CPT 76706Radiology

Us abdl aorta screen aaa

CPT code 76706 is for an ultrasound screening of the abdominal aorta to detect an abdominal aortic aneurysm (AAA), a potentially dangerous bulge in the main blood vessel that supplies blood to the abdomen and lower body.

Showing rates for

National Average

Base Medicare rate

$103.51

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

0.55

PE RVU (NF)

2.61

MP RVU

0.04

Total RVU

3.2

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

NCCI bundling edits

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Billing tips

Verify patient meets Medicare's one-time screening criteria: men age 65-75 with smoking history, or patients with family history of AAA. Medicare covers this only once in a lifetime.
Impact: Prevents 100% denial ($103.51 loss) due to coverage criteria not met
Use diagnosis code Z13.6 (encounter for screening for cardiovascular disorders) as primary diagnosis, not a diagnostic code like I71.4 (AAA without rupture), which indicates diagnostic rather than screening intent.
Impact: Wrong diagnosis code triggers denial as screening vs diagnostic study; requires corrected claim resubmission
Bill on the actual date of service when screening is performed, not the date of referral or order. Medicare beneficiaries become eligible during their welcome to Medicare visit or thereafter if criteria met.
Impact: Incorrect dating can result in coverage denials requiring appeal and delayed payment by 30-60 days
Do not bill 76706 with modifier 59 or XU on the same day as other abdominal ultrasound codes (76700, 76705) unless distinctly separate anatomical areas are examined with separate documentation.
Impact: Unbundling violations result in denial of the lower-paying code and potential recoupment audit
For split billing scenarios (hospital technical, radiologist professional), ensure both parties use matching modifiers (26 for professional, TC for technical) to equal the global rate.
Impact: Mismatched modifiers cause payment delays or overpayment recoupment; ensures proper $103.51 total distribution
Obtain and document an Advance Beneficiary Notice (ABN) if patient does not meet screening criteria but requests the study anyway, and append modifier GA.

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Frequently asked questions

What is the Medicare reimbursement rate for CPT code 76706 in 2025?

The 2025 Medicare national average payment rate for CPT code 76706 is $103.51 for both facility and non-facility settings. This rate includes 3.2 total RVUs multiplied by the 2025 conversion factor of 32.3465.

How often can CPT 76706 be billed for the same patient?

CPT 76706 can be billed only once in a patient's lifetime under Medicare's AAA screening benefit. This is a one-time preventive service for eligible beneficiaries. Subsequent abdominal aortic ultrasounds would require different codes and would be considered diagnostic rather than screening studies.

Who is eligible for AAA screening under Medicare using code 76706?

Medicare covers 76706 for men aged 65-75 who have smoked at least 100 cigarettes in their lifetime, or for individuals (men or women) who have a family history of abdominal aortic aneurysm. The screening must be ordered as part of the Welcome to Medicare preventive visit or thereafter if criteria are met.

What diagnosis code should be used when billing CPT 76706?

The appropriate primary diagnosis code for CPT 76706 is Z13.6 (encounter for screening for cardiovascular disorders). Using a diagnostic code such as I71.4 (abdominal aortic aneurysm without rupture) would indicate a diagnostic rather than screening study and may result in denial.

Can CPT 76706 be billed with other ultrasound codes on the same day?

Generally, 76706 should not be billed with comprehensive abdominal ultrasound codes (76700, 76705) or other aortic duplex codes (93978, 93979) on the same date as they are considered bundled or overlapping services. If medically necessary and documented as distinctly separate studies, modifier 59 may be appropriate, but this will likely trigger payer review.

What modifiers are commonly used with CPT code 76706?

Common modifiers for 76706 include modifier 26 (professional component only), TC (technical component only), GA (ABN on file when coverage criteria may not be met), and GY (statutorily excluded service). Modifier 26 and TC are used in split billing arrangements where the technical and professional components are billed separately.

What are the work RVUs and total RVUs for CPT 76706 in 2025?

For 2025, CPT 76706 has a work RVU of 0.55, practice expense RVU of 2.61 (both facility and non-facility), malpractice RVU of 0.04, for a total RVU of 3.2. These values are from the CMS Medicare Physician Fee Schedule RVU25A released December 23, 2024.