CPT 76700Radiology

Us exam abdom complete

CPT code 76700 is for a complete ultrasound examination of the abdomen, which uses sound waves to create images of organs like the liver, gallbladder, kidneys, pancreas, and spleen. This is a common imaging test ordered to evaluate abdominal pain, organ enlargement, or abnormal lab results.

Showing rates for

National Average

Base Medicare rate

$111.92

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

0.81

PE RVU (NF)

2.59

MP RVU

0.06

Total RVU

3.46

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

NCCI bundling edits

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Billing tips

Ensure all required structures are imaged and documented: liver, gallbladder, common bile duct, pancreas, spleen, kidneys, upper abdominal aorta, and IVC. Missing even one structure requires downcoding to 76705.
Impact: Billing 76705 instead of 76700 reduces reimbursement by approximately $40-50 (35-40% reduction). Proper documentation ensures full $111.92 payment.
Permanent images must be stored for all required anatomic areas. The written report must specifically mention visualization or attempted visualization of each required structure.
Impact: Failure to document all structures is the leading cause of downcoding during audits, resulting in recoupment of overpayments plus potential penalties
Bill globally (without modifiers) only when your practice owns the equipment and provides both technical and professional components. Hospital-based radiologists must use modifier 26.
Impact: Incorrect modifier use can result in 100% denial or overpayment. Modifier 26 typically pays approximately $30-35, while TC pays approximately $77-82
Do not bill 76700 with 76705 on the same date of service for the same anatomic area. If one area is complete and another limited, bill only the complete exam.
Impact: This is an NCCI edit violation that will result in automatic denial of the second code. CMS bundling edits prevent separate payment.
When bowel gas or body habitus limits visualization of required structures despite multiple attempts, document this thoroughly and bill 76705 for limited exam rather than 76700.
Impact: Proper coding to 76705 prevents audit exposure and compliance risk. Overcoding to 76700 when exam is limited can result in False Claims Act liability.

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Frequently asked questions

What is the difference between CPT 76700 and 76705?

CPT 76700 is a complete abdominal ultrasound that requires imaging and documentation of all specified organs (liver, gallbladder, bile duct, pancreas, spleen, both kidneys, aorta, and IVC). CPT 76705 is a limited abdominal ultrasound of one or more organs but not all required structures. 76700 reimburses at $111.92 while 76705 pays less due to reduced work. Use 76705 when technical factors prevent complete examination or when clinical question requires only specific organs.

How much does Medicare pay for CPT code 76700 in 2025?

Medicare pays $111.92 for CPT 76700 in 2025 under the national average non-facility rate. This is the global payment including both technical and professional components. The facility rate is also $111.92. Actual payment may vary by geographic locality based on the GPCI adjustments. When billed with modifier 26 (professional component only), payment is lower, typically around $30-35.

What organs must be included in a complete abdominal ultrasound 76700?

A complete abdominal ultrasound (76700) must include the liver, gallbladder, common bile duct, pancreas, spleen, both kidneys, upper abdominal aorta, and inferior vena cava (IVC). All structures must be evaluated in both transverse and longitudinal planes with permanent images stored. If any required structure cannot be visualized or is not examined, the study should be coded as 76705 (limited) instead.

Can I bill 76700 and 76705 together on the same day?

No, you cannot bill both 76700 and 76705 for the same anatomic region on the same date of service. These codes are mutually exclusive per NCCI edits. If you perform a complete exam of the abdomen, bill only 76700. If the exam is incomplete, bill only 76705. However, you could bill 76700 for abdomen and a separate pelvic ultrasound code if both areas were examined for different clinical indications.

What are the RVUs for CPT 76700 in 2025?

For 2025, CPT 76700 has a Work RVU of 0.81, non-facility Practice Expense RVU of 2.59, facility PE RVU of 2.59, and Malpractice RVU of 0.06, for a total of 3.46 RVUs. Using the 2025 conversion factor of 32.3465, this results in the Medicare payment of $111.92. These values are from the CMS Physician Fee Schedule RVU25A released December 23, 2024.

Do I need modifier 26 when billing 76700 in a hospital?

Yes, if you are a radiologist interpreting ultrasounds performed in a hospital that owns the equipment, you must append modifier 26 to bill only the professional component (interpretation). The hospital bills the technical component with modifier TC. If you work in a private office that owns the ultrasound equipment and employs the sonographer, bill 76700 globally without modifiers to receive payment for both components.

What diagnosis codes support medical necessity for 76700?

Common diagnosis codes supporting 76700 include abdominal pain (R10.x series), abnormal liver function tests (R94.5), jaundice (R17), hepatomegaly (R16.0), suspected gallstones (K80.x), pancreatic disorders (K85-K86), kidney disease (N28.x), screening for abdominal aortic aneurysm (Z13.6 in appropriate patients), or follow-up of known abdominal pathology. The diagnosis must justify why a complete rather than limited exam is necessary.