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See a sample rate comparisonCPT 76942 Fee Schedule
Medicare rates as of October 2026
CPT 76942 is classified under Radiology Procedures, in the Diagnostic Ultrasound Procedures subgroup.
Ultrasonic Guidance Proc, Ultrasonic Guidance For Needle Placement (E.G. Biopsy Aspiration Injection Localization Device) Imaging Supervision And Interpretation
| 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 59 - Distinct Procedural Service |
| Complexity Level | Low |
| Medicare Fee Schedule | $64.13 national non-facility rate (2026) · View Medicare rates for 76942 |
| Medicaid Fee Schedule | $51.885 median of the 8 states in the free preview · View Medicaid rates for 76942 |
National average reimbursement for CPT 76942 by major payers:
$80.73
BCBS / Anthem
$113.27
UnitedHealthcare
$122.93
Aetna
$121.78
Cigna
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CPT 76942
5 of 25 sample ratesHigher to lower in this preview
Robert Sommer
Columbia University In The City Of New York
$185.52Published rateChristina Baselga
Inova Health Care Services
$85.65Published rateRahul Kumar
Cardiac Arrhythmia Specialist PC
$52.58Published rateHelai Hesham
Columbia University In The City Of New York
$36.06Published rateAzriel Haimowitz
$20.95Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 76942 vs. Other Diagnostic Ultrasound Procedures Codes
The table lists codes related to 76942. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| 76942-CPT | Low | Ultrasonic Guidance Proc, Ultrasonic Guidance For Needle Placement (E.G. Biopsy Aspiration Injection Localization Device) Imaging Supervision And Interpretation |
| 77002-CPT | Low | X-Ray-Guided Needle Placement, Fluoroscopic Guidance Is Used To Place A Needle In A Precise Location. Fluoroscopy Is An X-Ray Technique That Shows Movement In Real-Time With The Aid Of Contrast Dye. |
| 77011-CPT | Moderate | Ct-Guided Imaging, A Ct (Computed Tomography) Scan Creates Images From Multiple Locations Around An Area. These Images Are Assembled Into A Stereotactic Image A 3-D Map That Uses Two Or More Points To Precisely Locate A Point In-Between. |
| 77012-CPT | Low | Ct-Guided Needle Placement, A Ct (Computed Tomography) Scan Is Used To Guide The Placement Of A Needle For A Biopsy. The Scanner Circles The Body Taking X-Rays And Assembles Them Into A 3-D Image. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 76942. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 76942 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 76942 is a code used for Diagnostic Ultrasound Procedures within Radiology Services. It is characterized as a moderate-complexity encounter, demanding more provider time and a moderate level of medical decision-making. This distinguishes it from lower-level codes, such as 77002, 77011, and 77012, which typically involve less time and simpler assessments. Procedures billed under 76942 usually encompass more intricate clinical scenarios, including multiple diagnoses, medication management, or comprehensive test interpretation. Consequently, this code generally leads to higher reimbursement and necessitates more detailed documentation compared to its lower-level counterparts. For specific fee schedule information related to CPT 76942 in your location, you can utilize Payerprice's fee schedule lookup tool.