Billing code 76978: Contrast ultrasoundMedicare rate & RVUs
Reports dynamic microbubble contrast ultrasound characterization of a target lesion, including evaluation of enhancement and washout, for the first lesion examined.
Medicare pays $171.35 for 76978 nationally in the office. Local office rates run $153.48–$226.53.
Medicare rate · 76978
Contrast ultrasound
Swap in your local Medicare rate.
- Work RVUs
- 1.58
- Total RVUs
- 5.13
- Global days
- XXX
National rate · 2026
$171.35
Office setting, before claim adjustments.
See every locality for 76978 → · 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 76978 covers
This service uses ultrasound with an injected microbubble contrast agent to assess a target lesion dynamically, including its perfusion pattern and contrast washout. It is commonly used to characterize indeterminate focal findings, such as a liver lesion, when contrast-enhanced ultrasound can provide information about vascular behavior. Imaging staff acquire the study, and a qualified physician interprets the findings and produces a report. It may be performed in a hospital or outpatient imaging setting.
Report 76978 for the first target lesion; code 76979 is used for each additional lesion when the service meets that code’s requirements. The record should identify the target lesion and document the dynamic contrast assessment and interpretation. The professional component may be reported with modifier 26, the technical component with modifier TC, or the global service without either modifier. The diagnostic imaging multiple procedure reduction applies to both the technical and professional components.
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 76978 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
$153.48 to $226.53
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $155.49 | Unavailable |
| Alaska* | $203.72 | Unavailable |
| Arizona | $167.29 | Unavailable |
| Arkansas | $153.48 | Unavailable |
| Atlanta | $174.02 | Unavailable |
| Austin | $177.75 | Unavailable |
| Bakersfield | $182.11 | Unavailable |
| Baltimore/Surr. Cntys | $181.39 | Unavailable |
| Beaumont | $160.74 | Unavailable |
| Brazoria | $170.00 | Unavailable |
| Chicago | $176.62 | Unavailable |
| Chico | $181.76 | Unavailable |
| Colorado | $178.62 | Unavailable |
| Connecticut | $181.98 | Unavailable |
| Dallas | $170.89 | Unavailable |
| Dc + Md/Va Suburbs | $195.09 | Unavailable |
| Delaware | $169.89 | Unavailable |
| Detroit | $169.60 | Unavailable |
| East St. Louis | $165.51 | Unavailable |
| El Centro | $181.77 | Unavailable |
| Fort Lauderdale | $175.54 | Unavailable |
| Fort Worth | $169.78 | Unavailable |
| Fresno | $181.76 | Unavailable |
| Galveston | $170.39 | Unavailable |
| Hanford-Corcoran | $181.76 | Unavailable |
| Hawaii, Guam | $185.73 | Unavailable |
| Houston | $172.22 | Unavailable |
| Idaho | $160.37 | Unavailable |
| Indiana | $161.22 | Unavailable |
| Iowa | $159.54 | Unavailable |
| Kansas | $158.63 | Unavailable |
| Kentucky | $158.27 | Unavailable |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | $193.48 | Unavailable |
| Madera | $181.76 | Unavailable |
| Manhattan | $195.35 | Unavailable |
| Merced | $181.76 | Unavailable |
| Metropolitan Boston | $195.50 | Unavailable |
| Metropolitan Kansas City | $164.24 | Unavailable |
| Metropolitan Philadelphia | $177.67 | Unavailable |
| Metropolitan St. Louis | $165.82 | Unavailable |
| Miami | $181.18 | Unavailable |
| Minnesota | $172.34 | Unavailable |
| Mississippi | $154.46 | Unavailable |
| Modesto | $181.76 | Unavailable |
| Montana** | $171.34 | Unavailable |
| Napa | $209.67 | Unavailable |
| Nebraska | $160.40 | Unavailable |
| Nevada** | $170.90 | Unavailable |
| New Hampshire | $175.65 | Unavailable |
| New Mexico | $162.45 | Unavailable |
| New Orleans | $165.00 | Unavailable |
| North Carolina | $162.42 | Unavailable |
| North Dakota** | $169.36 | Unavailable |
| Northern Nj | $193.34 | Unavailable |
| Nyc Suburbs/Long Island | $199.37 | Unavailable |
| Ohio | $161.35 | Unavailable |
| Oklahoma | $158.27 | Unavailable |
| Oxnard-Thousand Oaks-Ventura | $192.54 | Unavailable |
| Portland | $184.13 | Unavailable |
| Poughkpsie/N Nyc Suburbs | $185.37 | Unavailable |
| Puerto Rico | $172.56 | Unavailable |
| Queens | $197.17 | Unavailable |
| Redding | $181.76 | Unavailable |
| Rest Of California | $181.76 | Unavailable |
| Rest Of Florida | $167.96 | Unavailable |
| Rest Of Georgia | $159.54 | Unavailable |
| Rest Of Illinois | $163.20 | Unavailable |
| Rest Of Louisiana | $157.95 | Unavailable |
| Rest Of Maine | $160.87 | Unavailable |
| Rest Of Maryland | $172.98 | Unavailable |
| Rest Of Massachusetts | $177.62 | Unavailable |
| Rest Of Michigan | $161.75 | Unavailable |
| Rest Of Missouri | $155.36 | Unavailable |
| Rest Of New Jersey | $184.38 | Unavailable |
| Rest Of New York | $164.59 | Unavailable |
| Rest Of Oregon | $169.89 | Unavailable |
| Rest Of Pennsylvania | $161.71 | Unavailable |
| Rest Of Texas | $165.15 | Unavailable |
| Rest Of Washington | $177.34 | Unavailable |
| Rhode Island | $175.79 | Unavailable |
| Riverside-San Bernardino-Ontario | $182.87 | Unavailable |
| Sacramento-Roseville-Folsom | $190.48 | Unavailable |
| Salinas | $189.75 | Unavailable |
| San Diego-Chula Vista-Carlsbad | $193.99 | Unavailable |
| San Francisco-Oakland-Berkeley (Marin Cnty) | $221.80 | Unavailable |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | $221.69 | Unavailable |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | $226.53 | Unavailable |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | $226.07 | Unavailable |
| San Luis Obispo-Paso Robles | $186.71 | Unavailable |
| Santa Cruz-Watsonville | $195.68 | Unavailable |
| Santa Maria-Santa Barbara | $190.40 | Unavailable |
| Santa Rosa-Petaluma | $197.65 | Unavailable |
| Seattle (King Cnty) | $199.53 | Unavailable |
| South Carolina | $162.09 | Unavailable |
| South Dakota** | $169.13 | Unavailable |
| Southern Maine | $169.08 | Unavailable |
| Stockton | $181.76 | Unavailable |
| Suburban Chicago | $177.41 | Unavailable |
| Tennessee | $159.31 | Unavailable |
| Utah | $164.09 | Unavailable |
| Vallejo | $209.51 | Unavailable |
| Vermont | $168.54 | Unavailable |
| Virgin Islands | $172.56 | Unavailable |
| Virginia | $168.41 | Unavailable |
| Visalia | $181.76 | Unavailable |
| West Virginia | $157.69 | Unavailable |
| Wisconsin | $164.20 | Unavailable |
| Wyoming** | $170.48 | Unavailable |
| Yuba City | $181.76 | Unavailable |
76978 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.
$153.48
$204.14
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 | $203.72 | 1 |
| AL | $155.49 | 1 |
| AR | $153.48 | 1 |
| AZ | $167.29 | 1 |
| CA | $181.76–$226.53 | 29 |
| CO | $178.62 | 1 |
| CT | $181.98 | 1 |
| DC | $195.09 | 1 |
| DE | $169.89 | 1 |
| FL | $167.96–$181.18 | 3 |
| GA | $159.54–$174.02 | 2 |
| GU | $185.73 | 1 |
| HI | $185.73 | 1 |
| IA | $159.54 | 1 |
| ID | $160.37 | 1 |
| IL | $163.20–$177.41 | 4 |
| IN | $161.22 | 1 |
| KS | $158.63 | 1 |
| KY | $158.27 | 1 |
| LA | $157.95–$165.00 | 2 |
| MA | $177.62–$195.50 | 2 |
| MD | $172.98–$195.09 | 3 |
| ME | $160.87–$169.08 | 2 |
| MI | $161.75–$169.60 | 2 |
| MN | $172.34 | 1 |
| MO | $155.36–$165.82 | 3 |
| MS | $154.46 | 1 |
| MT | $171.34 | 1 |
| NC | $162.42 | 1 |
| ND | $169.36 | 1 |
| NE | $160.40 | 1 |
| NH | $175.65 | 1 |
| NJ | $184.38–$193.34 | 2 |
| NM | $162.45 | 1 |
| NV | $170.90 | 1 |
| NY | $164.59–$199.37 | 5 |
| OH | $161.35 | 1 |
| OK | $158.27 | 1 |
| OR | $169.89–$184.13 | 2 |
| PA | $161.71–$177.67 | 2 |
| PR | $172.56 | 1 |
| RI | $175.79 | 1 |
| SC | $162.09 | 1 |
| SD | $169.13 | 1 |
| TN | $159.31 | 1 |
| TX | $160.74–$177.75 | 8 |
| UT | $164.09 | 1 |
| VA | $168.41–$195.09 | 2 |
| VI | $172.56 | 1 |
| VT | $168.54 | 1 |
| WA | $177.34–$199.53 | 2 |
| WI | $164.20 | 1 |
| WV | $157.69 | 1 |
| WY | $170.48 | 1 |
How the 76978 rate is calculated
Each of 76978’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 · 76978
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 1.58Practice expense 3.45Malpractice 0.10
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 76978
The CMS indicators that decide how 76978 is paid alongside other services.
CMS payment indicators · 76978
Contrast 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
76978 without 26 · national office
$171.35
Contrast ultrasound
76978-26 · Professional component
$74.48
Pays only the interpretation and report.
76978 compared with similar codes
Compare codes
76978 vs 76979 vs 76982 vs 76942: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 76979Contrast ultrasound
- 76978 is for the first target lesion; 76979 is for each additional lesion in the same dynamic microbubble contrast service.
- 76982Ultrasound elastography
- 76982 is targeted ultrasound elastography for a first lesion, assessing tissue stiffness rather than microbubble contrast perfusion and washout.
- 76942Ultrasound needle guidance
- 76942 reports ultrasound guidance for a needle procedure such as biopsy. 76978 reports dynamic contrast characterization of the lesion, not needle guidance.
76978 billing questions
When is 76978 reported instead of 76979?
Use 76978 for the first target lesion examined with dynamic microbubble contrast characterization. Use 76979 for each additional lesion when applicable.
Can the professional and technical services be billed separately?
Yes. Report modifier 26 for the interpretation and report, or modifier TC for equipment and staff. 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 technical and professional components.
Is this code for ultrasound-guided biopsy?
No. 76978 describes dynamic microbubble contrast characterization of a lesion, not imaging guidance for a needle biopsy. Code 76942 describes ultrasound guidance for biopsy.
What documentation supports reporting the service?
Document the target lesion, the dynamic contrast assessment, and the physician’s interpretation and report. Identify additional lesions separately when reporting 76979.
Are contrast-agent supplies included in 76978?
The billing code service describes the contrast-enhanced examination. If billing the contrast-agent supply separately, use the applicable HCPCS code for the agent administered and follow the relevant coverage and billing requirements.
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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