CPT code 76641: Breast ultrasound, complete examination2026 Medicare rate & RVUs

Medicare pays $100.20 for 76641 nationally in the office. Local office rates run $88.84–$135.11.

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

What 76641 covers

A complete breast ultrasound evaluates all four quadrants and the retroareolar region of the breast; the axilla is included when examined. It is commonly used to assess a palpable lump, focal pain, or a finding seen on mammography. A sonographer may acquire the images, while a radiologist or other qualified physician interprets them and documents the findings in an imaging report. The examination may be performed in a hospital imaging department or an outpatient imaging center.

Select this code when the documented study is complete rather than limited to one or more specific areas. Report it for each breast examined; for a bilateral study, use modifier 50, which CMS pays at 150%. The service may be billed globally, or split into the professional interpretation with modifier 26 and the technical portion with modifier TC. The report and image documentation should support the examination's extent and the interpretation.

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 76641 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

76641 rates by state

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

How the 76641 rate is calculated

Each of 76641’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.

Payment rules and modifiers for 76641

The CMS indicators that decide how 76641 is paid alongside other services.

What modifiers do to the payment

When to use modifier 26

76641 compared with similar codes

How to choose

76642Breast ultrasoundLimited, unilateral

76641 represents evaluation of all four quadrants and the retroareolar region; 76642 is for a limited examination of selected areas.

77065Diagnostic mammogramOne breast, CAD included

77065 is unilateral diagnostic mammography, which uses mammographic imaging rather than ultrasound.

77066Diagnostic mammogramBilateral, including CAD

77066 is bilateral diagnostic mammography. It may be performed with breast ultrasound, but it describes a separate imaging modality.

Codes related to 76641

Related codes aren’t interchangeable: bill the code that matches the service performed.

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

Open CMS sourceHow we calculate rates