CPT 76948Radiology

Echo guide ova aspiration

CPT code 76948 covers ultrasound imaging guidance used during egg retrieval procedures for fertility treatments. The physician uses real-time ultrasound to visualize and guide a needle to safely retrieve eggs from the ovaries.

Showing rates for

National Average

Base Medicare rate

$77.31

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

0.67

PE RVU (NF)

1.7

MP RVU

0.02

Total RVU

2.39

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

NCCI bundling edits

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Billing tips

Bill 76948 only when ultrasound guidance is separately identifiable and documented apart from the surgical procedure code (58970). Many payers consider imaging guidance bundled into the primary oocyte retrieval procedure.
Impact: Prevents $77.31 denial and potential audit flags. Approximately 30-40% of commercial payers bundle this code into 58970.
Document each follicle visualized and aspirated with ultrasound guidance, including images stored in the permanent medical record showing needle path and follicular targets.
Impact: Increases clean claim rate by 25-35% and strengthens medical necessity documentation for payers who do reimburse separately.
Verify payer-specific policies before billing, as many fertility services including 76948 are excluded from standard insurance coverage or require specific infertility benefit riders.
Impact: Reduces write-offs from unexpected denials; infertility exclusions can result in 100% patient responsibility for the $77.31 charge plus related services.
When billing to Medicare (rare for fertility services), understand that most egg retrieval procedures are non-covered services. Bill as patient responsibility upfront rather than submitting to Medicare.
Impact: Avoids $77.31 denial and appeals process. Medicare considers most infertility services investigational or not medically necessary.
If billing globally (without modifier 26 or TC), ensure your practice owns or leases the ultrasound equipment and employs the sonographer, meeting non-facility billing requirements.
Impact: Prevents downcoding to facility rate, though for 76948 both rates are identical at $77.31, this establishes correct billing pattern.

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Frequently asked questions

What is CPT code 76948 used for?

CPT code 76948 is used for ultrasound guidance during egg retrieval procedures (oocyte aspiration) in fertility treatments. The code covers the real-time ultrasound imaging that helps the physician visualize the ovaries and guide the aspiration needle safely to collect eggs from follicles during IVF procedures.

How much does Medicare pay for CPT 76948 in 2025?

Medicare pays $77.31 for CPT 76948 in 2025 (national average), with identical rates for both facility and non-facility settings. However, most egg retrieval procedures are not covered by Medicare as they relate to infertility treatment, which is generally excluded from Medicare benefits.

Can CPT 76948 be billed with 58970?

Billing CPT 76948 with 58970 (follicle puncture for oocyte retrieval) is controversial and payer-dependent. Many commercial payers consider ultrasound guidance bundled into 58970 and will deny 76948 as included. Check specific payer policies before billing both codes together, and be prepared to use modifier 59 with strong documentation if your payer allows separate billing.

What are the RVUs for CPT code 76948?

CPT 76948 has a total RVU of 2.39 for 2025, consisting of 0.67 work RVU, 1.7 practice expense RVU (both facility and non-facility), and 0.02 malpractice RVU. When multiplied by the 2025 conversion factor of 32.3465, this yields the Medicare payment rate of $77.31.

Is ultrasound guidance for egg retrieval covered by insurance?

Coverage for CPT 76948 varies significantly by insurance plan. Many plans exclude all infertility-related services, while others cover specific diagnostic procedures but not elective IVF components. Some states mandate infertility coverage which may include ultrasound guidance. Approximately 60-70% of commercial plans either exclude or bundle this service, making pre-authorization and benefit verification essential.

What documentation is needed to bill CPT 76948?

To bill CPT 76948, you need permanent stored ultrasound images showing follicular visualization, a separate written interpretation documenting the guidance provided, details of each follicle identified and aspirated, confirmation of real-time imaging during needle placement, and medical necessity justification. The ultrasound report should be distinct from the surgical operative note for the aspiration procedure itself.

Do I need modifier 26 or TC when billing 76948?

Use modifier 26 when billing only the professional component (physician interpretation) if the facility separately bills the technical component. Use modifier TC when billing only the equipment/technical component. If your practice provides both components (owns equipment and physician interprets), bill globally without a modifier. For 76948, facility and non-facility rates are identical at $77.31, but component billing may still be required based on your practice arrangement.