2017 Urology Payment Information

The following chart provides payment information that is based on the national unadjusted Medicare physician fee schedule for the ultrasound services discussed. Payment will vary by geographic region.

The information provided below is intended to assist providers in determining appropriate codes and the other information for reimbursement purposes. It represents the information available to United Medical Instruments as of January 2017. Subsequent guidance might alter the information provided. United Medical Instruments disclaims any responsibility to update the information provided. It is the provider’s responsibility to determine and submit appropriate codes, modifiers, and claims for the services rendered. Before filing any claims, providers should verify current requirements and policies with the applicable payer.

Urology Ultrasound CPT Codes and Descriptions

Medicare Physician Fee Schedule – National Average*
CPT Code Description Private Office Hospital Professional Component Technical 2  Component
Ultrasound Evaluation
76857 Us exam pelvic limited $49.17 $49.17 $25.48 $23.69
76870 Ultrasound, scrotum and contents $69.62 $69.62 $33.02 $36.61
76872 Ultrasound, transrectal $96.90 $96.90 $34.09 $62.81
76873 Ultrasound, transrectal; prostate volume study for brachytherapy treatment planning $174.42 $174.42 $79.67 $94.75
76770 Ultrasound, retroperitoneal (e.g., renal, aorta, nodes), real time with image documentation; complete $115.56 $115.56 $37.68 $77.88
76775 Ultrasound, retroperitoneal (e.g., renal, aorta, nodes), real time with image documentation; limited $59.58 $59.58 $29.43 $30.15
76942 Ultrasonic guidance for needle placement (e.g., biopsy, aspiration, injection, localization device), imaging supervision and interpretation $61.37 $61.37 $33.02 $28.35
Procedures
51798 Measurement of post-voiding residual urine and/or bladder capacity by ultrasound, non-imaging $19.74 $19.74 n/a n/a
55700 Biopsy, prostate; needle or punch, single or multiple, any approach $253.37 $136.02 n/a n/a


1
Professional Payment: use to estimate the reimbursement to the physician.

2Technical Payment: use to estimate the reimbursement to the technologist.

CPT™ five digit codes, nomenclature and other data are Copyright 2015 American Medical Association. All rights reserved. No fee schedules, basic units, relative values or related listings are included in CPT. The AMA assumes no liability for the data contained herein. Applicable FARS/DFARS restrictions apply to government use. 

Deficit Reduction Act of 2005 Adjustment has not been figured into the above global fees.