CPT 76391Radiology

Mr elastography

CPT code 76391 covers MR elastography, an advanced MRI technique that measures tissue stiffness to detect abnormalities like liver fibrosis or tumors without a biopsy.

Showing rates for

National Average

Base Medicare rate

$196.34

This calculator gives a typical-case estimate using standard Medicare modifier rules. Actual payment depends on payer policies, documentation, code-specific CMS status indicators, and locality. Verify before billing.

RVU breakdown

Work RVU

1.1

PE RVU (NF)

4.9

MP RVU

0.07

Total RVU

6.07

Conversion factor: 32.3465 · Source: CMS MPFS RVU25A · Confidence: High

NCCI bundling edits

Loading bundling edits…

Billing tips

Always bill 76391 in conjunction with the appropriate base MRI code (e.g., 74181-74183 for liver MRI) as it is an add-on procedure
Impact: Failure to link with base code results in 100% claim denial; proper pairing ensures full $196.34 reimbursement
Document the specific quantitative stiffness measurements in kilopascals (kPa) and the anatomic region assessed in the radiology report
Impact: Lack of quantitative data accounts for 35-40% of audit recoupments; proper documentation protects the full payment
Verify LCD coverage for the specific anatomic region; Medicare primarily covers liver MRE but coverage varies by MAC for other organs
Impact: Billing for non-covered anatomic regions (e.g., brain MRE in some jurisdictions) results in denial; ABNs can recover costs from patients
Do not bill 76391 on the same date as liver biopsy codes (47000, 47001) without clear documentation of why both were medically necessary
Impact: Concurrent billing raises red flags and may trigger medical necessity denials; proper justification prevents $196.34 loss
Confirm the facility has the specific CPT-required MRE equipment (passive or active driver system) and that it was actually used
Impact: Equipment verification during audits is common; false claims can result in recoupment plus penalties exceeding 3x the $196.34 payment
For facility billing, ensure the charge is captured on the same claim/encounter as the base MRI to demonstrate the add-on relationship
Impact: Split billing across different dates or claims may reduce reimbursement by 20-100% or trigger denials

Live Field Datano reports yet

Real billers contribute denial patterns and appeal strategies for this code. Once 5+ reports come in, you’ll see live aggregated data here — the only place this exists, free.

Working with CPT 76391?

Get the free Revenue Protection Toolkit — the denial triggers, modifier pitfalls, and bundling conflicts that quietly cost you reimbursement. Instant download.

Help build the field knowledge

MedPayIQ gets smarter as billers contribute. If you've had this code denied, share what happened so others learn from it. Anonymous, no patient info.

Related actions

Frequently asked questions

What is the Medicare reimbursement rate for CPT code 76391 in 2025?

The 2025 Medicare national average reimbursement for CPT 76391 is $196.34 for both facility and non-facility settings. This rate is based on a total of 6.07 RVUs multiplied by the 2025 conversion factor of $32.3465.

Can CPT 76391 be billed alone or does it require another code?

CPT 76391 cannot be billed alone; it is an add-on code that must be reported with a primary MRI code such as 74181-74183 for liver MRI, 77046-77049 for breast MRI, or 70551-70553 for brain MRI. Billing 76391 without a base MRI code will result in denial.

What documentation is required to bill CPT 76391 for MR elastography?

Documentation must include quantitative stiffness measurements in kilopascals (kPa), the specific anatomic region assessed, quality metrics of the elastography data, clinical indication for performing elastography, and integration of findings with standard MRI sequences. The report should demonstrate that actual elastography hardware was used, not just standard MRI.

Does Medicare cover MR elastography for organs other than the liver?

Medicare coverage for 76391 varies by jurisdiction and anatomic region. Liver MR elastography has the broadest coverage for fibrosis staging. Brain, breast, and other organ elastography may have limited or no coverage depending on the local Medicare Administrative Contractor (MAC) policy. Verify your LCD before performing the procedure.

How often can CPT 76391 be billed for the same patient?

Frequency limitations vary by payer and clinical indication. For liver fibrosis monitoring, most payers allow MR elastography annually or when there is significant clinical change. More frequent billing requires documentation of acute clinical events, treatment changes, or disease progression that justifies repeat assessment.

What modifiers are commonly used with CPT 76391?

Common modifiers include 26 (professional component only), TC (technical component only), and 59 (distinct procedural service to prevent bundling denials). Modifier 76 may be used for repeat procedures on the same day due to technical issues. Split billing scenarios in hospital settings frequently require modifier 26 for radiologist interpretation.

Can CPT 76391 be billed with ultrasound or CT elastography?

No, CPT 76391 is specific to MR elastography performed during magnetic resonance imaging. Ultrasound elastography is reported with different codes (76981-76983), and CT does not have standard elastography capabilities. Each elastography modality has distinct CPT codes and cannot be substituted.