CPT code 76604: Chest ultrasound, diagnostic examination2026 Medicare rate & RVUs in Wisconsin

Reports diagnostic ultrasound of the chest, including assessment of pleural spaces, chest wall, or mediastinal structures for a clinical concern such as pleural fluid.

CMS RVU26DEffective Oct 1, 2026One payment locality129.1K Medicare services in 2024

In Wisconsin, Medicare pays $58.28 for 76604 in the office.

$58.28Office (non-facility)
Not available in this settingHospital or facility
−4.6%vs the national office rate ($61.12)

Check a contract rate as a % of Medicare · 76604 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 76604 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Wisconsin
  2. What 76604 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 76604 covers

This service uses real-time ultrasound to evaluate chest structures, with saved images supporting the examination and interpretation. Common clinical questions include whether pleural fluid is present and the appearance of the pleural space; the examination can also assess chest-wall or mediastinal structures. Radiologists, pulmonologists, emergency physicians, and other qualified practitioners may perform or interpret it in office, hospital, or emergency settings.

Report 76604 when the documented service is a diagnostic chest ultrasound, rather than breast imaging or ultrasound used only to guide a procedure. The record should identify the clinical question, area examined, images obtained, and findings or interpretation. A physician may report the professional component with modifier 26, the equipment and staff portion with modifier TC, or the global service without either modifier. CMS applies the diagnostic imaging multiple-procedure reduction to both the technical and professional components when applicable.

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.

How Wisconsin compares for 76604

Across 109 of 109 payment localities, the office rate for 76604 runs from $54.66 in Arkansas to $80.20 in San Benito County, CA. Wisconsin pays $58.28. The RVUs are the same everywhere; the geographic indexes change the dollars.

76604 in Wisconsin vs other payment areas
  1. Wisconsin · this page$58.28
  2. Los Angeles, CA · California$68.69+$10.41
  3. Washington, DC area · District of Columbia$69.49+$11.21
  4. Miami, FL · Florida$65.32+$7.04
  5. Chicago, IL · Illinois$63.62+$5.34
  6. Manhattan, NY · New York$69.84+$11.56
  7. Alaska · Alaska$72.67+$14.39

Other areas in Wisconsin first, then benchmark localities. Bars start at $0.

Every other payment area

76604 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$55.39—
ArkansasArkansas$54.66—
ArizonaArizona$59.64—
Bakersfield, CACalifornia$64.69—
Chico, CACalifornia$64.53—
El Centro, CACalifornia$64.53—
Fresno, CACalifornia$64.53—
Hanford, CACalifornia$64.53—

76604 rates by state

Office rate range in each state. Select a state to see its payment localities.

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$54.66

$72.67

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
76604 office rate range by state
State / territoryOffice rate rangeLocalities
AK$72.671
AL$55.391
AR$54.661
AZ$59.641
CA$64.53–$80.2029
CO$63.561
CT$64.951
DC$69.491
DE$60.571
FL$60.20–$65.323
GA$57.12–$62.162
GU$65.911
HI$65.911
IA$56.711
ID$57.041
IL$58.58–$63.634
IN$57.341
KS$56.451
KY$56.531
LA$56.44–$58.992
MA$63.22–$69.512
MD$61.66–$69.493
ME$57.29–$60.152
MI$57.85–$60.872
MN$61.111
MO$55.55–$59.203
MS$55.121
MT$61.121
NC$57.841
ND$60.131
NE$57.001
NH$62.561
NJ$65.75–$68.872
NM$58.131
NV$60.881
NY$58.62–$71.375
OH$57.651
OK$56.461
OR$60.47–$65.462
PA$57.75–$63.442
PR$61.541
RI$62.631
SC$57.831
SD$60.011
TN$56.701
TX$57.40–$63.308
UT$58.551
VA$59.95–$69.492
VI$61.541
VT$59.901
WA$63.10–$70.892
WI$58.281
WV$56.591
WY$60.691

See 76604 in every payment locality

How the 76604 rate is calculated

Each of 76604’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 · 76604

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.58

0.58 RVUs× 1.000 GPCI

Practice expense1.20

1.20 RVUs× 1.000 GPCI

Malpractice0.05

0.05 RVUs× 1.000 GPCI

Adjusted RVUs

1.8300

Conversion factor

$33.4009

Medicare rate

$61.12

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Wisconsin inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

8,733

Code
76604
Physician work
0.58
Practice expense
1.20
Malpractice
0.05

GPCI2026.csv

111

Locality
Wisconsin
Physician work
1.000
Practice expense
0.958
Malpractice
0.308
Office calculation for 76604 in Wisconsin
ComponentRVULocality factorAdjusted
Physician work0.58× 1.0000.5800
Practice expense1.20× 0.9581.1496
Malpractice0.05× 0.3080.0154
Total RVUs1.7450
Conversion factor× 33.4009

Office rate, Wisconsin$58.28

Office: (0.58 × 1 + 1.2 × 0.958 + 0.05 × 0.308) × $33.4009 = $58.28

Open 76604 in the RVU calculator

Payment rules and modifiers for 76604

The CMS indicators that decide how 76604 is paid alongside other services.

CMS payment indicators · 76604

Chest ultrasound, diagnostic examination

RuleCMS valueWhat it means
Global periodXXXThe global surgery concept doesn’t apply.
Multiple procedures4Diagnostic imaging reduction applies to the technical component (and professional component) of additional services.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical1Diagnostic test with separate professional (26) and technical (TC) components.

What modifiers do to the payment

Modifier 26 · payment effect

With and without the modifier

76604 without 26 · national office

$61.12

Chest ultrasound, diagnostic examination

76604-26 · Professional component

$27.72

Pays only the interpretation and report.

When to use modifier 26

How 76604 has changed in Wisconsin

76604 · Office / nonfacility

$58.28

Effective 2026-10-01

The base rate is $4.41 higher than on 2025-10-01, moving from $53.87 to $58.28 (8.2%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release
  1. January 1, 2026

    RVU26A

    $53.87changed to$58.28

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 0.59 changed to 0.58
    • Practice expense RVU 1.11 changed to 1.20
    • Malpractice RVU 0.04 changed to 0.05
    • Practice expense GPCI 0.957 changed to 0.958
    • Malpractice GPCI 0.331 changed to 0.308

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $54.48changed to$53.87

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 1.08 changed to 1.11

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $53.60changed to$54.48

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $54.65changed to$53.60

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 1.06 changed to 1.08
    • Malpractice RVU 0.05 changed to 0.04
    • Practice expense GPCI 0.950 changed to 0.957
    • Malpractice GPCI 0.314 changed to 0.331
  5. January 1, 2023

    RVU23A

    $56.79changed to$54.65

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 1.10 changed to 1.06
    • Practice expense GPCI 0.942 changed to 0.950
    • Malpractice GPCI 0.296 changed to 0.314

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $64.49changed to$56.79

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 1.32 changed to 1.10

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $76.56changed to$64.49

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 1.60 changed to 1.32
    • Malpractice RVU 0.04 changed to 0.05
    • Practice expense GPCI 0.949 changed to 0.942
    • Malpractice GPCI 0.322 changed to 0.296

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $86.54changed to$76.56

    • Conversion factor 36.0391 changed to 36.0896
    • Work RVU 0.55 changed to 0.59
    • Practice expense RVU 1.92 changed to 1.60
    • Practice expense GPCI 0.957 changed to 0.949
    • Malpractice GPCI 0.347 changed to 0.322

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $87.48changed to$86.54

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 1.95 changed to 1.92

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $86.27changed to$87.48

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 1.92 changed to 1.95
    • Practice expense GPCI 0.956 changed to 0.957
    • Malpractice GPCI 0.457 changed to 0.347

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $85.47changed to$86.27

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 1.90 changed to 1.92
    • Practice expense GPCI 0.955 changed to 0.956
    • Malpractice GPCI 0.566 changed to 0.457

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $85.78changed to$85.47

    • Conversion factor 35.9335 changed to 35.8043

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $85.35changed to$85.78

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $86.05changed to$85.35

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 1.91 changed to 1.90
    • Practice expense GPCI 0.958 changed to 0.955
    • Malpractice GPCI 0.557 changed to 0.566

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $86.41changed to$86.05

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 2.05 changed to 1.91
    • Practice expense GPCI 0.960 changed to 0.958
    • Malpractice GPCI 0.547 changed to 0.557

    Held through RVU14B, RVU14C, RVU14D.

  16. October 1, 2013

    RVU13D

    No ratechanged to$86.41

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$58.28Not available in this settingRVU26D
2026-07-01$58.28Not available in this settingRVU26C
2026-04-01$58.28Not available in this settingRVU26B
2026-01-01$58.28Not available in this settingRVU26A
2025-10-01$53.87Not available in this settingRVU25D
2025-07-01$53.87Not available in this settingRVU25C
2025-04-01$53.87Not available in this settingRVU25B
2025-01-01$53.87Not available in this settingRVU25A
2024-10-01$54.48Not available in this settingRVU24D
2024-07-01$54.48Not available in this settingRVU24C
2024-04-01$54.48Not available in this settingRVU24B
2024-03-09$54.48Not available in this settingRVU24AR
2024-01-01$53.60Not available in this settingRVU24A
2023-10-01$54.65Not available in this settingRVU23D
2023-07-01$54.65Not available in this settingRVU23C
2023-04-01$54.65Not available in this settingRVU23B
2023-01-01$54.65Not available in this settingRVU23A
2022-10-01$56.79Not available in this settingRVU22D
2022-07-01$56.79Not available in this settingRVU22C
2022-04-01$56.79Not available in this settingRVU22B
2022-01-01$56.79Not available in this settingRVU22A
2021-10-01$64.49Not available in this settingRVU21D
2021-07-01$64.49Not available in this settingRVU21C
2021-04-01$64.49Not available in this settingRVU21B
2021-01-01$64.49Not available in this settingRVU21A
2020-10-01$76.56Not available in this settingRVU20D
2020-07-01$76.56Not available in this settingRVU20C
2020-04-01$76.56Not available in this settingRVU20B
2020-01-01$76.56Not available in this settingRVU20A
2019-10-01$86.54Not available in this settingRVU19D
2019-07-01$86.54Not available in this settingRVU19C
2019-04-01$86.54Not available in this settingRVU19B
2019-01-01$86.54Not available in this settingRVU19A
2018-10-01$87.48Not available in this settingRVU18D
2018-07-01$87.48Not available in this settingRVU18C
2018-04-01$87.48Not available in this settingRVU18B
2018-01-01$87.48Not available in this settingRVU18AR1
2017-10-01$86.27Not available in this settingRVU17D
2017-07-01$86.27Not available in this settingRVU17C
2017-04-01$86.27Not available in this settingRVU17B
2017-01-01$86.27Not available in this settingRVU17A
2016-10-01$85.47Not available in this settingRVU16D
2016-07-01$85.47Not available in this settingRVU16C
2016-04-01$85.47Not available in this settingRVU16B
2016-01-01$85.47Not available in this settingRVU16A
2015-10-01$85.78Not available in this settingRVU15D
2015-07-01$85.78Not available in this settingRVU15C
2015-04-01$85.35Not available in this settingRVU15B
2015-01-01$85.35Not available in this settingRVU15A
2014-10-01$86.05Not available in this settingRVU14D
2014-07-01$86.05Not available in this settingRVU14C
2014-04-01$86.05Not available in this settingRVU14B
2014-01-01$86.05Not available in this settingRVU14A
2013-10-01$86.41Not available in this settingRVU13D
2013-07-01Rate data unavailableNot available in this settingRVU13C
2013-04-01Rate data unavailableNot available in this settingRVU13B
2013-01-01Rate data unavailableNot available in this settingRVU13AR

Price 76604 for an earlier date of service

Where the Wisconsin rate applies

Wisconsin is a Medicare payment area, not a city. Our Census mapping connects it to 807 cities and communities in Wisconsin. Some span more than one payment area; confirm with the service ZIP.

  • Abbotsford
  • Abrams
  • Adams
  • Adell
  • Albany
  • Algoma
  • Allens Grove
  • Allenton

Browse all communities in Wisconsin

76604 billing questions

When should 76604 be used instead of 76641 or 76642?

Use 76604 for diagnostic ultrasound of thoracic structures such as the pleural space, chest wall, or mediastinum. Codes 76641 and 76642 describe breast ultrasound, with the choice depending on the extent of the breast examination.

Can the professional and technical portions be billed separately?

Yes. Report modifier 26 for the physician's interpretation and modifier TC for the equipment and staff portion; billing without either modifier represents the global service.

Can 76604 be reported with thoracentesis?

It may be reported when a distinct diagnostic chest examination is performed and documented. Do not treat imaging that is integral to the thoracentesis as a separate diagnostic examination.

What documentation supports 76604?

Document the reason for the study, the thoracic area evaluated, saved images, and the findings or interpretation. The record should make clear that the service was diagnostic rather than solely procedural guidance.

How does the multiple-procedure reduction affect this code?

CMS applies the diagnostic imaging multiple-procedure reduction to the technical and professional components when applicable. The reduction can therefore affect either separately billed component.

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

Show the CMS file lines behind this rate
RVUs for 76604PPRRVU2026_Oct_nonQPP.csv, line 8,733 (RVU26D)
Geographic factors for WisconsinGPCI2026.csv, line 111 (RVU26D)

Open CMS sourceHow we calculate rates

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