CPT code 76642: Breast ultrasound, limited, unilateral2026 Medicare rate & RVUs in Aromas, California

CPT 76642: $92.92–$111.58 office across 2 localities in Aromas, CA in 2026 Medicare. Compare each area.

CMS RVU26DEffective Oct 1, 20262 payment localities

Medicare pays $92.92–$111.58 for 76642 in the office in Aromas, California, from Salinas, CA to San Benito County, CA. Which amount applies depends on the service address.

$92.92–$111.58Office (non-facility)
—Hospital or facility

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 76642 for the payment locality that covers the ZIP.

On this page 6 sections
  1. Rate in Aromas, California
  2. By payment locality
  3. City and payment areas
  4. How it’s calculated
  5. Payment rules
  6. Sources

Where 76642 pays more and less in Aromas, California

Aromas, California maps to 2 Medicare payment localities in our Census-to-CMS crosswalk. A city name alone doesn’t confirm an address’s payment area.

76642 office and facility rates by payment locality
Payment localityOfficeFacility
Salinas, CA$92.92Unavailable
San Benito County, CA$111.58Unavailable

How payment areas work in Aromas

City limits and Medicare payment areas are different maps. These are the payment areas that cover the city’s counties; the service ZIP decides which one applies.

  • Monterey · Monterey County
  • San Benito · San Benito County

City boundaries: 2026 Census geography · Census source · CMS county-to-locality definitions

How the 76642 rate is calculated

Each of 76642’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 · 76642

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.66

0.66 RVUs× 1.000 GPCI

Practice expense1.79

1.79 RVUs× 1.000 GPCI

Malpractice0.05

0.05 RVUs× 1.000 GPCI

Adjusted RVUs

2.5000

Conversion factor

$33.4009

Medicare rate

$83.50

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

Payment rules and modifiers for 76642

The CMS indicators that decide how 76642 is paid alongside other services.

CMS payment indicators · 76642

Breast ultrasound, limited, unilateral

RuleCMS valueWhat it means
Global periodXXXThe global surgery concept doesn’t apply.
Multiple procedures0No multiple-procedure reduction.
Bilateral (modifier 50)1Bilateral with modifier 50 pays 150% of the fee schedule amount.
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

76642 without 26 · national office

$83.50

Breast ultrasound, limited, unilateral

76642-26 · Professional component

$31.40

Pays only the interpretation and report.

When to use modifier 26

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 76642PPRRVU2026_Oct_nonQPP.csv, line 8,739 (RVU26D)

Open CMS sourceHow we calculate rates

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Your codes at your locality, with payer contracts beside Medicare.

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