Billing code 76536: Head and neck ultrasoundMedicare rate & RVUs in Georgia
Report diagnostic head and neck soft tissue ultrasound for thyroid nodules, salivary masses, parathyroid assessment, or cervical lymphadenopathy, with stored images and interpretation.
Medicare pays $99.21–$110.30 for 76536 in the office in Georgia, from Rest Of Georgia to Atlanta. 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.
On this page 9 sections
What 76536 covers
This exam evaluates superficial soft tissue structures of the head and neck with real-time ultrasound and permanent image documentation. The most common use is thyroid imaging for palpable nodules, goiter, abnormal thyroid labs, or follow-up of known nodules. It also covers parathyroid localization before surgery, parotid and submandibular gland masses, neck lumps, and cervical lymph node assessment in head and neck or thyroid cancer surveillance. Sonographers in radiology departments and imaging centers usually acquire the images and radiologists interpret them, though endocrinologists and otolaryngologists may perform and read the study in the office.
Report one unit for a head and neck soft tissue examination, regardless of how many glands or nodes are examined. The report should identify the structures evaluated, describe findings such as nodule size, composition, and location, and reference stored images. CMS prices this diagnostic test by component: modifier 26 identifies the interpretation and report, modifier TC identifies the equipment, staff, and supplies, and billing without a modifier claims the global service when one entity provides both. Hospital-based radiologists typically bill with modifier 26 while the facility bills the technical portion.
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 76536 pays more and less in Georgia
| Payment locality | Office | Facility |
|---|---|---|
| Atlanta | $110.30 | Unavailable |
| Rest Of Georgia | $99.21 | Unavailable |
How the 76536 rate is calculated
Each of 76536’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 · 76536
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 0.55Practice expense 2.66Malpractice 0.04
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 76536
The CMS indicators that decide how 76536 is paid alongside other services.
CMS payment indicators · 76536
Head and neck ultrasound
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| 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
76536 without 26 · national office
$108.55
Head and neck ultrasound
76536-26 · Professional component
$26.39
Pays only the interpretation and report.
76536 compared with similar codes
Compare codes
76536 vs 93880 vs 76506 vs 76942 vs 76882: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 93880Carotid duplex
- 93880 is a duplex vascular study of the carotid arteries with Doppler flow analysis. Use 76536 to evaluate thyroid, parathyroid, salivary glands, or lymph nodes rather than carotid blood flow.
- 76506Cranial ultrasound
- 76506 images the brain and intracranial structures, usually in infants through the fontanelle. 76536 covers superficial head and neck soft tissues such as the thyroid and parotid.
- 76942Ultrasound needle guidance
- 76942 reports ultrasound guidance for needle placement. 76536 is a diagnostic head and neck soft tissue examination with its own images and interpretation report.
- 76882Extremity ultrasound
- 76882 is a limited nonvascular ultrasound of an extremity. Use 76536 for a diagnostic soft tissue ultrasound of the neck, face, or salivary glands.
76536 billing questions
Should carotid artery ultrasound be billed with this code?
No. Carotid evaluation is a vascular duplex study reported with 93880 or 93882. This code is for nonvascular soft tissues like the thyroid, parathyroids, salivary glands, and lymph nodes.
Can this be billed with an ultrasound-guided thyroid fine needle aspiration?
Ultrasound guidance is included in 10005 and 10006, so this code should not be reported just for localizing the needle target. A separately documented diagnostic neck ultrasound with its own report may be reportable when medically necessary.
Which modifier does a radiologist reading a hospital outpatient study use?
The radiologist appends modifier 26 for the interpretation and report, and the hospital reports the technical portion on its facility claim. An office that provides both the imaging and interpretation bills the code without a modifier.
Is it reported per gland or per side?
Report one unit for the head and neck soft tissue examination, even when the thyroid, parathyroids, and cervical lymph nodes are all evaluated.
What documentation supports the claim?
A signed interpretation should describe the structures examined and findings, with images retained. Measurements and characterization of any nodules or nodes support follow-up studies.
Is infant head ultrasound through the fontanelle reported here?
No. Brain imaging through the fontanelle is reported with 76506. This code addresses superficial soft tissues of the head and neck, not intracranial contents.
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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