CPT 76978Radiology

Us trgt dyn mbubb 1st les

CPT code 76978 covers specialized ultrasound imaging using contrast microbubbles to enhance visualization of blood flow and tissue perfusion during real-time, dynamic imaging of the first lesion examined.

Showing rates for

National Average

Base Medicare rate

$188.26

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

1.62

PE RVU (NF)

4.11

MP RVU

0.09

Total RVU

5.82

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

NCCI bundling edits

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Billing tips

Bill 76978 as an add-on code only with a primary ultrasound procedure (such as 76700, 76705, 76770, or 76775); it cannot be billed alone
Impact: Failure to bill with appropriate primary code results in 100% denial; proper pairing ensures $188.26 payment
Document the specific contrast agent used (brand name and dose), time of injection, and dynamic imaging phases captured throughout the examination
Impact: Detailed contrast documentation reduces audit risk by 60-70% and supports medical necessity
Separately document and justify each lesion when multiple lesions are evaluated; use 76978 for first lesion only, then appropriate add-on codes for additional lesions
Impact: Proper lesion-specific documentation can increase reimbursement by $150-$300 when multiple lesions require contrast characterization
Verify patient's contrast agent contraindications and document informed consent specific to microbubble contrast use before the procedure
Impact: Pre-procedure documentation prevents post-service denials for medical necessity and reduces liability exposure
Submit claim within 24-48 hours with complete imaging report that specifically describes contrast enhancement patterns and how they influenced diagnosis
Impact: Timely filing with comprehensive reports reduces payer follow-up requests by 40% and accelerates payment by 10-15 days
Track and bill for microbubble contrast agent separately using appropriate HCPCS codes (Q9950-Q9957 depending on agent used) in addition to the imaging service
Impact: Contrast agent costs ($200-$400 per vial) are not included in 76978 payment; separate billing recovers these significant supply costs

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Frequently asked questions

What is the 2025 Medicare reimbursement rate for CPT code 76978?

The 2025 Medicare national average reimbursement for CPT 76978 is $188.26 for both facility and non-facility settings, based on 5.82 total RVUs and a conversion factor of 32.3465.

Can CPT 76978 be billed alone or does it require a primary procedure code?

CPT 76978 is an add-on code and cannot be billed alone. It must be reported with a primary ultrasound procedure code such as 76700, 76705, 76770, or 76775. Billing 76978 without a primary procedure will result in denial.

What is the difference between CPT 76978 and standard ultrasound codes?

CPT 76978 specifically covers the additional work of administering microbubble contrast agents and performing real-time dynamic imaging to assess tissue perfusion and vascularity, whereas standard ultrasound codes cover only conventional gray-scale and Doppler imaging without contrast enhancement.

How many times can 76978 be billed per patient encounter?

CPT 76978 is reported once for the first lesion evaluated with contrast-enhanced ultrasound. If additional lesions are evaluated during the same session, different add-on codes or documentation strategies may apply depending on payer policy; verify specific guidelines with the payer.

What documentation is required to support billing CPT 76978?

Required documentation includes the specific contrast agent used with dose, medical necessity justification, informed consent, time-stamped dynamic imaging phases (arterial, portal, delayed), detailed contrast enhancement patterns, and explanation of how contrast findings influenced diagnosis or management decisions.

Are microbubble contrast agents included in the 76978 reimbursement?

No, the $188.26 Medicare payment for 76978 covers only the imaging service. Microbubble contrast agents must be billed separately using appropriate HCPCS codes (Q9950-Q9957 depending on the specific agent used), as these supplies represent additional costs of $200-$400 per vial.

Which medical specialties most commonly bill CPT code 76978?

CPT 76978 is most commonly billed by radiologists, interventional radiologists, and gastroenterologists/hepatologists who perform advanced ultrasound imaging for liver and kidney lesion characterization. It requires specific training in contrast-enhanced ultrasound techniques and contrast agent administration.