CPT code 76098: Specimen X-ray, surgical specimen2026 Medicare rate & RVUs in New Jersey
Radiographic imaging of an excised surgical specimen, commonly used during breast lesion removal to confirm the target or localization marker is present.
Medicare pays $46.54–$48.92 for 76098 in the office in New Jersey, from Rest of New Jersey to Northern New Jersey. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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What 76098 covers
Code 76098 covers radiographic imaging of tissue or another specimen removed during surgery. A common example is breast specimen radiography after excision of a mammographic or ultrasound target: the image helps the surgeon confirm that the lesion, calcifications, or localization marker is in the removed tissue. Radiology staff typically obtain the image in or near the operating room, and a radiologist interprets it.
Report the service for imaging and interpretation of the excised specimen, not for imaging the patient’s breast or microscopic examination of the tissue. Documentation should identify the specimen and link the image and interpretation to the operative target. CMS recognizes professional and technical components: modifier 26 identifies the interpretation, modifier TC identifies the equipment and staff, and billing without either modifier represents the global service.
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
Where 76098 pays more and less in New Jersey
| Payment locality | Office | Facility |
|---|---|---|
| Northern New Jersey | $48.92 | Unavailable |
| Rest of New Jersey | $46.54 | Unavailable |
How the 76098 rate is calculated
Each of 76098’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 76098
RVUs × geographic indexes × conversion factor
Work0.30
0.30 RVUs× 1.000 GPCI
Practice expense0.96
0.96 RVUs× 1.000 GPCI
Malpractice0.03
0.03 RVUs× 1.000 GPCI
Adjusted RVUs
1.2900
Conversion factor
$33.4009
Medicare rate
$43.09
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 76098
The CMS indicators that decide how 76098 is paid alongside other services.
CMS payment indicators · 76098
Specimen X-ray, surgical specimen
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 1 | Diagnostic test with separate professional (26) and technical (TC) components. |
What modifiers do to the payment
Modifier 26 · payment effect
With and without the modifier
76098 without 26 · national office
$43.09
Specimen X-ray, surgical specimen
76098-26 · Professional component
$14.70
Pays only the interpretation and report.
76098 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 77065Diagnostic mammogramOne breast, CAD included
- 77065 is diagnostic mammography of the patient’s breast. Use 76098 for radiographic imaging of tissue already removed during surgery.
- 88307Tissue pathology examLevel V specimen
- 88307 reports surgical pathology examination of tissue. It does not report the radiographic image of the specimen captured by 76098.
- 76000FluoroscopyUnder one hour
- 76000 reports fluoroscopy during a procedure, imaging the patient in real time. Code 76098 concerns an excised specimen.
76098 billing questions
How is 76098 different from diagnostic breast imaging?
76098 images tissue after it has been removed during surgery. Diagnostic breast imaging, such as 77065, images the patient’s breast.
Can the radiograph and pathology examination both be reported?
Yes. The radiograph documents the specimen’s imaging findings, while pathology evaluates the tissue microscopically; they are distinct services.
When should modifier 26 or TC be used?
Use modifier 26 for the professional interpretation and modifier TC for the technical service, including equipment and staff. Billing without either modifier represents the global service.
What documentation supports reporting 76098?
The record should identify the removed specimen and include the specimen image and its interpretation, connecting the imaging findings to the surgical target.
Is 76098 the same as an X-ray taken during surgery?
No. 76098 is for imaging a removed surgical specimen. Fluoroscopy, such as 76000, images the patient during a procedure.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
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