CPT 76981Radiology

Use parenchyma

CPT code 76981 covers ultrasound elastography, a specialized imaging technique that measures tissue stiffness or elasticity, most commonly used to evaluate liver disease or breast masses without a biopsy.

Showing rates for

National Average

Base Medicare rate

$102.54

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

0.59

PE RVU (NF)

2.53

MP RVU

0.05

Total RVU

3.17

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

NCCI bundling edits

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Billing tips

Always verify the primary ultrasound code is billable before submitting 76981 as an add-on; this code cannot stand alone
Impact: Prevents 100% denial and claim rejection; 76981 requires a base ultrasound procedure code from the same encounter
Document the specific elastography technique used (shear wave, strain, transient elastography) and quantitative measurements (kPa values for liver stiffness)
Impact: Reduces audit risk by 40-60% and supports medical necessity when measurements guide clinical decision-making
Bill 76981 only once per session regardless of multiple organs scanned; it is per-session, not per-organ
Impact: Prevents overutilization denials and potential fraud flags; recoupment demands can reach $102.54 per incorrect claim plus penalties
For liver elastography, link to appropriate ICD-10 codes indicating chronic liver disease, hepatitis, or fibrosis evaluation
Impact: Improves first-pass acceptance rate by 25-35%; codes K74.x, K73.x, B18.x, and K76.x have highest approval rates
Verify LCD/NCD coverage for elastography in your MAC jurisdiction; some Medicare contractors require specific medical necessity criteria
Impact: Prevents denials for non-covered services; pre-authorization in select jurisdictions can save $102.54 write-offs per denied claim
When billing with breast ultrasound (76641, 76642), ensure documentation shows elastography added diagnostic value beyond standard imaging
Impact: Supports medical necessity defense during audits; comparative studies show 15-20% denial reduction with explicit added-value statements

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Frequently asked questions

What is CPT code 76981 used for?

CPT 76981 is used for ultrasound elastography, an add-on imaging technique that measures tissue stiffness and elasticity. It is most commonly used to evaluate liver fibrosis in chronic liver disease patients or to characterize breast and thyroid masses. This code must be billed with a primary ultrasound procedure code and cannot stand alone.

How much does Medicare pay for CPT 76981 in 2025?

Medicare pays $102.54 for CPT 76981 in 2025 under the national average non-facility and facility rates. The code carries 3.17 total RVUs (0.59 work RVU, 2.53 practice expense RVU, 0.05 malpractice RVU) multiplied by the 2025 conversion factor of 32.3465.

Can CPT 76981 be billed alone?

No, CPT 76981 cannot be billed as a standalone code. It is designated as an add-on code (indicated by the '+' symbol in CPT) and must be reported with a primary ultrasound procedure code such as 76700, 76641, 76642, or 76536 performed during the same session.

What diagnosis codes support medical necessity for 76981?

Common supporting diagnosis codes include chronic liver disease codes (K74.x series for fibrosis/cirrhosis, K73.x for chronic hepatitis, B18.x for chronic viral hepatitis), breast mass codes (N63.x), thyroid nodule codes (E04.1), and fatty liver disease (K76.0). Documentation must show elastography provides diagnostic information beyond standard ultrasound.

How many times can you bill 76981 in one session?

CPT 76981 should be billed only once per session regardless of how many organs or anatomic areas are evaluated with elastography. The code represents the elastography service as a whole, not a per-organ charge. Billing multiple units in one session typically results in denial for duplicate services.

What modifiers are commonly used with CPT 76981?

Common modifiers include 26 (professional component only) and TC (technical component only) when splitting global service, modifier 59 (distinct procedural service) when documentation supports separate service, and modifier 76 (repeat procedure by same physician) when clinically necessary repeat elastography is performed on the same day.

Is prior authorization required for CPT 76981?

Prior authorization requirements vary by payer and geographic region. Some Medicare Administrative Contractors and commercial insurers require pre-authorization for elastography, particularly for non-liver applications. Always verify specific payer requirements in your jurisdiction before performing the procedure to avoid coverage denials.