CPT 76983Radiology

Use ea addl target lesion

CPT code 76983 covers ultrasound imaging guidance used during procedures to destroy or remove each additional target lesion beyond the first one. This is an add-on code that cannot be billed alone and requires a primary ablation procedure code.

Showing rates for

National Average

Base Medicare rate

$57.58

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

0.47

PE RVU (NF)

1.28

MP RVU

0.03

Total RVU

1.78

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

NCCI bundling edits

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Billing tips

Verify the primary ablation code includes ultrasound guidance for the first lesion before billing 76983
Impact: Prevents denial for incorrect code pairing; 76983 requires base codes like 76940 or procedure-specific codes that bundle first-lesion imaging
Document each additional lesion separately with size, location, and anatomic landmarks in the procedure report
Impact: Essential for audit defense; inadequate lesion-specific documentation is the leading cause of 76983 denials and recoupment
Report 76983 for each additional lesion beyond the first up to the maximum number supported by medical necessity
Impact: At $57.58 per unit, treating 3 additional lesions yields $172.74; undercoding loses revenue while overcoding risks fraud allegations
Ensure real-time imaging documentation shows active guidance during ablation, not just pre-procedure localization
Impact: Real-time monitoring requirement distinguishes billable guidance from diagnostic imaging; missing real-time documentation triggers 30-50% denial rates
Check NCCI edits quarterly as 76983 bundling rules change with updates to primary ablation codes
Impact: Proactive edit monitoring prevents claim rejections; January 2025 edits may affect pairing with new ablation technology codes
Bill facility and non-facility settings identically as both reimburse $57.58 with matching RVUs
Impact: Simplifies billing across settings; no place-of-service adjustments needed unlike most imaging codes

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Frequently asked questions

What is CPT code 76983 used for?

CPT 76983 is an add-on code for ultrasound guidance during ablation of each additional target lesion beyond the first one. It's reported when a physician uses real-time ultrasound imaging to guide the destruction of multiple lesions during a single treatment session, with the primary ablation code covering the first lesion.

How much does Medicare pay for CPT 76983 in 2025?

Medicare pays $57.58 for CPT 76983 in 2025 under the national average rate, applicable to both facility and non-facility settings. The code has 1.78 total RVUs (0.47 work RVU, 1.28 practice expense RVU, 0.03 malpractice RVU) multiplied by the 2025 conversion factor of 32.3465.

Can CPT 76983 be billed alone or does it require another code?

CPT 76983 cannot be billed alone; it is an add-on code that must be reported with a primary ablation procedure code. The primary code should include ultrasound guidance for the first lesion, and 76983 is added for each additional lesion treated during the same session.

How many times can I bill CPT 76983 for a single patient encounter?

You can bill CPT 76983 once for each additional lesion beyond the first that receives ultrasound-guided ablation during the procedure. There is no arbitrary limit, but each unit must be medically necessary and thoroughly documented with specific lesion identification and separate guidance documentation.

What documentation is needed to support billing CPT 76983?

Documentation must include identification of each additional lesion with specific anatomic location, size measurements, proof of real-time ultrasound guidance during ablation of each lesion, stored imaging, and medical necessity justification for treating multiple lesions. Each lesion requires individual description and documentation of separate ultrasound guidance.

What is the difference between CPT 76940 and 76983?

CPT 76940 is for ultrasound guidance during needle placement procedures (biopsies, aspirations, injections), while 76983 is specifically for add-on ultrasound guidance during ablation of additional lesions beyond the first. 76983 is always an add-on code, whereas 76940 can be a standalone code depending on the primary procedure.

What modifiers are commonly used with CPT 76983?

Common modifiers for 76983 include modifier 59 or XS for distinct procedural services when multiple add-on codes might appear bundled, RT/LT for laterality when treating bilateral lesions, and modifier 76 for repeat procedures on the same day. Modifier 26 is generally not applicable as the code has identical facility and non-facility rates.