FeeBase
Log inGet started
Menu
On this page

CMS RVU26D · Effective 2026-10-01

76642 in Beaumont

Office / nonfacility

$78.00

Base rate per service

Facility setting

Not available in this setting

Base rate per service

Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.

Radiology

About 76642: Limited unilateral breast ultrasound

Real-time ultrasound of one breast targeted to a specific area or finding, such as a palpable lump or mammographic abnormality, with image documentation and axilla when scanned.

A limited breast ultrasound evaluates one breast with real-time scanning focused on a defined region rather than the entire breast. Typical indications include a palpable lump, focal pain, nipple discharge, a mass or asymmetry seen on diagnostic mammography, or short-interval follow-up of a known probably benign lesion. The axilla is included when it is scanned. A sonographer or radiologist performs the exam in an imaging center, hospital outpatient department, or breast surgeon's office, and a radiologist or breast surgeon interprets it with permanent images and a written report.

Choose this code when the exam does not cover all four quadrants plus the retroareolar region; full surveys go to the complete code. The report should state the side, the targeted area or clock-face location, findings, and an impression. The code is unilateral, so scanning both breasts is reported with modifier 50, which CMS pays at 150%. It splits into a professional component (modifier 26) for the interpretation and a technical component (modifier TC) for equipment and staff; reporting without either modifier bills the global service, used when one entity both performs and reads the study.

CMS billing rules for 76642

Professional and technical components
Diagnostic test with a professional component (modifier 26, interpretation) and a technical component (modifier TC, equipment and staff); billing without a modifier is the global service.
Bilateral procedures
Bilateral procedure with modifier 50 is paid at 150%.

Where the value comes from

  • Work RVU0.66 · 26%
  • Practice expense (office) RVU1.79 · 72%
  • Malpractice RVU0.05 · 2%

664K

Medicare services in 2024 · #190 by national volume

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.

76642 compared with similar codes

Office rates for Beaumont, from the same CMS release.

76641

Breast ultrasound

Complete examination

$93.35

76641 requires documentation of all four quadrants plus the retroareolar region; any targeted or partial exam of the breast is 76642.

76604

Chest ultrasound

Diagnostic examination

$57.40

76604 images the chest wall or mediastinum, not breast parenchyma. Breast lumps and mammographic findings are reported with breast ultrasound codes.

19083

Breast biopsy

First lesion, ultrasound-guided

$442.12

19083 is a breast biopsy with ultrasound guidance included; 76642 describes a diagnostic breast exam and is not billed solely for imaging used to guide the biopsy needle.

The same code, a different location

How does Beaumont compare?

In Austin, the office rate for 76642 is $86.82—$8.82 higher than the $78.00 rate in Beaumont. Both use the same code, release and participation basis.

76642 across payment areas

Same release and payment basis · bars start at $0

  1. Beaumont · This locality

    $78.00

  2. Austin

    $86.82

    $8.82 higher than Beaumont

  3. Brazoria

    $82.77

    $4.77 higher than Beaumont

  4. Dallas

    $83.22

    $5.22 higher than Beaumont

  5. Fort Worth

    $82.65

    $4.65 higher than Beaumont

  6. Galveston

    $82.97

    $4.97 higher than Beaumont

  7. Houston

    $83.89

    $5.89 higher than Beaumont

Other payment areas listed in Texas appear first, followed by selected cross-country examples. The chart compares amounts, not distance.

Across 109 of 109 CMS payment localities with a supported office rate, 76642 ranges from $74.26 in Arkansas to $111.58 in San Jose-Sunnyvale-Santa Clara (San Benito Cnty). This is a geographic range, not an average.

The code’s RVUs stay the same in these comparisons. Geographic adjustments to work, practice expense and malpractice change the dollar amount. A city name alone may not identify the payment area for a service address.

Compare all 108 other payment areas

  • Rest Of Texas

    Texas · 76642

    Office

    $80.29

    Facility

    Unavailable

    $2.29 higher than Beaumont for the office setting.

  • Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty)

    California · 76642

    Office

    $94.79

    Facility

    Unavailable

    $16.79 higher than Beaumont for the office setting.

  • Dc + Md/Va Suburbs

    District of Columbia · 76642

    Office

    $95.52

    Facility

    Unavailable

    $17.52 higher than Beaumont for the office setting.

  • Miami

    Florida · 76642

    Office

    $88.51

    Facility

    Unavailable

    $10.51 higher than Beaumont for the office setting.

  • Chicago

    Illinois · 76642

    Office

    $86.12

    Facility

    Unavailable

    $8.12 higher than Beaumont for the office setting.

  • Manhattan

    New York · 76642

    Office

    $95.58

    Facility

    Unavailable

    $17.58 higher than Beaumont for the office setting.

  • Alaska*

    Alaska · 76642

    Office

    $97.66

    Facility

    Unavailable

    $19.66 higher than Beaumont for the office setting.

  • Alabama

    Alabama · 76642

    Office

    $75.30

    Facility

    Unavailable

    $2.70 lower than Beaumont for the office setting.

  • Arkansas

    Arkansas · 76642

    Office

    $74.26

    Facility

    Unavailable

    $3.74 lower than Beaumont for the office setting.

  • Arizona

    Arizona · 76642

    Office

    $81.41

    Facility

    Unavailable

    $3.41 higher than Beaumont for the office setting.

  • Bakersfield

    California · 76642

    Office

    $89.01

    Facility

    Unavailable

    $11.01 higher than Beaumont for the office setting.

  • Chico

    California · 76642

    Office

    $88.84

    Facility

    Unavailable

    $10.84 higher than Beaumont for the office setting.

  • El Centro

    California · 76642

    Office

    $88.85

    Facility

    Unavailable

    $10.85 higher than Beaumont for the office setting.

  • Fresno

    California · 76642

    Office

    $88.84

    Facility

    Unavailable

    $10.84 higher than Beaumont for the office setting.

  • Hanford-Corcoran

    California · 76642

    Office

    $88.84

    Facility

    Unavailable

    $10.84 higher than Beaumont for the office setting.

  • Madera

    California · 76642

    Office

    $88.84

    Facility

    Unavailable

    $10.84 higher than Beaumont for the office setting.

  • Merced

    California · 76642

    Office

    $88.84

    Facility

    Unavailable

    $10.84 higher than Beaumont for the office setting.

  • Modesto

    California · 76642

    Office

    $88.84

    Facility

    Unavailable

    $10.84 higher than Beaumont for the office setting.

  • Napa

    California · 76642

    Office

    $103.08

    Facility

    Unavailable

    $25.08 higher than Beaumont for the office setting.

  • Oxnard-Thousand Oaks-Ventura

    California · 76642

    Office

    $94.37

    Facility

    Unavailable

    $16.37 higher than Beaumont for the office setting.

  • Redding

    California · 76642

    Office

    $88.84

    Facility

    Unavailable

    $10.84 higher than Beaumont for the office setting.

  • Rest Of California

    California · 76642

    Office

    $88.84

    Facility

    Unavailable

    $10.84 higher than Beaumont for the office setting.

  • Riverside-San Bernardino-Ontario

    California · 76642

    Office

    $89.39

    Facility

    Unavailable

    $11.39 higher than Beaumont for the office setting.

  • Sacramento-Roseville-Folsom

    California · 76642

    Office

    $93.27

    Facility

    Unavailable

    $15.27 higher than Beaumont for the office setting.

  • Salinas

    California · 76642

    Office

    $92.92

    Facility

    Unavailable

    $14.92 higher than Beaumont for the office setting.

  • San Diego-Chula Vista-Carlsbad

    California · 76642

    Office

    $95.12

    Facility

    Unavailable

    $17.12 higher than Beaumont for the office setting.

  • San Francisco-Oakland-Berkeley (Marin Cnty)

    California · 76642

    Office

    $109.21

    Facility

    Unavailable

    $31.21 higher than Beaumont for the office setting.

  • San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty)

    California · 76642

    Office

    $109.15

    Facility

    Unavailable

    $31.15 higher than Beaumont for the office setting.

  • San Jose-Sunnyvale-Santa Clara (San Benito Cnty)

    California · 76642

    Office

    $111.58

    Facility

    Unavailable

    $33.58 higher than Beaumont for the office setting.

  • San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty)

    California · 76642

    Office

    $111.35

    Facility

    Unavailable

    $33.35 higher than Beaumont for the office setting.

  • San Luis Obispo-Paso Robles

    California · 76642

    Office

    $91.41

    Facility

    Unavailable

    $13.41 higher than Beaumont for the office setting.

  • Santa Cruz-Watsonville

    California · 76642

    Office

    $96.04

    Facility

    Unavailable

    $18.04 higher than Beaumont for the office setting.

  • Santa Maria-Santa Barbara

    California · 76642

    Office

    $93.27

    Facility

    Unavailable

    $15.27 higher than Beaumont for the office setting.

  • Santa Rosa-Petaluma

    California · 76642

    Office

    $97.02

    Facility

    Unavailable

    $19.02 higher than Beaumont for the office setting.

  • Stockton

    California · 76642

    Office

    $88.84

    Facility

    Unavailable

    $10.84 higher than Beaumont for the office setting.

  • Vallejo

    California · 76642

    Office

    $103.00

    Facility

    Unavailable

    $25.00 higher than Beaumont for the office setting.

  • Visalia

    California · 76642

    Office

    $88.84

    Facility

    Unavailable

    $10.84 higher than Beaumont for the office setting.

  • Yuba City

    California · 76642

    Office

    $88.84

    Facility

    Unavailable

    $10.84 higher than Beaumont for the office setting.

  • Colorado

    Colorado · 76642

    Office

    $87.23

    Facility

    Unavailable

    $9.23 higher than Beaumont for the office setting.

  • Connecticut

    Connecticut · 76642

    Office

    $88.90

    Facility

    Unavailable

    $10.90 higher than Beaumont for the office setting.

  • Delaware

    Delaware · 76642

    Office

    $82.73

    Facility

    Unavailable

    $4.73 higher than Beaumont for the office setting.

  • Fort Lauderdale

    Florida · 76642

    Office

    $85.63

    Facility

    Unavailable

    $7.63 higher than Beaumont for the office setting.

  • Rest Of Florida

    Florida · 76642

    Office

    $81.71

    Facility

    Unavailable

    $3.71 higher than Beaumont for the office setting.

  • Atlanta

    Georgia · 76642

    Office

    $84.86

    Facility

    Unavailable

    $6.86 higher than Beaumont for the office setting.

  • Rest Of Georgia

    Georgia · 76642

    Office

    $77.37

    Facility

    Unavailable

    $0.63 lower than Beaumont for the office setting.

  • Hawaii, Guam

    Hawaii · 76642

    Office

    $90.99

    Facility

    Unavailable

    $12.99 higher than Beaumont for the office setting.

  • Iowa

    Iowa · 76642

    Office

    $77.41

    Facility

    Unavailable

    $0.59 lower than Beaumont for the office setting.

  • Idaho

    Idaho · 76642

    Office

    $77.84

    Facility

    Unavailable

    $0.16 lower than Beaumont for the office setting.

  • East St. Louis

    Illinois · 76642

    Office

    $80.41

    Facility

    Unavailable

    $2.41 higher than Beaumont for the office setting.

  • Rest Of Illinois

    Illinois · 76642

    Office

    $79.24

    Facility

    Unavailable

    $1.24 higher than Beaumont for the office setting.

  • Suburban Chicago

    Illinois · 76642

    Office

    $86.56

    Facility

    Unavailable

    $8.56 higher than Beaumont for the office setting.

  • Indiana

    Indiana · 76642

    Office

    $78.28

    Facility

    Unavailable

    $0.28 higher than Beaumont for the office setting.

  • Kansas

    Kansas · 76642

    Office

    $76.93

    Facility

    Unavailable

    $1.07 lower than Beaumont for the office setting.

  • Kentucky

    Kentucky · 76642

    Office

    $76.72

    Facility

    Unavailable

    $1.28 lower than Beaumont for the office setting.

  • New Orleans

    Louisiana · 76642

    Office

    $80.20

    Facility

    Unavailable

    $2.20 higher than Beaumont for the office setting.

  • Rest Of Louisiana

    Louisiana · 76642

    Office

    $76.56

    Facility

    Unavailable

    $1.44 lower than Beaumont for the office setting.

  • Metropolitan Boston

    Massachusetts · 76642

    Office

    $95.82

    Facility

    Unavailable

    $17.82 higher than Beaumont for the office setting.

  • Rest Of Massachusetts

    Massachusetts · 76642

    Office

    $86.68

    Facility

    Unavailable

    $8.68 higher than Beaumont for the office setting.

  • Baltimore/Surr. Cntys

    Maryland · 76642

    Office

    $88.62

    Facility

    Unavailable

    $10.62 higher than Beaumont for the office setting.

  • Rest Of Maryland

    Maryland · 76642

    Office

    $84.30

    Facility

    Unavailable

    $6.30 higher than Beaumont for the office setting.

  • Rest Of Maine

    Maine · 76642

    Office

    $78.09

    Facility

    Unavailable

    $0.09 higher than Beaumont for the office setting.

  • Southern Maine

    Maine · 76642

    Office

    $82.35

    Facility

    Unavailable

    $4.35 higher than Beaumont for the office setting.

  • Detroit

    Michigan · 76642

    Office

    $82.56

    Facility

    Unavailable

    $4.56 higher than Beaumont for the office setting.

  • Rest Of Michigan

    Michigan · 76642

    Office

    $78.52

    Facility

    Unavailable

    $0.52 higher than Beaumont for the office setting.

  • Minnesota

    Minnesota · 76642

    Office

    $84.06

    Facility

    Unavailable

    $6.06 higher than Beaumont for the office setting.

  • Metropolitan Kansas City

    Missouri · 76642

    Office

    $79.82

    Facility

    Unavailable

    $1.82 higher than Beaumont for the office setting.

  • Metropolitan St. Louis

    Missouri · 76642

    Office

    $80.64

    Facility

    Unavailable

    $2.64 higher than Beaumont for the office setting.

  • Rest Of Missouri

    Missouri · 76642

    Office

    $75.21

    Facility

    Unavailable

    $2.79 lower than Beaumont for the office setting.

  • Mississippi

    Mississippi · 76642

    Office

    $74.76

    Facility

    Unavailable

    $3.24 lower than Beaumont for the office setting.

  • Montana**

    Montana · 76642

    Office

    $83.50

    Facility

    Unavailable

    $5.50 higher than Beaumont for the office setting.

  • North Carolina

    North Carolina · 76642

    Office

    $78.89

    Facility

    Unavailable

    $0.89 higher than Beaumont for the office setting.

  • North Dakota**

    North Dakota · 76642

    Office

    $82.51

    Facility

    Unavailable

    $4.51 higher than Beaumont for the office setting.

  • Nebraska

    Nebraska · 76642

    Office

    $77.86

    Facility

    Unavailable

    $0.14 lower than Beaumont for the office setting.

  • New Hampshire

    New Hampshire · 76642

    Office

    $85.74

    Facility

    Unavailable

    $7.74 higher than Beaumont for the office setting.

  • Northern Nj

    New Jersey · 76642

    Office

    $94.57

    Facility

    Unavailable

    $16.57 higher than Beaumont for the office setting.

  • Rest Of New Jersey

    New Jersey · 76642

    Office

    $90.05

    Facility

    Unavailable

    $12.05 higher than Beaumont for the office setting.

  • New Mexico

    New Mexico · 76642

    Office

    $78.88

    Facility

    Unavailable

    $0.88 higher than Beaumont for the office setting.

  • Nevada**

    Nevada · 76642

    Office

    $83.28

    Facility

    Unavailable

    $5.28 higher than Beaumont for the office setting.

  • Nyc Suburbs/Long Island

    New York · 76642

    Office

    $97.64

    Facility

    Unavailable

    $19.64 higher than Beaumont for the office setting.

  • Poughkpsie/N Nyc Suburbs

    New York · 76642

    Office

    $90.52

    Facility

    Unavailable

    $12.52 higher than Beaumont for the office setting.

  • Queens

    New York · 76642

    Office

    $96.53

    Facility

    Unavailable

    $18.53 higher than Beaumont for the office setting.

  • Rest Of New York

    New York · 76642

    Office

    $80.02

    Facility

    Unavailable

    $2.02 higher than Beaumont for the office setting.

  • Ohio

    Ohio · 76642

    Office

    $78.31

    Facility

    Unavailable

    $0.31 higher than Beaumont for the office setting.

  • Oklahoma

    Oklahoma · 76642

    Office

    $76.73

    Facility

    Unavailable

    $1.27 lower than Beaumont for the office setting.

  • Portland

    Oregon · 76642

    Office

    $90.06

    Facility

    Unavailable

    $12.06 higher than Beaumont for the office setting.

  • Rest Of Oregon

    Oregon · 76642

    Office

    $82.77

    Facility

    Unavailable

    $4.77 higher than Beaumont for the office setting.

  • Metropolitan Philadelphia

    Pennsylvania · 76642

    Office

    $86.67

    Facility

    Unavailable

    $8.67 higher than Beaumont for the office setting.

  • Rest Of Pennsylvania

    Pennsylvania · 76642

    Office

    $78.51

    Facility

    Unavailable

    $0.51 higher than Beaumont for the office setting.

  • Puerto Rico

    Puerto Rico · 76642

    Office

    $84.13

    Facility

    Unavailable

    $6.13 higher than Beaumont for the office setting.

  • Rhode Island

    Rhode Island · 76642

    Office

    $85.71

    Facility

    Unavailable

    $7.71 higher than Beaumont for the office setting.

  • South Carolina

    South Carolina · 76642

    Office

    $78.71

    Facility

    Unavailable

    $0.71 higher than Beaumont for the office setting.

  • South Dakota**

    South Dakota · 76642

    Office

    $82.39

    Facility

    Unavailable

    $4.39 higher than Beaumont for the office setting.

  • Tennessee

    Tennessee · 76642

    Office

    $77.29

    Facility

    Unavailable

    $0.71 lower than Beaumont for the office setting.

  • Utah

    Utah · 76642

    Office

    $79.74

    Facility

    Unavailable

    $1.74 higher than Beaumont for the office setting.

  • Virginia

    Virginia · 76642

    Office

    $81.99

    Facility

    Unavailable

    $3.99 higher than Beaumont for the office setting.

  • Virgin Islands

    United States Virgin Islands · 76642

    Office

    $84.13

    Facility

    Unavailable

    $6.13 higher than Beaumont for the office setting.

  • Vermont

    Vermont · 76642

    Office

    $82.08

    Facility

    Unavailable

    $4.08 higher than Beaumont for the office setting.

  • Rest Of Washington

    Washington · 76642

    Office

    $86.56

    Facility

    Unavailable

    $8.56 higher than Beaumont for the office setting.

  • Seattle (King Cnty)

    Washington · 76642

    Office

    $97.87

    Facility

    Unavailable

    $19.87 higher than Beaumont for the office setting.

  • Wisconsin

    Wisconsin · 76642

    Office

    $79.84

    Facility

    Unavailable

    $1.84 higher than Beaumont for the office setting.

  • West Virginia

    West Virginia · 76642

    Office

    $76.39

    Facility

    Unavailable

    $1.61 lower than Beaumont for the office setting.

  • Wyoming**

    Wyoming · 76642

    Office

    $83.07

    Facility

    Unavailable

    $5.07 higher than Beaumont for the office setting.

See how rates vary across the country

76642 · Office / nonfacility · Non-QP. Choose a state to explore its payment localities. A range means the amount varies within that state.

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.

$74.26

$100.21

Color shows the midpoint of each state’s locality range.

View all state and territory rates as a table
State / territoryRate rangeLocalities
AK$97.661
AL$75.301
AR$74.261
AZ$81.411
CA$88.84–$111.5829
CO$87.231
CT$88.901
DC$95.521
DE$82.731
FL$81.71–$88.513
GA$77.37–$84.862
GU$90.991
HI$90.991
IA$77.411
ID$77.841
IL$79.24–$86.564
IN$78.281
KS$76.931
KY$76.721
LA$76.56–$80.202
MA$86.68–$95.822
MD$84.30–$95.523
ME$78.09–$82.352
MI$78.52–$82.562
MN$84.061
MO$75.21–$80.643
MS$74.761
MT$83.501
NC$78.891
ND$82.511
NE$77.861
NH$85.741
NJ$90.05–$94.572
NM$78.881
NV$83.281
NY$80.02–$97.645
OH$78.311
OK$76.731
OR$82.77–$90.062
PA$78.51–$86.672
PR$84.131
RI$85.711
SC$78.711
SD$82.391
TN$77.291
TX$78.00–$86.828
UT$79.741
VA$81.99–$95.522
VI$84.131
VT$82.081
WA$86.56–$97.872
WI$79.841
WV$76.391
WY$83.071

Explore 76642 on the national rate map →

Where does this rate apply?

Beaumont is a Medicare payment area. Our Census mapping connects it to 13 cities and communities in Texas, including the examples shown here.

Some communities span more than one payment area. Follow a city link to compare all of its mapped areas, or check the service-location ZIP above for an address-level starting point.

Browse all communities in Texas →

Use this rate

What is a percentage of Medicare worth?

Turn a percentage into dollars for 76642 in Beaumont. This uses the base rate on this page, so the locality and release stay consistent.

Reference amount per service

$85.80

$78.00 × 110% = $85.80

A contract may specify another Medicare year or additional adjustments. This is percentage arithmetic on the displayed base rate, not a claim adjudication.

Working with a whole code list?

Compare an offer across your annual code mix, including an older Medicare schedule or flat per-code rates.

Compare your contract offer →

How this local rate is calculated

Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 76642 in Beaumont.

PPRRVU2026_Oct_nonQPP.csv

8,739

Code
76642
Physician work
0.66
Practice expense
1.79
Malpractice
0.05

GPCI2026.csv

97

Locality
Beaumont
Physician work
1.000
Practice expense
0.910
Malpractice
0.929
Office / nonfacility calculation for 76642 in Beaumont
ComponentRVULocality factorAdjusted
Physician work0.66× 1.0000.6600
Practice expense1.79× 0.9101.6289
Malpractice0.05× 0.9290.0465
Total RVUs2.3354
Conversion factor× 33.4009

Office / nonfacility rate, Beaumont$78.00

Open 76642 in the RVU calculator →

Explore RVUs, geographic factors and the full formula

Office / nonfacility

Office / nonfacility calculation inputs
ComponentRVULocal GPCI
Work0.661
Practice expense1.790.91
Malpractice0.050.929

(0.66 × 1 + 1.79 × 0.91 + 0.05 × 0.929) × $33.4009 = $78.00

The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.

How this rate has changed

76642 · Office / nonfacility

$78.00

Effective 2026-10-01

The base rate is $1.60 higher than on 2025-10-01, moving from $76.40 to $78.00 (2.1%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

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

  1. January 1, 2026

    RVU26A

    $76.40changed to$78.00

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 0.68 changed to 0.66
    • Practice expense RVU 1.81 changed to 1.79
    • Practice expense GPCI 0.903 changed to 0.910
    • Malpractice GPCI 0.947 changed to 0.929

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    Earliest loaded release: $76.40

    Held through RVU25B, RVU25C, RVU25D.

Explore release dates and calculate this code in an earlier period →

Each row uses the accepted CMS release effective on that date and the same contractor and locality identifiers. Missing rates stay visible. Historical boundaries may differ; verify the service address for an older claim.

Inspect every release and its CMS source
Effective fromOffice / nonfacilityFacilityCMS release
2026-10-01$78.00Not available in this settingRVU26D
2026-07-01$78.00Not available in this settingRVU26C
2026-04-01$78.00Not available in this settingRVU26B
2026-01-01$78.00Not available in this settingRVU26A
2025-10-01$76.40Not available in this settingRVU25D
2025-07-01$76.40Not available in this settingRVU25C
2025-04-01$76.40Not available in this settingRVU25B
2025-01-01$76.40Not available in this settingRVU25A

76642 billing questions

When should 76642 be reported instead of 76641?

Use 76642 when the scan targets a specific area or finding in one breast. Use 76641 only when all four quadrants and the retroareolar region are examined and documented.

How is a limited ultrasound of both breasts billed?

Report 76642 once with modifier 50, which Medicare pays at 150% of the unilateral amount. Do not report two units or two lines without the bilateral modifier for Medicare.

Is axillary scanning billed separately?

No. Evaluation of the axilla is included in this code when performed, so a separate limited ultrasound of the axilla is not added for the same side.

Which modifier does a hospital-based radiologist append?

When the hospital owns the equipment and bills the technical portion, the reading radiologist reports 76642 with modifier 26 for the interpretation only. A freestanding center that performs and reads the exam bills globally without a modifier.

Can 76642 be billed for ultrasound guidance during a breast biopsy?

No. Ultrasound-guided breast biopsy code 19083 includes the imaging guidance, so 76642 is not reported just to guide the biopsy needle.

Where these rates come from

FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.

Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.

RVUs for 76642PPRRVU2026_Oct_nonQPP.csv, line 8,739 (RVU26D)
Geographic factors for BeaumontGPCI2026.csv, line 97 (RVU26D)
Open CMS sourceHow this rate is calculatedBuild a fee sheet