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See a sample rate comparisonHealthcare providers use this code to document and receive reimbursement for visits that address high-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 | 11 - Office 22 - On Campus Outpatient Hospital |
| Common Modifiers | None 59 - Distinct Procedural Service 26 - Professional component |
| Complexity Level | High |
| Medicare Fee Schedule | View Medicare rates for 76999 |
National average reimbursement for CPT 76999 by major payers:

$1,008.41

$58.37

$201.36

$418.32
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Multicare Health System
University Health Systems Inc
Medical University Hospital Authority
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Rate Benchmarking
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See a sample payer proposalCPT 76999 vs. Other Diagnostic Ultrasound Procedures Codes
The CPT 76999 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 76999 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 |
|---|---|---|
| 76885-CPT | Low | Us Exam Infant Hips Dynamic, Ultrasound Infant Hips Real Time With Imaging Documentation Dynamic Requiring Physician Or Other Qualified Health Care Professional Manipulation |
| 76886-CPT | Low | Us Exam Infant Hips Static, Ultrasound Infant Hips Real Time With Imaging Documentation Limited Static Not Requiring Physician Or Other Qualified Health Care Professional Manipulation |
| 76999-CPT | High | Ultrasound Exam, Ultrasound Uses Sound Waves To Create A Video Image Of A Body Part. It Is Used As A Visual Guide During A Procedure As Well As To Assess Functions Such As Blood Flow In Real-Time. |
| 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 76999. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 76999 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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