Ultrasound, chest, real-time with image documentation
Relative Value Units (RVUs)
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Clinical Information
When to Use
For ultrasound of chest
Common Scenarios
Documentation Requirements
- Indication for chest ultrasound
- Findings and interpretation
- Real-time imaging documented
- Comparison to prior studies if available
- Report documentation
Coding Guidelines
Common Modifiers
Bundling Rules
- Includes ultrasound chest
- Includes interpretation and report
- Real-time imaging included
- Chest X-ray coded separately
- CT chest coded separately
Exclusions
- 71020 (chest X-ray, 2 views)
- 76536 (ultrasound, soft tissues of head and neck)
- 76700 (ultrasound, abdominal, complete)
- 76705 (ultrasound, abdominal, limited)
Coding Notes
Clinical scenarios
- Indication for chest ultrasound
- Findings and interpretation
- Real-time imaging documented
- Indication for chest ultrasound
- Findings and interpretation
- Real-time imaging documented
- Indication for chest ultrasound
- Findings and interpretation
- Real-time imaging documented
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Code Details
Medicare Pricing
PFSRVU Breakdown
OPPS Details
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Get instant answers about 76604 - pricing, bundling rules, or billing questions.
Ask a QuestionFrequently Asked Questions
CPT 76604 is the billing code for "Ultrasound, chest, real-time with image documentation". For ultrasound of chest
Medicare pays approximately $56.28 for CPT 76604 (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 76604 has a total RVU of 2.91, broken down as: Work RVU 0.55, Practice Expense RVU 2.30, and Malpractice RVU 0.06. RVUs (Relative Value Units) determine Medicare reimbursement rates.
Key documentation requirements for CPT 76604 include: Indication for chest ultrasound; Findings and interpretation; Real-time imaging documented; Comparison to prior studies if available. Missing or incomplete documentation is a leading cause of claim denials for this code.
Bundling considerations for CPT 76604: Includes ultrasound chest. Includes interpretation and report Use an NCCI bundling checker to verify specific code combinations before billing.
Common modifiers for CPT 76604 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 76604 is 15-25 minutes typical procedure time. Time-based codes require documentation of the actual time spent providing the service.