fee Schedule | View Medicaid rates for 76937 |
National average reimbursement for CPT 76937 by major payers:

$51.40

$42.01

$48.66

$53.40
Choose a payer to see a sample of rates for CPT 76937.
North Shore-Lij Medical PC
Associated Medical Professionals Of Ny, PLLC
Associated Medical Professionals Of Ny, PLLC
Town Center Orthopaedic Associates, P.C.
Richard Arnold Berger Md Corp
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Rate Benchmarking
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See a sample payer proposalCPT 76937 vs. Other Diagnostic Ultrasound Procedures Codes
The CPT 76937 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 76937 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 |
|---|---|---|
| 76932-CPT | Low | Ultrasound-Guided Heart Biopsy, Heart Surgery That Uses Ultrasound (Sound Waves) Guidance To Remove A Sample Of Tissue For Testing (Biopsy). |
| 76936-CPT | Moderate | Echo Guide For Artery Repair, Ultrasound Guided Compression Repair Of Arterial Pseudoaneurysm Or Arteriovenous Fistulae (Includes Diagnostic Ultrasound Evaluation Compression Of Lesion And Imaging) |
| 76937-CPT | Low | Us Guide Vascular Access, Ultrasound Guidance For Vascular Access Requiring Ultrasound Evaluation Of Potential Access Sites Documentation Of Selected Vessel Patency Concurrent Realtime Ultrasound Visualization Of Vascular Needle Entry With Permanent Recording And Reporting List Separately In Addition To Code For Primary Procedure |
| 77001-CPT | Low | Fluoroguide For Vein Device, Fluoroscopic Guidance For Central Venous Access Device Placement Replacement Catheter Only Or Complete Or Removal Includes Fluoroscopic Guidance For Vascular Access And Catheter Manipulation Any Necessary Contrast Injections Through Access Site Or Catheter With Related Venography Radiologic Supervision And Interpretation And Radiographic Documentation Of Final Catheter Position List Separately In Addition To Code For Primary Procedure |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 76937. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 76937 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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