Billing code 76604: Chest ultrasoundMedicare rate & RVUs
Reports diagnostic ultrasound of the chest, including assessment of pleural spaces, chest wall, or mediastinal structures for a clinical concern such as pleural fluid.
Medicare pays $61.12 for 76604 nationally in the office. Local office rates run $54.66–$80.20.
Medicare rate · 76604
Chest ultrasound
Swap in your local Medicare rate.
- Work RVUs
- 0.58
- Total RVUs
- 1.83
- Global days
- XXX
National rate · 2026
$61.12
Office setting, before claim adjustments.
See every locality for 76604 → · 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.
On this page 10 sections
What 76604 covers
This service uses real-time ultrasound to evaluate chest structures, with saved images supporting the examination and interpretation. Common clinical questions include whether pleural fluid is present and the appearance of the pleural space; the examination can also assess chest-wall or mediastinal structures. Radiologists, pulmonologists, emergency physicians, and other qualified practitioners may perform or interpret it in office, hospital, or emergency settings.
Report 76604 when the documented service is a diagnostic chest ultrasound, rather than breast imaging or ultrasound used only to guide a procedure. The record should identify the clinical question, area examined, images obtained, and findings or interpretation. A physician may report the professional component with modifier 26, the equipment and staff portion with modifier TC, or the global service without either modifier. CMS applies the diagnostic imaging multiple-procedure reduction to both the technical and professional 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 76604 pays more and less
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 payment localities
$54.66 to $80.20
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $55.39 | Unavailable |
| Alaska* | $72.67 | Unavailable |
| Arizona | $59.64 | Unavailable |
| Arkansas | $54.66 | Unavailable |
| Atlanta | $62.16 | Unavailable |
| Austin | $63.30 | Unavailable |
| Bakersfield | $64.69 | Unavailable |
| Baltimore/Surr. Cntys | $64.76 | Unavailable |
| Beaumont | $57.40 | Unavailable |
| Brazoria | $60.55 | Unavailable |
| Chicago | $63.62 | Unavailable |
| Chico | $64.53 | Unavailable |
| Colorado | $63.56 | Unavailable |
| Connecticut | $64.95 | Unavailable |
| Dallas | $60.90 | Unavailable |
| Dc + Md/Va Suburbs | $69.49 | Unavailable |
| Delaware | $60.57 | Unavailable |
| Detroit | $60.87 | Unavailable |
| East St. Louis | $59.61 | Unavailable |
| El Centro | $64.53 | Unavailable |
| Fort Lauderdale | $62.99 | Unavailable |
| Fort Worth | $60.52 | Unavailable |
| Fresno | $64.53 | Unavailable |
| Galveston | $60.71 | Unavailable |
| Hanford-Corcoran | $64.53 | Unavailable |
| Hawaii, Guam | $65.91 | Unavailable |
| Houston | $61.63 | Unavailable |
| Idaho | $57.04 | Unavailable |
| Indiana | $57.34 | Unavailable |
| Iowa | $56.71 | Unavailable |
| Kansas | $56.45 | Unavailable |
| Kentucky | $56.53 | Unavailable |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | $68.69 | Unavailable |
| Madera | $64.53 | Unavailable |
| Manhattan | $69.84 | Unavailable |
| Merced | $64.53 | Unavailable |
| Metropolitan Boston | $69.51 | Unavailable |
| Metropolitan Kansas City | $58.64 | Unavailable |
| Metropolitan Philadelphia | $63.44 | Unavailable |
| Metropolitan St. Louis | $59.20 | Unavailable |
| Miami | $65.32 | Unavailable |
| Minnesota | $61.11 | Unavailable |
| Mississippi | $55.12 | Unavailable |
| Modesto | $64.53 | Unavailable |
| Montana** | $61.12 | Unavailable |
| Napa | $74.27 | Unavailable |
| Nebraska | $57.00 | Unavailable |
| Nevada** | $60.88 | Unavailable |
| New Hampshire | $62.56 | Unavailable |
| New Mexico | $58.13 | Unavailable |
| New Orleans | $58.99 | Unavailable |
| North Carolina | $57.84 | Unavailable |
| North Dakota** | $60.13 | Unavailable |
| Northern Nj | $68.87 | Unavailable |
| Nyc Suburbs/Long Island | $71.37 | Unavailable |
| Ohio | $57.65 | Unavailable |
| Oklahoma | $56.46 | Unavailable |
| Oxnard-Thousand Oaks-Ventura | $68.33 | Unavailable |
| Portland | $65.46 | Unavailable |
| Poughkpsie/N Nyc Suburbs | $66.15 | Unavailable |
| Puerto Rico | $61.54 | Unavailable |
| Queens | $70.40 | Unavailable |
| Redding | $64.53 | Unavailable |
| Rest Of California | $64.53 | Unavailable |
| Rest Of Florida | $60.20 | Unavailable |
| Rest Of Georgia | $57.12 | Unavailable |
| Rest Of Illinois | $58.58 | Unavailable |
| Rest Of Louisiana | $56.44 | Unavailable |
| Rest Of Maine | $57.29 | Unavailable |
| Rest Of Maryland | $61.66 | Unavailable |
| Rest Of Massachusetts | $63.22 | Unavailable |
| Rest Of Michigan | $57.85 | Unavailable |
| Rest Of Missouri | $55.55 | Unavailable |
| Rest Of New Jersey | $65.75 | Unavailable |
| Rest Of New York | $58.62 | Unavailable |
| Rest Of Oregon | $60.47 | Unavailable |
| Rest Of Pennsylvania | $57.75 | Unavailable |
| Rest Of Texas | $58.92 | Unavailable |
| Rest Of Washington | $63.10 | Unavailable |
| Rhode Island | $62.63 | Unavailable |
| Riverside-San Bernardino-Ontario | $65.07 | Unavailable |
| Sacramento-Roseville-Folsom | $67.58 | Unavailable |
| Salinas | $67.32 | Unavailable |
| San Diego-Chula Vista-Carlsbad | $68.80 | Unavailable |
| San Francisco-Oakland-Berkeley (Marin Cnty) | $78.49 | Unavailable |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | $78.44 | Unavailable |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | $80.20 | Unavailable |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | $79.96 | Unavailable |
| San Luis Obispo-Paso Robles | $66.25 | Unavailable |
| Santa Cruz-Watsonville | $69.37 | Unavailable |
| Santa Maria-Santa Barbara | $67.54 | Unavailable |
| Santa Rosa-Petaluma | $70.07 | Unavailable |
| Seattle (King Cnty) | $70.89 | Unavailable |
| South Carolina | $57.83 | Unavailable |
| South Dakota** | $60.01 | Unavailable |
| Southern Maine | $60.15 | Unavailable |
| Stockton | $64.53 | Unavailable |
| Suburban Chicago | $63.63 | Unavailable |
| Tennessee | $56.70 | Unavailable |
| Utah | $58.55 | Unavailable |
| Vallejo | $74.19 | Unavailable |
| Vermont | $59.90 | Unavailable |
| Virgin Islands | $61.54 | Unavailable |
| Virginia | $59.95 | Unavailable |
| Visalia | $64.53 | Unavailable |
| West Virginia | $56.59 | Unavailable |
| Wisconsin | $58.28 | Unavailable |
| Wyoming** | $60.69 | Unavailable |
| Yuba City | $64.53 | Unavailable |
76604 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.
$54.66
$72.67
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 | $72.67 | 1 |
| AL | $55.39 | 1 |
| AR | $54.66 | 1 |
| AZ | $59.64 | 1 |
| CA | $64.53–$80.20 | 29 |
| CO | $63.56 | 1 |
| CT | $64.95 | 1 |
| DC | $69.49 | 1 |
| DE | $60.57 | 1 |
| FL | $60.20–$65.32 | 3 |
| GA | $57.12–$62.16 | 2 |
| GU | $65.91 | 1 |
| HI | $65.91 | 1 |
| IA | $56.71 | 1 |
| ID | $57.04 | 1 |
| IL | $58.58–$63.63 | 4 |
| IN | $57.34 | 1 |
| KS | $56.45 | 1 |
| KY | $56.53 | 1 |
| LA | $56.44–$58.99 | 2 |
| MA | $63.22–$69.51 | 2 |
| MD | $61.66–$69.49 | 3 |
| ME | $57.29–$60.15 | 2 |
| MI | $57.85–$60.87 | 2 |
| MN | $61.11 | 1 |
| MO | $55.55–$59.20 | 3 |
| MS | $55.12 | 1 |
| MT | $61.12 | 1 |
| NC | $57.84 | 1 |
| ND | $60.13 | 1 |
| NE | $57.00 | 1 |
| NH | $62.56 | 1 |
| NJ | $65.75–$68.87 | 2 |
| NM | $58.13 | 1 |
| NV | $60.88 | 1 |
| NY | $58.62–$71.37 | 5 |
| OH | $57.65 | 1 |
| OK | $56.46 | 1 |
| OR | $60.47–$65.46 | 2 |
| PA | $57.75–$63.44 | 2 |
| PR | $61.54 | 1 |
| RI | $62.63 | 1 |
| SC | $57.83 | 1 |
| SD | $60.01 | 1 |
| TN | $56.70 | 1 |
| TX | $57.40–$63.30 | 8 |
| UT | $58.55 | 1 |
| VA | $59.95–$69.49 | 2 |
| VI | $61.54 | 1 |
| VT | $59.90 | 1 |
| WA | $63.10–$70.89 | 2 |
| WI | $58.28 | 1 |
| WV | $56.59 | 1 |
| WY | $60.69 | 1 |
How the 76604 rate is calculated
Each of 76604’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 · 76604
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 0.58Practice expense 1.20Malpractice 0.05
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 76604
The CMS indicators that decide how 76604 is paid alongside other services.
CMS payment indicators · 76604
Chest ultrasound
| 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
76604 without 26 · national office
$61.12
Chest ultrasound
76604-26 · Professional component
$27.72
Pays only the interpretation and report.
76604 compared with similar codes
Compare codes
76604 vs 76641 vs 76642 vs 76942: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 76641Breast ultrasound
- This code describes a complete breast ultrasound, not an examination of pleural, chest-wall, or mediastinal structures.
- 76642Breast ultrasound
- This code describes a limited breast ultrasound. Choose it for a focused breast examination, not a diagnostic thoracic ultrasound.
- 76942Ultrasound needle guidance
- This code concerns ultrasound guidance for needle placement. It is not a substitute for a separately performed diagnostic chest examination.
76604 billing questions
When should 76604 be used instead of 76641 or 76642?
Use 76604 for diagnostic ultrasound of thoracic structures such as the pleural space, chest wall, or mediastinum. Codes 76641 and 76642 describe breast ultrasound, with the choice depending on the extent of the breast examination.
Can the professional and technical portions be billed separately?
Yes. Report modifier 26 for the physician's interpretation and modifier TC for the equipment and staff portion; billing without either modifier represents the global service.
Can 76604 be reported with thoracentesis?
It may be reported when a distinct diagnostic chest examination is performed and documented. Do not treat imaging that is integral to the thoracentesis as a separate diagnostic examination.
What documentation supports 76604?
Document the reason for the study, the thoracic area evaluated, saved images, and the findings or interpretation. The record should make clear that the service was diagnostic rather than solely procedural guidance.
How does the multiple-procedure reduction affect this code?
CMS applies the diagnostic imaging multiple-procedure reduction to the technical and professional components when applicable. The reduction can therefore affect either separately billed component.
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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