CPT code 76870: Scrotal ultrasound, testes and scrotal contents2026 Medicare rate & RVUs in Texas
Scrotal ultrasound evaluates the testes and surrounding structures for pain, swelling, masses, fluid collections, and other suspected scrotal abnormalities.
Medicare pays $91.56–$102.80 for 76870 in the office in Texas, from Beaumont, TX to Austin, TX. 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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On this page 9 sections
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.
Where 76870 pays more and less in Texas
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
8 payment localities
$91.56 to $102.80
8 of 8 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Austin, TX | $102.80 | Unavailable |
| Beaumont, TX | $91.56 | Unavailable |
| Brazoria, TX | $97.65 | Unavailable |
| Dallas, TX | $98.18 | Unavailable |
| Fort Worth, TX | $97.44 | Unavailable |
| Galveston, TX | $97.88 | Unavailable |
| Houston, TX | $98.79 | Unavailable |
| Rest of Texas | $94.49 | Unavailable |
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
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
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| Multiple procedures | 4 | Diagnostic imaging reduction applies to the technical component (and professional component) of additional services. |
| 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
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.
76870 compared with similar codes
Compare codes · National
5 codes, side by side
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
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