Billing code 76965: Ultrasound guidanceMedicare rate & RVUs in Guam
Reports ultrasound guidance used while radioactive sources are placed into tissue, commonly during prostate brachytherapy implantation.
Medicare pays $102.64 for 76965 in the office in Guam (Hawaii, Guam). 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 76965 covers
This service covers ultrasound used to guide placement of radioactive sources into tissue for interstitial radiation treatment. A common setting is prostate brachytherapy, where a urologist or radiation oncologist uses ultrasound during seed implantation to visualize the target and guide source placement. The service is guidance for treatment, not a diagnostic ultrasound examination of the prostate.
Report 76965 when the ultrasound is used for interstitial radioelement application, rather than for a different ultrasound-guided procedure. Documentation should identify the treatment guidance performed and include the imaging and interpretation supporting it. CMS recognizes professional and technical components: modifier 26 reports the interpretation, modifier TC reports the equipment and staff, and an unmodified claim represents the global service. The code may be reported in connection with the source-placement procedure, such as prostate implantation, when the guidance service is performed.
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.
76965 in Hawaii, Guam
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam | $102.64 | Unavailable |
How the 76965 rate is calculated
Each of 76965’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 · 76965
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 1.31Practice expense 1.52Malpractice 0.06
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 76965
The CMS indicators that decide how 76965 is paid alongside other services.
CMS payment indicators · 76965
Ultrasound guidance
| 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
76965 without 26 · national office
$96.53
Ultrasound guidance
76965-26 · Professional component
$67.80
Pays only the interpretation and report.
76965 compared with similar codes
Compare codes
76965 vs 76942 vs 76998 vs 55875: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 76942Ultrasound needle guidance
- Choose 76965 for ultrasound guidance during interstitial radioactive source application. Code 76942 describes ultrasound guidance for needle placement in other procedures, such as biopsy.
- 76998Us guide intraop
- Code 76998 covers intraoperative ultrasound guidance more generally. Code 76965 is the specific choice when ultrasound guides interstitial radioelement application.
- 55875Prostate brachytherapy
- Code 55875 reports transperineal needle or catheter placement for prostate interstitial source implantation; 76965 reports the ultrasound guidance used for that treatment.
76965 billing questions
How is 76965 different from 76942?
76965 is for ultrasound guidance during interstitial radioactive source application. Use 76942 for ultrasound guidance of needle placement in other procedures, such as a biopsy.
Does 76965 report the radioactive seed implantation itself?
No. It reports the ultrasound guidance for interstitial source application. The implantation procedure, such as prostate needle placement reported with 55875, is a separate service.
Which modifiers identify the professional and technical portions?
Modifier 26 reports the professional interpretation, and modifier TC reports the technical portion, including equipment and staff. Without either modifier, the claim represents the global service.
What documentation supports reporting 76965?
Document that ultrasound guided interstitial radioelement placement, the treatment target, and the imaging and interpretation performed. A diagnostic ultrasound alone does not establish this guidance service.
Is this code specific to prostate brachytherapy?
No. Prostate seed implantation is a common example, but the defining service is ultrasound guidance for interstitial radioactive source application.
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
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