CPT code 76981: Ultrasound elastography, parenchymal tissue2026 Medicare rate & RVUs in Maryland
Ultrasound elastography evaluates tissue stiffness across an organ’s parenchyma, commonly the liver, and is reported with imaging documentation and interpretation.
Medicare pays $113.75–$130.11 for 76981 in the office in Maryland, from Rest of Maryland to Washington, DC area. 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 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.
Where 76981 pays more and less in Maryland
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
3 payment localities
$113.75 to $130.11
| Payment locality | Office | Facility |
|---|---|---|
| Baltimore area, MD | $119.89 | Unavailable |
| Rest of Maryland | $113.75 | Unavailable |
| Washington, DC area | $130.11 | Unavailable |
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.
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.
76981 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 76982Ultrasound elastographyFirst target lesion
- 76981 assesses parenchymal tissue, commonly the liver; 76982 evaluates a discrete target lesion.
- 76983Ultrasound elastographyEach additional target lesion
- 76983 reports an additional target lesion in the 76982 lesion-elastography service, not another parenchymal assessment under 76981.
- 76978Contrast ultrasoundFirst target lesion
- 76978 uses contrast-enhanced ultrasound to assess a lesion; 76981 evaluates stiffness across parenchymal tissue.
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
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