CPT 76979Radiology

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CPT code 76979 covers additional ultrasound imaging using special microbubble contrast agents to target and visualize specific areas of concern beyond the first lesion. This is an add-on code used when evaluating multiple lesions during the same ultrasound session with contrast enhancement.

Showing rates for

National Average

Base Medicare rate

$119.68

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

0.85

PE RVU (NF)

2.8

MP RVU

0.05

Total RVU

3.7

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

NCCI bundling edits

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Billing tips

Always bill 76979 in conjunction with primary microbubble contrast ultrasound code (76978); this add-on code cannot be billed alone
Impact: Prevents automatic denial; ensures you receive base code payment plus $119.68 for each additional lesion documented
Document each additional lesion separately with distinct anatomic location, size measurements, and contrast enhancement characteristics
Impact: Supports billing multiple units of 76979; proper documentation can add $119.68 per additional lesion versus losing reimbursement for undocumented lesions
Report the exact number of additional lesions as separate line items with unit quantity; do not combine multiple lesions into one unit
Impact: Maximizes appropriate reimbursement; billing 3 additional lesions correctly yields $359.04 versus $119.68 if improperly combined
Verify contrast agent administration is documented with specific agent name, dose, route, and timing in relation to imaging
Impact: Prevents medical necessity denials; contrast documentation is required for any payment of the $119.68 per lesion
Ensure physician report explicitly states real-time dynamic imaging was performed for each additional targeted area, not just stored image review
Impact: Meets CPT definition requirements; lack of real-time documentation can result in 100% denial of $119.68 per additional lesion
Check payer-specific policies on maximum number of billable additional lesions per session before submitting claims
Impact: Some payers limit to 2-3 additional lesions; exceeding limits without prior authorization results in denial of excess units at $119.68 each

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Frequently asked questions

What is CPT code 76979 used for?

CPT 76979 is an add-on code for ultrasound targeting with microbubble contrast for each additional lesion beyond the first. It's used when a physician performs contrast-enhanced ultrasound imaging on multiple separate areas or lesions during the same session, commonly for liver lesion characterization or cardiac perfusion studies.

How much does Medicare pay for CPT 76979 in 2025?

Medicare pays $119.68 for CPT 76979 in 2025 (national average). Both facility and non-facility rates are identical at $119.68, with total RVUs of 3.70 (0.85 work RVU, 2.8 practice expense RVU, 0.05 malpractice RVU).

Can CPT 76979 be billed alone?

No, CPT 76979 cannot be billed alone. It is an add-on code that must be reported with the primary microbubble contrast ultrasound code 76978. Billing 76979 without the primary code will result in automatic claim denial.

How many times can you bill CPT 76979 per session?

You can bill CPT 76979 once for each additional lesion or targeted area beyond the first, as clinically appropriate. However, payers may have specific limits (often 2-4 additional lesions) and each must be separately documented with distinct anatomic location and clinical justification.

What modifiers are commonly used with CPT 76979?

Common modifiers for CPT 76979 include modifier 59 (distinct procedural service for separate lesions), modifier 76 (repeat procedure by same physician), and modifier XU (unusual non-overlapping service). Modifiers 26 and TC are not typically used as facility and non-facility rates are identical.

What documentation is required to bill CPT 76979?

Documentation must include: the primary contrast ultrasound procedure (76978), specific anatomic location and size of each additional lesion, contrast agent details, real-time dynamic imaging findings for each lesion, separate interpretation of each lesion's contrast enhancement pattern, and medical necessity for imaging multiple lesions.

What is the difference between CPT 76978 and 76979?

CPT 76978 is the primary code for ultrasound targeting with microbubble contrast for the first lesion or area, while CPT 76979 is the add-on code for each additional lesion imaged during the same session. 76978 must always be billed first, followed by 76979 for each subsequent lesion evaluated.