CPT code 76981: Ultrasound elastography, parenchymal tissue2026 Medicare rate & RVUs in Iowa
Ultrasound elastography evaluates tissue stiffness across an organ’s parenchyma, commonly the liver, and is reported with imaging documentation and interpretation.
In Iowa, Medicare pays $103.95 for 76981 in the office.
Check a contract rate as a % of Medicare · 76981 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 sections
What 76981 covers
This service uses ultrasound elastography to assess tissue stiffness across an organ’s parenchyma rather than a discrete mass. A common clinical use is evaluating liver stiffness in a patient with chronic liver disease. Radiologists and clinicians in specialties such as hepatology or gastroenterology may perform or interpret the study in office or facility settings. The code includes imaging documentation, interpretation, and a report.
Select this code when the study evaluates parenchymal tissue; focal target-lesion elastography is coded separately. Documentation should identify the organ or tissue examined, support the parenchymal assessment, and include the findings and interpretation. The service has professional and technical components: modifier 26 identifies the interpretation, modifier TC identifies the equipment and staff, and billing without either modifier represents the global service. CMS’s diagnostic imaging multiple-procedure reduction applies to both 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 Iowa compares for 76981
Across 109 of 109 payment localities, the office rate for 76981 runs from $98.96 in Arkansas to $154.67 in San Benito County, CA. Iowa pays $103.95. The RVUs are the same everywhere; the geographic indexes change the dollars.
- Iowa · this page$103.95
- Los Angeles, CA · California$129.72+$25.77
- Washington, DC area · District of Columbia$130.11+$26.16
- Miami, FL · Florida$118.37+$14.42
- Chicago, IL · Illinois$114.89+$10.94
- Manhattan, NY · New York$129.46+$25.51
- Alaska · Alaska$127.62+$23.67
Other areas in Iowa first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $100.50 | — |
| ArkansasArkansas | $98.96 | — |
| ArizonaArizona | $109.52 | — |
| Bakersfield, CACalifornia | $121.22 | — |
| Chico, CACalifornia | $121.09 | — |
| El Centro, CACalifornia | $121.09 | — |
| Fresno, CACalifornia | $121.09 | — |
| Hanford, CACalifornia | $121.09 | — |
| Madera, CACalifornia | $121.09 | — |
| Merced, CACalifornia | $121.09 | — |
| Modesto, CACalifornia | $121.09 | — |
| Napa, CACalifornia | $142.33 | — |
| Oxnard, CACalifornia | $129.32 | — |
| Redding, CACalifornia | $121.09 | — |
| Rest of CaliforniaCalifornia | $121.09 | — |
| Riverside, CACalifornia | $121.53 | — |
| Sacramento, CACalifornia | $127.61 | — |
| Salinas, CACalifornia | $127.15 | — |
| San Diego, CACalifornia | $130.53 | — |
| Marin County, CACalifornia | $151.34 | — |
| San Francisco, CACalifornia | $151.29 | — |
| San Benito County, CACalifornia | $154.67 | — |
| Santa Clara County, CACalifornia | $154.49 | — |
| San Luis Obispo, CACalifornia | $125.04 | — |
| Santa Cruz, CACalifornia | $132.10 | — |
| Santa Maria, CACalifornia | $127.73 | — |
| Santa Rosa, CACalifornia | $133.46 | — |
| Stockton, CACalifornia | $121.09 | — |
| Vallejo, CACalifornia | $142.27 | — |
| Visalia, CACalifornia | $121.09 | — |
| Yuba City, CACalifornia | $121.09 | — |
| ColoradoColorado | $118.38 | — |
| ConnecticutConnecticut | $120.30 | — |
| DelawareDelaware | $111.42 | — |
| Fort Lauderdale, FLFlorida | $114.83 | — |
| Rest of FloridaFlorida | $109.19 | — |
| Atlanta, GAGeorgia | $114.36 | — |
| Rest of GeorgiaGeorgia | $102.90 | — |
| Hawaii, Guam, HIHawaii | $124.58 | — |
| IdahoIdaho | $104.51 | — |
| East St. Louis, ILIllinois | $106.57 | — |
| Rest of IllinoisIllinois | $105.32 | — |
| Suburban Chicago, ILIllinois | $116.21 | — |
| IndianaIndiana | $105.17 | — |
| KansasKansas | $103.08 | — |
| KentuckyKentucky | $102.25 | — |
| New Orleans, LALouisiana | $107.32 | — |
| Rest of LouisianaLouisiana | $101.94 | — |
| Metropolitan Boston, MAMassachusetts | $131.03 | — |
| Rest of MassachusettsMassachusetts | $117.47 | — |
| Baltimore area, MDMaryland | $119.89 | — |
| Rest of MarylandMaryland | $113.75 | — |
| Rest of MaineMaine | $104.71 | — |
| Southern Maine, MEMaine | $111.24 | — |
| Detroit, MIMichigan | $110.26 | — |
| Rest of MichiganMichigan | $104.74 | — |
| MinnesotaMinnesota | $114.28 | — |
| Metropolitan Kansas City, MOMissouri | $106.93 | — |
| Metropolitan St. Louis, MOMissouri | $108.15 | — |
| Rest of MissouriMissouri | $99.85 | — |
| MississippiMississippi | $99.44 | — |
| MontanaMontana | $112.56 | — |
| North CarolinaNorth Carolina | $105.92 | — |
| North DakotaNorth Dakota | $111.77 | — |
| NebraskaNebraska | $104.66 | — |
| New HampshireNew Hampshire | $116.16 | — |
| Northern New JerseyNew Jersey | $128.57 | — |
| Rest of New JerseyNew Jersey | $121.92 | — |
| New MexicoNew Mexico | $105.21 | — |
| NevadaNevada | $112.43 | — |
| NYC suburbs and Long Island, NYNew York | $132.31 | — |
| Poughkeepsie and northern NYC suburbs, NYNew York | $122.44 | — |
| Queens, NYNew York | $131.11 | — |
| Rest of New YorkNew York | $107.57 | — |
| OhioOhio | $104.58 | — |
| OklahomaOklahoma | $102.43 | — |
| Portland, OROregon | $122.72 | — |
| Rest of OregonOregon | $111.80 | — |
| Metropolitan Philadelphia, PAPennsylvania | $116.93 | — |
| Rest of PennsylvaniaPennsylvania | $104.96 | — |
| Puerto RicoPuerto Rico | $113.55 | — |
| Rhode IslandRhode Island | $115.82 | — |
| South CarolinaSouth Carolina | $105.38 | — |
| South DakotaSouth Dakota | $111.67 | — |
| TennesseeTennessee | $103.58 | — |
| Austin, TXTexas | $117.77 | — |
| Beaumont, TXTexas | $104.20 | — |
| Brazoria, TXTexas | $111.60 | — |
| Dallas, TXTexas | $112.18 | — |
| Fort Worth, TXTexas | $111.28 | — |
| Galveston, TXTexas | $111.84 | — |
| Houston, TXTexas | $112.58 | — |
| Rest of TexasTexas | $107.75 | — |
| UtahUtah | $106.91 | — |
| VirginiaVirginia | $110.61 | — |
| Virgin Islands, VIUnited States Virgin Islands | $113.55 | — |
| VermontVermont | $110.98 | — |
| Rest of WashingtonWashington | $117.36 | — |
| King County, WAWashington | $134.14 | — |
| WisconsinWisconsin | $107.78 | — |
| West VirginiaWest Virginia | $101.10 | — |
| WyomingWyoming | $112.21 | — |
76981 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.
$98.96
$137.88
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $127.62 | 1 |
| AL | $100.50 | 1 |
| AR | $98.96 | 1 |
| AZ | $109.52 | 1 |
| CA | $121.09–$154.67 | 29 |
| CO | $118.38 | 1 |
| CT | $120.30 | 1 |
| DC | $130.11 | 1 |
| DE | $111.42 | 1 |
| FL | $109.19–$118.37 | 3 |
| GA | $102.90–$114.36 | 2 |
| GU | $124.58 | 1 |
| HI | $124.58 | 1 |
| IA | $103.95 | 1 |
| ID | $104.51 | 1 |
| IL | $105.32–$116.21 | 4 |
| IN | $105.17 | 1 |
| KS | $103.08 | 1 |
| KY | $102.25 | 1 |
| LA | $101.94–$107.32 | 2 |
| MA | $117.47–$131.03 | 2 |
| MD | $113.75–$130.11 | 3 |
| ME | $104.71–$111.24 | 2 |
| MI | $104.74–$110.26 | 2 |
| MN | $114.28 | 1 |
| MO | $99.85–$108.15 | 3 |
| MS | $99.44 | 1 |
| MT | $112.56 | 1 |
| NC | $105.92 | 1 |
| ND | $111.77 | 1 |
| NE | $104.66 | 1 |
| NH | $116.16 | 1 |
| NJ | $121.92–$128.57 | 2 |
| NM | $105.21 | 1 |
| NV | $112.43 | 1 |
| NY | $107.57–$132.31 | 5 |
| OH | $104.58 | 1 |
| OK | $102.43 | 1 |
| OR | $111.80–$122.72 | 2 |
| PA | $104.96–$116.93 | 2 |
| PR | $113.55 | 1 |
| RI | $115.82 | 1 |
| SC | $105.38 | 1 |
| SD | $111.67 | 1 |
| TN | $103.58 | 1 |
| TX | $104.20–$117.77 | 8 |
| UT | $106.91 | 1 |
| VA | $110.61–$130.11 | 2 |
| VI | $113.55 | 1 |
| VT | $110.98 | 1 |
| WA | $117.36–$134.14 | 2 |
| WI | $107.78 | 1 |
| WV | $101.10 | 1 |
| WY | $112.21 | 1 |
How the 76981 rate is calculated
Each of 76981’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 · 76981
RVUs × geographic indexes × conversion factor
Work0.58
0.58 RVUs× 1.000 GPCI
Practice expense2.75
2.75 RVUs× 1.000 GPCI
Malpractice0.04
0.04 RVUs× 1.000 GPCI
Adjusted RVUs
3.3700
Conversion factor
$33.4009
Medicare rate
$112.56
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
The exact Iowa inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
8,898
- Code
- 76981
- Physician work
- 0.58
- Practice expense
- 2.75
- Malpractice
- 0.04
GPCI2026.csv
53
- Locality
- Iowa
- Physician work
- 1.000
- Practice expense
- 0.915
- Malpractice
- 0.397
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.58 | × 1.000 | 0.5800 |
| Practice expense | 2.75 | × 0.915 | 2.5163 |
| Malpractice | 0.04 | × 0.397 | 0.0159 |
| Total RVUs | 3.1121 | ||
| Conversion factor | × 33.4009 | ||
Office rate, Iowa$103.95
Office: (0.58 × 1 + 2.75 × 0.915 + 0.04 × 0.397) × $33.4009 = $103.95
Payment rules and modifiers for 76981
The CMS indicators that decide how 76981 is paid alongside other services.
CMS payment indicators · 76981
Ultrasound elastography, parenchymal tissue
| 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
76981 without 26 · national office
$112.56
Ultrasound elastography, parenchymal tissue
76981-26 · Professional component
$29.06
Pays only the interpretation and report.
How 76981 has changed in Iowa
76981 · Office / nonfacility
$103.95
Effective 2026-10-01
The base rate is $9.41 higher than on 2025-10-01, moving from $94.54 to $103.95 (10.0%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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
January 1, 2026
RVU26A
$94.54changed to$103.95
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 0.59 changed to 0.58
- Practice expense RVU 2.53 changed to 2.75
- Malpractice RVU 0.05 changed to 0.04
- Practice expense GPCI 0.913 changed to 0.915
- Malpractice GPCI 0.457 changed to 0.397
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$96.23changed to$94.54
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 2.50 changed to 2.53
- Malpractice RVU 0.04 changed to 0.05
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$94.66changed to$96.23
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$97.53changed to$94.66
- Conversion factor 33.8872 changed to 32.7442
- Practice expense RVU 2.49 changed to 2.50
- Malpractice RVU 0.05 changed to 0.04
- Practice expense GPCI 0.910 changed to 0.913
- Malpractice GPCI 0.441 changed to 0.457
January 1, 2023
RVU23A
$99.31changed to$97.53
- Conversion factor 34.6062 changed to 33.8872
- Practice expense GPCI 0.907 changed to 0.910
- Malpractice GPCI 0.425 changed to 0.441
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$100.45changed to$99.31
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 2.50 changed to 2.49
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$100.79changed to$100.45
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 2.41 changed to 2.50
- Malpractice RVU 0.04 changed to 0.05
- Malpractice GPCI 0.424 changed to 0.425
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$100.48changed to$100.79
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 2.40 changed to 2.41
- Malpractice RVU 0.05 changed to 0.04
- Malpractice GPCI 0.423 changed to 0.424
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
No ratechanged to$100.48
Held through RVU19B, RVU19C, RVU19D.
January 1, 2013
RVU13AR
Earliest loaded release: No rate
Held through RVU13B, RVU13C, RVU13D, RVU14A, RVU14B, RVU14C, RVU14D, RVU15A, RVU15B, RVU15C, RVU15D, RVU16A, RVU16B, RVU16C, RVU16D, RVU17A, RVU17B, RVU17C, RVU17D, RVU18AR1, RVU18B, RVU18C, RVU18D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $103.95 | Not available in this setting | RVU26D |
| 2026-07-01 | $103.95 | Not available in this setting | RVU26C |
| 2026-04-01 | $103.95 | Not available in this setting | RVU26B |
| 2026-01-01 | $103.95 | Not available in this setting | RVU26A |
| 2025-10-01 | $94.54 | Not available in this setting | RVU25D |
| 2025-07-01 | $94.54 | Not available in this setting | RVU25C |
| 2025-04-01 | $94.54 | Not available in this setting | RVU25B |
| 2025-01-01 | $94.54 | Not available in this setting | RVU25A |
| 2024-10-01 | $96.23 | Not available in this setting | RVU24D |
| 2024-07-01 | $96.23 | Not available in this setting | RVU24C |
| 2024-04-01 | $96.23 | Not available in this setting | RVU24B |
| 2024-03-09 | $96.23 | Not available in this setting | RVU24AR |
| 2024-01-01 | $94.66 | Not available in this setting | RVU24A |
| 2023-10-01 | $97.53 | Not available in this setting | RVU23D |
| 2023-07-01 | $97.53 | Not available in this setting | RVU23C |
| 2023-04-01 | $97.53 | Not available in this setting | RVU23B |
| 2023-01-01 | $97.53 | Not available in this setting | RVU23A |
| 2022-10-01 | $99.31 | Not available in this setting | RVU22D |
| 2022-07-01 | $99.31 | Not available in this setting | RVU22C |
| 2022-04-01 | $99.31 | Not available in this setting | RVU22B |
| 2022-01-01 | $99.31 | Not available in this setting | RVU22A |
| 2021-10-01 | $100.45 | Not available in this setting | RVU21D |
| 2021-07-01 | $100.45 | Not available in this setting | RVU21C |
| 2021-04-01 | $100.45 | Not available in this setting | RVU21B |
| 2021-01-01 | $100.45 | Not available in this setting | RVU21A |
| 2020-10-01 | $100.79 | Not available in this setting | RVU20D |
| 2020-07-01 | $100.79 | Not available in this setting | RVU20C |
| 2020-04-01 | $100.79 | Not available in this setting | RVU20B |
| 2020-01-01 | $100.79 | Not available in this setting | RVU20A |
| 2019-10-01 | $100.48 | Not available in this setting | RVU19D |
| 2019-07-01 | $100.48 | Not available in this setting | RVU19C |
| 2019-04-01 | $100.48 | Not available in this setting | RVU19B |
| 2019-01-01 | $100.48 | Not available in this setting | RVU19A |
| 2018-10-01 | Not in this release | Not in this release | RVU18D |
| 2018-07-01 | Not in this release | Not in this release | RVU18C |
| 2018-04-01 | Not in this release | Not in this release | RVU18B |
| 2018-01-01 | Not in this release | Not in this release | RVU18AR1 |
| 2017-10-01 | Not in this release | Not in this release | RVU17D |
| 2017-07-01 | Not in this release | Not in this release | RVU17C |
| 2017-04-01 | Not in this release | Not in this release | RVU17B |
| 2017-01-01 | Not in this release | Not in this release | RVU17A |
| 2016-10-01 | Not in this release | Not in this release | RVU16D |
| 2016-07-01 | Not in this release | Not in this release | RVU16C |
| 2016-04-01 | Not in this release | Not in this release | RVU16B |
| 2016-01-01 | Not in this release | Not in this release | RVU16A |
| 2015-10-01 | Not in this release | Not in this release | RVU15D |
| 2015-07-01 | Not in this release | Not in this release | RVU15C |
| 2015-04-01 | Not in this release | Not in this release | RVU15B |
| 2015-01-01 | Not in this release | Not in this release | RVU15A |
| 2014-10-01 | Not in this release | Not in this release | RVU14D |
| 2014-07-01 | Not in this release | Not in this release | RVU14C |
| 2014-04-01 | Not in this release | Not in this release | RVU14B |
| 2014-01-01 | Not in this release | Not in this release | RVU14A |
| 2013-10-01 | Not in this release | Not in this release | RVU13D |
| 2013-07-01 | Not in this release | Not in this release | RVU13C |
| 2013-04-01 | Not in this release | Not in this release | RVU13B |
| 2013-01-01 | Not in this release | Not in this release | RVU13AR |
Where the Iowa rate applies
Iowa is a Medicare payment area, not a city. Our Census mapping connects it to 1026 cities and communities in Iowa. Some span more than one payment area; confirm with the service ZIP.
- Ackley
- Ackworth
- Adair
- Adel
- Afton
- Agency
- Ainsworth
- Akron
76981 billing questions
When should 76981 be selected instead of 76982?
Use 76981 for elastography of parenchymal tissue, such as liver tissue. Use 76982 when the examination targets a discrete lesion.
Can 76983 be added to 76981 for another area?
No. Code 76983 is the additional-lesion code associated with 76982, not an add-on to parenchymal elastography.
How are the professional and technical services reported?
Report modifier 26 for the professional interpretation or TC for the technical service. Without either modifier, the claim represents the global service.
Does the multiple-procedure reduction affect both components?
Yes. CMS applies the diagnostic imaging multiple-procedure reduction to both the professional and technical components when applicable.
What should the report document?
Document the parenchymal tissue examined and the elastography findings, with the interpretation and report supporting that the study assessed tissue rather than a discrete target lesion.
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
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