Ultrasound, soft tissues of head and neck (eg, thyroid, parathyroid, parotid), real time with image documentation

CPT 76536 is the billing code for "Ultrasound, soft tissues of head and neck (eg, thyroid, parathyroid, parotid), real time with image documentation". For ultrasound of soft tissues of head and neck

Medicare pays approximately $106.10 for CPT 76536 (national average). Actual payment varies by geographic location due to GPCI adjustments. Hospital and commercial insurance rates are typically 2-4x higher than Medicare rates.

CPT 76536 has a total RVU of 3.16, broken down as: Work RVU 0.60, Practice Expense RVU 2.50, and Malpractice RVU 0.06. RVUs (Relative Value Units) determine Medicare reimbursement rates.

Key documentation requirements for CPT 76536 include: Indication for ultrasound; Area(s) imaged; Findings and interpretation; Real-time imaging documented. Missing or incomplete documentation is a leading cause of claim denials for this code.

Bundling considerations for CPT 76536: Includes ultrasound head and neck soft tissues. Includes interpretation and report Use an NCCI bundling checker to verify specific code combinations before billing.

Common modifiers for CPT 76536 include: 26 (Professional component only (interpretation)), TC (Technical component only (equipment/staff)), 59 (Distinct procedural service if performed separately). Modifiers indicate special circumstances and can affect reimbursement or prevent claim denials.

The typical time requirement for CPT 76536 is 15-25 minutes typical procedure time. Time-based codes require documentation of the actual time spent providing the service.