CPT 76987Radiology

Dx intraop epicar car us chd

CPT code 76987 covers diagnostic ultrasound imaging performed during open-heart surgery to evaluate congenital heart defects by placing the ultrasound probe directly on the heart's surface. This imaging helps surgeons visualize heart structures in real-time to guide surgical repair of birth defects in the heart.

Showing rates for

National Average

Base Medicare rate

$92.19

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

1.9

PE RVU (NF)

0.68

MP RVU

0.27

Total RVU

2.85

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

NCCI bundling edits

Loading bundling edits…

Billing tips

Document the specific timing relationship to the surgical procedure, ensuring clear indication that ultrasound was performed intraoperatively (not pre-op or post-op TEE)
Impact: Prevents denials for incorrect code selection; saves approximately $92.19 per claim by avoiding downcoding to non-intraoperative echocardiography codes
Clearly document the congenital heart disease indication and how the epicardial ultrasound findings impacted surgical decision-making or confirmed repair adequacy
Impact: Establishes medical necessity and reduces denial risk by 60-70%, ensuring the full $92.19 reimbursement with 2.85 RVUs
Verify that the operative report from the cardiac surgeon documents the presence and use of intraoperative ultrasound to support your separate claim
Impact: Strengthens claim validity during audits; coordinated documentation prevents payer requests for refunds averaging $92.19 per disputed claim
Bill separately from transesophageal echocardiography (TEE) codes when both are performed, using modifier 59 or XU with clear documentation of distinct purposes
Impact: Allows reimbursement for both procedures when medically necessary, potentially adding $92.19 plus TEE payment instead of bundled denial
Ensure the interpreting physician's report is completed and signed separately from the surgical operative note within required timeframes
Impact: Meets compliance requirements and prevents delayed payment or denials; typically ensures payment within 30 days versus 60+ day appeals
Verify payer-specific policies on intraoperative imaging as some commercial payers may require pre-authorization even for intraoperative add-on services

Live Field Datano reports yet

Real billers contribute denial patterns and appeal strategies for this code. Once 5+ reports come in, you’ll see live aggregated data here — the only place this exists, free.

Working with CPT 76987?

Get the free Revenue Protection Toolkit — the denial triggers, modifier pitfalls, and bundling conflicts that quietly cost you reimbursement. Instant download.

Help build the field knowledge

MedPayIQ gets smarter as billers contribute. If you've had this code denied, share what happened so others learn from it. Anonymous, no patient info.

Related actions

Frequently asked questions

What is the Medicare reimbursement rate for CPT code 76987 in 2025?

The 2025 Medicare national average reimbursement rate for CPT 76987 is $92.19 for both facility and non-facility settings. This is based on 2.85 total RVUs (1.9 work RVU, 0.68 PE RVU, 0.27 MP RVU) multiplied by the 2025 conversion factor of 32.3465.

Can CPT 76987 be billed with transesophageal echocardiography codes?

Yes, CPT 76987 can be billed separately from TEE codes (93312-93318) when both are medically necessary and performed during the same operative session, but requires modifier 59 or XU with documentation clearly distinguishing the purpose and timing of each procedure. The epicardial approach provides different anatomic windows than TEE and may be necessary for specific surgical guidance.

Who can bill CPT code 76987 for intraoperative epicardial ultrasound?

CPT 76987 can be billed by cardiologists (especially pediatric or adult congenital specialists), radiologists with cardiac imaging expertise, or cardiovascular surgeons who perform and interpret the epicardial ultrasound examination. The interpreting physician must be credentialed in echocardiography interpretation and provide a separate written report.

Is CPT 76987 only used for pediatric congenital heart surgery?

No, while CPT 76987 is commonly used in pediatric congenital heart surgery, it also applies to adult patients undergoing surgical repair of congenital heart defects. The code is specific to congenital heart disease (any age) rather than acquired cardiac conditions, and requires epicardial ultrasound during open cardiac surgery.

What documentation is required to support billing CPT 76987?

Documentation must include evidence of congenital heart disease, confirmation of intraoperative timing during open cardiac surgery, description of epicardial probe placement, specific structures examined, findings that influenced surgical decisions, and a complete separate interpretation report signed by a qualified physician. The surgical operative note should corroborate the use of intraoperative ultrasound.

Does CPT 76987 include both professional and technical components?

CPT 76987 has identical facility and non-facility rates ($92.19), suggesting it represents primarily professional interpretation services. The technical component (equipment and technologist) is typically included in the hospital's facility fee for the surgical procedure. Modifier 26 is rarely applicable since the professional work comprises the entire valued service.

How does CPT 76987 differ from other intraoperative echocardiography codes?

CPT 76987 is specific to epicardial ultrasound (probe placed directly on the heart surface) during surgery for congenital heart defects. This differs from TEE codes (93312-93318) where the probe is in the esophagus, and from other ultrasound guidance codes that are not specific to congenital cardiac surgery. The epicardial approach and congenital diagnosis are defining characteristics.