CPT 76965 Fee Schedule
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.
| Key Fact | Detail |
|---|---|
| Service Type | • Radiology Procedures • Diagnostic Ultrasound Procedures |
| Common Place of Service | • 22 - On Campus Outpatient Hospital • 24 - Ambulatory Surgical Center |
| Common Modifiers | • None • 26 - Professional component • TC - Technical component |
| Complexity Level | Low |
National average reimbursement for CPT 76965 by major payers:
$123.77
$145.08
$131.76
$168.29
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 76965 | ||||||
United | 76965 | $304.48 | 1144647272 - ABIEYUWA EWEKA | 580566121 - (GA) JOHN D ARCHBOLD MEMORIAL HOSPITAL INC | IA | Vascular & Interventional Radiology Physician (2085R0204X) |
United | 76965 | $427.32 | 1376637322 - PAUL WHALEY | 203562205 - (MA) ANESTHETICS OF WORCESTER PC | MA | Certified Registered Nurse Anesthetist (367500000X) |
United | 76965 | $144.53 | 1154324184 - TERRI WILLIAMS-WEEKES | 873928715 - (MA) TMC RADIOLOGY CRA LLC | NY | Pediatric Radiology Physician (2085P0229X) |
United | 76965 | $77.87 | 1760773717 - AARON FALCHOOK | 596014973 - (FL) SOUTH BROWARD HOSPITAL DISTRICT | FL | Radiation Oncology Physician (2085R0001X) |
United | 76965 | $73.12 | 1104830900 - VAL VERDE HOSPITAL CORPORATION, VAL VERDE REGIONAL MEDICAL CENTER | 742941598 - VAL VERDE HOSPITAL CORPORATION | TX | General Acute Care Hospital (282N00000X) |
United | 76965 | $154.30 | 1962821991 - BERTHINA COLEMAN | 381459362 - WILLIAM BEAUMONT HOSPITAL | WA | Diagnostic Radiology Physician (2085R0202X) |
United | 76965 | $302.97 | 1821380932 - SVETLANA YABLOK | 223970667 - (NY) NORTH SHORE-LIJ RADIOLOGY SERVICES P C | FL | Diagnostic Radiology Physician (2085R0202X) |
United | 76965 | $47.00 | 1538139738 - PETER KALOS | 900730395 | AZ | Anesthesiology Physician (207L00000X) |
United | 76965 | $28.75 | 1225147234 - BASIM KAHLEIFEH | 205497203 - BAPTIST HEALTH MEDICAL GROUP INC | KY | Obstetrics & Gynecology Physician (207V00000X) |
United | 76965 | $154.30 | 1962821991 - BERTHINA COLEMAN | 822768899 - BEAUMONT MEDICAL GROUP - HOSPITAL-BASED SERVICES | WA | Diagnostic Radiology Physician (2085R0202X) |
United | 76965 | $216.13 | 1821380932 - SVETLANA YABLOK | 223970667 - (NY) NORTH SHORE-LIJ RADIOLOGY SERVICES P C | FL | Diagnostic Radiology Physician (2085R0202X) |
United | 76965 | $83.58 | 1154372423 - KEVIN KROEGER | 202552772 - (MD) PROFESSIONAL SERVICES OF HOLY CROSS | OH | Diagnostic Radiology Physician (2085R0202X) |
United | 76965 | $309.64 | 1902845043 - NOEL TAN | 592013191 | FL | Neonatal-Perinatal Medicine Physician (2080N0001X) |
United | 76965 | $100.04 | 1639134430 - JAMES BURLESON | 752403687 - (TX) SCURRY COUNTY HOSPITAL DISTRICT | TX | Family Medicine Physician (207Q00000X) |
United | 76965 | $66.95 | 1073502985 - CHU CHEN | 42484572 - MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC. | MA | Pediatrics Physician (208000000X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 76965 vs. Other Diagnostic Ultrasound Procedures Codes
The CPT 76965 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 76965 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 |
|---|---|---|
| 76965-CPT | Low | Ultrasonic Guidance For Interstitial Radioelement Application |
| 76975-CPT | Low | Gastrointestinal Endoscopic Ultrasound, Radiological Supervision & Int |
| 76977-CPT | Low | Ultrasound Bone Density Measurement And Interpretation Peripheral Site(S) Any Method |
| 77002-CPT | Low | Fluoroscopic Guidance For Needle Placement (Eg Biopsy Aspiration Injection Localization Device) (List Separately In Addition To Code For Primary Procedure). (Desc Revised 1/1/2017) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 76965. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 76965 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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