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CPT code 76998: Intraoperative ultrasound, surgical guidance2026 Medicare rate & RVUs

Reports ultrasound guidance during an operation, with Medicare recognizing professional, technical, or global reporting under carrier-priced status.

CMS RVU26DEffective Oct 1, 2026109 payment localities26.1K Medicare services in 2024

Medicare rate · 76998

Intraoperative ultrasound, surgical guidance

Office or facility?

Work RVUs
0
Total RVUs
0.00
Global days
XXX

National rate · 2026

—

Not priced in the facility setting.

See every locality for 76998 →Billed by an NP, PA or therapist? →

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 10 sections
  1. Medicare rate
  2. What 76998 covers
  3. By payment locality
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Similar codes
  8. Related codes
  9. Billing questions
  10. Sources

What 76998 covers

This code reports ultrasound guidance performed during an operation. The imaging supports the physician’s work in the operative setting. It is distinct from codes that define a particular ultrasound-guided task, such as tissue ablation or needle placement, and from codes for specifically defined intraoperative diagnostic ultrasound services, such as thoracic-aorta imaging. The physician providing the imaging service may report the global service or a separately identified professional or technical portion, as appropriate.

Medicare assigns status C, or carrier priced: CMS publishes no national payment, and the Medicare Administrative Contractor sets payment for each claim. The code represents a diagnostic test with a professional interpretation component and a technical component for equipment and staff. Modifier 26 identifies the professional interpretation; modifier TC identifies the technical component. Reporting without either modifier represents the global service.

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 76998 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

76998 office and facility rates by payment locality
Payment localityOfficeFacility
AlabamaUnavailableUnavailable
AlaskaUnavailableUnavailable
ArizonaUnavailableUnavailable
ArkansasUnavailableUnavailable
Atlanta, GAUnavailableUnavailable
Austin, TXUnavailableUnavailable
Bakersfield, CAUnavailableUnavailable
Baltimore area, MDUnavailableUnavailable
Beaumont, TXUnavailableUnavailable
Brazoria, TXUnavailableUnavailable

76998 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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.

View every state and territory as a table
76998 office rate range by state
State / territoryOffice rate rangeLocalities
AKNo published base rate1
ALNo published base rate1
ARNo published base rate1
AZNo published base rate1
CANo published base rate29
CONo published base rate1
CTNo published base rate1
DCNo published base rate1
DENo published base rate1
FLNo published base rate3
GANo published base rate2
GUNo published base rate1
HINo published base rate1
IANo published base rate1
IDNo published base rate1
ILNo published base rate4
INNo published base rate1
KSNo published base rate1
KYNo published base rate1
LANo published base rate2
MANo published base rate2
MDNo published base rate3
MENo published base rate2
MINo published base rate2
MNNo published base rate1
MONo published base rate3
MSNo published base rate1
MTNo published base rate1
NCNo published base rate1
NDNo published base rate1
NENo published base rate1
NHNo published base rate1
NJNo published base rate2
NMNo published base rate1
NVNo published base rate1
NYNo published base rate5
OHNo published base rate1
OKNo published base rate1
ORNo published base rate2
PANo published base rate2
PRNo published base rate1
RINo published base rate1
SCNo published base rate1
SDNo published base rate1
TNNo published base rate1
TXNo published base rate8
UTNo published base rate1
VANo published base rate2
VINo published base rate1
VTNo published base rate1
WANo published base rate2
WINo published base rate1
WVNo published base rate1
WYNo published base rate1

How the 76998 rate is calculated

Each of 76998’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 · 76998

RVUs × geographic indexes × conversion factor

Office or facility?

Work0.00

0.00 RVUs× 1.000 GPCI

Practice expense0.00

0.00 RVUs× 1.000 GPCI

Malpractice0.00

0.00 RVUs× 1.000 GPCI

Adjusted RVUs

0.0000

Conversion factor

$33.4009

Medicare rate

$0.00

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

Payment rules and modifiers for 76998

The CMS indicators that decide how 76998 is paid alongside other services.

CMS payment indicators · 76998

Intraoperative ultrasound, surgical guidance

RuleCMS valueWhat it means
Global periodXXXThe global surgery concept doesn’t apply.
Multiple procedures0No multiple-procedure reduction.
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

76998 without 26 · national facility

$0.00

Intraoperative ultrasound, surgical guidance

76998-26 · Professional component

$48.77

Pays only the interpretation and report.

When to use modifier 26

76998 compared with similar codes

Compare codes · National

4 codes, side by side

Office or facility?

  • 76998

    Intraoperative ultrasound, surgical guidance0 wRVU

    Not priced

  • 76942

    Ultrasound needle guidance, biopsy, aspiration, injection, or localization0.65 wRVU

    $64.13

  • 76940

    Tissue ablation guidance, ultrasound guidance0 wRVU

    Not priced

  • 76984

    Aortic ultrasound, intraoperative diagnostic0 wRVU

    Not priced

How to choose

76942Ultrasound needle guidanceBiopsy, aspiration, injection, or localization
76942 is for ultrasound guidance for needle placement. 76998 is for guidance performed during an operation.
76940Tissue ablation guidanceUltrasound guidance
76940 identifies ultrasound guidance for tissue ablation; 76998 describes other intraoperative ultrasound guidance.
76984Aortic ultrasoundIntraoperative diagnostic
76984 identifies diagnostic intraoperative ultrasound focused on the thoracic aorta. 76998 is the general intraoperative guidance code.

Codes related to 76998

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 76998
CodeHow it relatesNational office range
Used instead
76942Ultrasound needle guidance, biopsy, aspiration, injection, or localizationUsed for ultrasound guidance specifically for needle placement rather than general intraoperative guidance.$57.69–$84.06
76940Tissue ablation guidance, ultrasound guidanceUsed for ultrasound guidance specifically during tissue ablation.No office rate
76984Aortic ultrasound, intraoperative diagnosticSpecific code for diagnostic intraoperative ultrasound of the thoracic aorta.No office rate
76987Epicardial ultrasound, congenital heart diseaseSpecific code for diagnostic intraoperative epicardial cardiac ultrasound in congenital heart disease.No office rate

76998 billing questions

When should this code be chosen over 76942?

Use 76998 for ultrasound guidance performed during an operation. Code 76942 describes ultrasound guidance for needle placement, such as for a biopsy or injection.

How does this differ from 76940?

Code 76940 is specific to ultrasound guidance for tissue ablation. Use 76998 for intraoperative ultrasound guidance when the service is not the specific ablation guidance described by 76940.

How are the professional and technical portions reported?

Modifier 26 identifies the professional interpretation, and modifier TC identifies the technical portion, including equipment and staff. Report the code without either modifier for the global service.

How does Medicare price 76998?

Medicare assigns status C, carrier priced. CMS publishes no national payment, and the Medicare Administrative Contractor sets payment for each claim.

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

Open CMS sourceHow we calculate rates

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