CPT code 76870: Scrotal ultrasound, testes and scrotal contents2026 Medicare rate & RVUs in Guam

Scrotal ultrasound evaluates the testes and surrounding structures for pain, swelling, masses, fluid collections, and other suspected scrotal abnormalities.

CMS RVU26DEffective Oct 1, 20261 payment locality137.2K Medicare services in 2024

Medicare pays $108.26 for 76870 in the office in Guam (Hawaii, Guam, HI). Which amount applies depends on the service address.

$108.26Office (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.

Your location

Medicare pays by the payment locality where the service is performed.

On this page 9 sections
  1. Rate in Guam
  2. What 76870 covers
  3. By payment locality
  4. How it’s calculated
  5. Payment rules
  6. Similar codes
  7. Related codes
  8. Billing questions
  9. Sources

What 76870 covers

Scrotal ultrasound uses a transducer over the scrotum to image the testes and surrounding contents, including the epididymides and fluid collections. It is commonly ordered for testicular pain or swelling, a palpable mass, suspected torsion or inflammation, and evaluation of hydrocele or varicocele. Radiologists and other qualified imaging professionals perform or interpret the study in hospital and outpatient imaging settings.

Report 76870 for diagnostic sonographic assessment of scrotal contents. Documentation should identify the clinical indication, structures examined, findings, and interpretation. The service may be billed globally when one entity provides both image acquisition and interpretation, or split with modifier 26 for the professional interpretation and modifier TC for the technical service. CMS applies diagnostic imaging multiple-procedure reduction to both professional and technical components when applicable imaging services are reported together.

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.

76870 in Hawaii, Guam, HI

76870 office and facility rates by payment locality
Payment localityOfficeFacility
Hawaii, Guam, HI$108.26Unavailable

How the 76870 rate is calculated

Each of 76870’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 · 76870

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.62

0.62 RVUs× 1.000 GPCI

Practice expense2.28

2.28 RVUs× 1.000 GPCI

Malpractice0.05

0.05 RVUs× 1.000 GPCI

Adjusted RVUs

2.9500

Conversion factor

$33.4009

Medicare rate

$98.53

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

Payment rules and modifiers for 76870

The CMS indicators that decide how 76870 is paid alongside other services.

CMS payment indicators · 76870

Scrotal ultrasound, testes and scrotal contents

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

76870 without 26 · national office

$98.53

Scrotal ultrasound, testes and scrotal contents

76870-26 · Professional component

$29.73

Pays only the interpretation and report.

When to use modifier 26

76870 compared with similar codes

Compare codes · National

5 codes, side by side

Office or facility?

  • 76870

    Scrotal ultrasound, testes and scrotal contents0.62 wRVU

    $98.53

  • 76856

    Pelvic ultrasound, complete, nonobstetric0.67 wRVU

    $105.21+$6.68

  • 76857

    Pelvic ultrasound, limited or follow-up0.49 wRVU

    $51.10−$47.43

  • 93975

    Vascular duplex, complete organ inflow and outflow1.13 wRVU

    $259.19+$160.66

  • 93976

    Vascular duplex, limited abdominal, pelvic, or scrotal study0.78 wRVU

    $155.98+$57.45

How to choose

76856Pelvic ultrasoundComplete, nonobstetric
Choose 76856 for a complete pelvic ultrasound. Choose 76870 when the diagnostic target is the testes and scrotal contents.
76857Pelvic ultrasoundLimited or follow-up
76857 describes a limited pelvic ultrasound; 76870 evaluates scrotal structures rather than pelvic organs.
93975Vascular duplexComplete organ inflow and outflow
93975 represents a complete arterial and venous duplex study. It is distinct from the anatomic scrotal ultrasound represented by 76870.
93976Vascular duplexLimited abdominal, pelvic, or scrotal study
93976 represents a limited duplex study; 76870 is the scrotal ultrasound examination and is not selected solely for a limited vascular study.

76870 billing questions

How does 76870 differ from a pelvic ultrasound?

76870 examines the testes and scrotal contents. Codes 76856 and 76857 are for pelvic-organ imaging, not a substitute for a scrotal study.

When should modifier 26 or TC be used?

Use modifier 26 when billing only the professional interpretation, or TC for the technical service, including equipment and staff. Billing without either modifier represents the global service.

Can a duplex code be reported with 76870?

A separate duplex code may be appropriate when a distinct, medically necessary vascular duplex study is performed and documented. Color-flow images alone do not establish that a separate duplex service was performed.

How does the imaging multiple-procedure reduction affect 76870?

When applicable diagnostic imaging services are reported together, CMS applies the multiple-procedure reduction to both the technical and professional components.

What documentation supports 76870?

Document the reason for the examination, the scrotal structures evaluated, the sonographic findings, and the interpreting professional's report.

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 76870PPRRVU2026_Oct_nonQPP.csv, line 8,832 (RVU26D)
Geographic factors for Hawaii, Guam, HIGPCI2026.csv, line 46 (RVU26D)

Open CMS sourceHow we calculate rates

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