What is CPT Code 76998?

CPT Code 76998 describes Ultrasound Guidance, Intraoperative. It is used by healthcare providers to document and receive reimbursement for visits involving moderate-level medical decision-making.

What is a fee schedule for CPT 76998?

A fee schedule for CPT 76998 is a list of fixed prices that healthcare providers charge for this specific service. These prices vary depending on payer type, geographic location, and provider contracts.

How much will a specific medical procedure cost?

The cost of a medical procedure can vary widely based on your location, the specific provider, and your insurance plan. To get an estimate for a specific procedure using a CPT code and your location, you can use tools like Payerprice's fee schedule lookup tool.

How do I find out what my insurance covers?

To understand what your specific insurance plan covers, including deductibles, copayments, and coinsurance for various services, the best approach is to contact your insurance provider directly. You can usually find their customer service number on your insurance card or on their official website.

What's the difference between in-network and out-of-network providers?

In-network providers have a contract with your insurance company, agreeing to provide services at negotiated rates. This usually means lower out-of-pocket costs for you. Out-of-network providers do not have such a contract, so your insurance might cover less, or not at all, leading to higher costs for you.

A CPT (Current Procedural Terminology) code is a five-digit numerical code used by healthcare providers to describe medical, surgical, and diagnostic services. These codes are essential for accurate billing and to help insurance companies process claims for reimbursement.

Where can I find pricing information for medical services?

Finding transparent pricing for medical services can be challenging, but there are resources available. For specific fee schedule information based on CPT codes and your location, you can utilize tools such as Payerprice's fee schedule lookup tool. This can help you get an estimate of costs before your service.

What is a deductible, copay, and coinsurance?

These are common terms related to your insurance costs: * **Deductible:** The amount you must pay out-of-pocket for covered healthcare services before your insurance plan starts to pay. * **Copay (Copayment):** A fixed amount you pay for a covered healthcare service after you've paid your deductible (if applicable). * **Coinsurance:** Your share of the cost of a healthcare service, calculated as a percentage (e.g., 20%) of the allowed amount for the service, after you've paid your deductible.

CPT 76998 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 Guidance In Surgery, Ultrasound (Sound Wave) Guidance During Surgery Enhances The View Of A Body Area. This Enables Precise Placement Of Instruments Or Devices As Well As Accurate Work In Difficult Areas.

Key Fact	Detail
Service Type	Radiology Procedures Diagnostic Ultrasound Procedures
Common Place of Service	11 - Office 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 76998
Medicaid Fee Schedule	View Medicaid rates for 76998

National average reimbursement for CPT 76998 by major payers:

$130.96

$196.29

$99.64

$190.93

Compare published rates across providers.

Choose a payer to see a sample of rates for CPT 76998.

CPT 76998

5 of 25 sample ratesHigher to lower in this preview

Brittany Papworth
NCObstetrics & Gynecology PhysicianNPI 1801241567Tax ID 56-2120710
$422.41Published rate
Matthew Lilley
The Orthopedic And Neurosurgical Center Of The Cascades
OROrthopaedic Surgery PhysicianNPI 1003166612Tax ID 93-1261079
$265.11Published rate
Laura Pickford
Internal Medicine Associates Of Reston
VAObstetrics & Gynecology PhysicianNPI 1356327381Tax ID 20-2265068
$218.91Published rate
Gil Porat
KSHospitalist PhysicianNPI 1750350450Tax ID 84-0438224
$134.89Published rate
Dhruv Pateder
Town Center Orthopaedic Associates, P.C.
VAOrthopaedic Surgery of the Spine PhysicianNPI 1366540072Tax ID 54-1383504
$75.15Published rate

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Summit Women's CareDenver, Colorado

September 2, 2026

Contracting Manager
UnitedHealthcare
Commercial PPO

Re: Request for fee schedule renegotiation

We request a formal review of our Commercial PPO fee schedule. The comparison below summarizes our current rate alongside published rates for comparable Denver-area practices.

Market evidence · CPT 59485

Current rate: $152.40
Market median: $147.00
Market position: 61st percentile

The comparison includes 1,284 published rates from 96 provider groups, scoped to OB/GYN providers in a professional, office-based setting.

We would welcome a discussion of our fee schedule and the supporting July 2026 market analysis. Please let us know a suitable time to review the comparison together.

Sincerely,
Summit Women's Care

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CPT 76998 vs. Other Diagnostic Ultrasound Procedures Codes

The CPT 76998 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 76998 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
76978-CPT	Moderate	Ultrasound Targeted Dynamic M, Ultrasound Targeted Dynamic Microbubble Sonographic Contrast Characterization (Non-Cardiac) Initial Lesion
76979-CPT	Moderate	Ultrasound Targeted Dynamic M, Ultrasound Targeted Dynamic Microbubble Sonographic Contrast Characterization (Non-Cardiac) Each Additional Lesion With Separate Injection (List Separately In Addition To Code For Primary Procedure)
76998-CPT	Low	Ultrasound Guidance In Surgery, Ultrasound (Sound Wave) Guidance During Surgery Enhances The View Of A Body Area. This Enables Precise Placement Of Instruments Or Devices As Well As Accurate Work In Difficult Areas.
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 76998. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 76998 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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CPT 76998 Fee Schedule

Compare published rates across providers.

Brittany Papworth

Matthew Lilley

Laura Pickford

Gil Porat

Dhruv Pateder