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See a sample rate comparisonCPT 76998 Fee Schedule
Medicare rates as of October 2026
CPT 76998 is classified under Radiology Procedures, in the Diagnostic Ultrasound Procedures subgroup.
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 | 26 - Professional component 59 - Distinct Procedural Service |
| Complexity Level | Low |
| Medicare Fee Schedule | $48.77 national non-facility rate (2026) · View Medicare rates for 76998 |
| Medicaid Fee Schedule | $53.32 median of the 7 states in the free preview · View Medicaid rates for 76998 |
National average reimbursement for CPT 76998 by major payers:
$130.96
BCBS / Anthem
$196.29
UnitedHealthcare
$99.64
Aetna
$190.93
Cigna
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CPT 76998
5 of 25 sample ratesHigher to lower in this preview
Brittany Papworth
$422.41Published rateMatthew Lilley
The Orthopedic And Neurosurgical Center Of The Cascades
$265.11Published rateLaura Pickford
Internal Medicine Associates Of Reston
$218.91Published rateGil Porat
$134.89Published rateDhruv Pateder
Town Center Orthopaedic Associates, P.C.
$75.15Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 76998 vs. Other Diagnostic Ultrasound Procedures Codes
The table lists codes related to 76998. Select one to see its fee schedule.
| 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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Frequently Asked Questions
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.
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.
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.
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.
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.