$99.09–$108.85
Choose 76856 for a complete pelvic ultrasound. Choose 76870 when the diagnostic target is the testes and scrotal contents.
On this page
CMS RVU26D · Effective 2026-10-01
76870 Scrotal ultrasound Medicare reimbursement rates in Illinois
Scrotal ultrasound evaluates the testes and surrounding structures for pain, swelling, masses, fluid collections, and other suspected scrotal abnormalities. Compare 76870 office and facility rates across CMS payment localities in Illinois.
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.
What does Medicare pay for 76870 in Illinois?
Illinois has 4 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 4 payment areas shown below, using the same CMS release.
Office / nonfacility
$92.85–$102.02
4 of 4 localities have a supported rate.
Facility setting
No supported rate
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Where 76870 pays more and less in Illinois
4 payment localities
$92.85 to $102.02
Diagnostic ultrasound
About 76870: Scrotal ultrasound examination
Scrotal ultrasound evaluates the testes and surrounding structures for pain, swelling, masses, fluid collections, and other suspected scrotal abnormalities.
Scrotal ultrasound uses a transducer over the scrotum to image the testes and surrounding contents, including the epididymides and fluid collections. It is commonly ordered for testicular pain or swelling, a palpable mass, suspected torsion or inflammation, and evaluation of hydrocele or varicocele. Radiologists and other qualified imaging professionals perform or interpret the study in hospital and outpatient imaging settings.
Report 76870 for diagnostic sonographic assessment of scrotal contents. Documentation should identify the clinical indication, structures examined, findings, and interpretation. The service may be billed globally when one entity provides both image acquisition and interpretation, or split with modifier 26 for the professional interpretation and modifier TC for the technical service. CMS applies diagnostic imaging multiple-procedure reduction to both professional and technical components when applicable imaging services are reported together.
CMS billing rules for 76870
- 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.
- Multiple procedures
- Diagnostic imaging multiple procedure reduction applies to the technical and professional components.
Where the value comes from
- Work RVU0.62 · 21%
- Practice expense (office) RVU2.28 · 77%
- Malpractice RVU0.05 · 2%
137.2K
Medicare services in 2024 · #471 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.
76870 compared with similar codes
Office rates for Illinois, from the same CMS release.
$48.95–$53.15
76857 describes a limited pelvic ultrasound; 76870 evaluates scrotal structures rather than pelvic organs.
$242.75–$268.67
93975 represents a complete arterial and venous duplex study. It is distinct from the anatomic scrotal ultrasound represented by 76870.
93976
No office rateVascular study
93976 represents a limited duplex study; 76870 is the scrotal ultrasound examination and is not selected solely for a limited vascular study.
Compare 76870 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
4 of 4 payment localities
Chicago →
Office / nonfacility
$101.22
Facility
Unavailable
East St. Louis →
Office / nonfacility
$94.13
Facility
Unavailable
Rest Of Illinois →
Office / nonfacility
$92.85
Facility
Unavailable
Suburban Chicago →
Office / nonfacility
$102.02
Facility
Unavailable
Need rates for a whole code list?
Fee-sheet and API access are in early access. Tell us which codes and locations your team needs.
76870 billing questions
How does 76870 differ from a pelvic ultrasound?
76870 examines the testes and scrotal contents. Codes 76856 and 76857 are for pelvic-organ imaging, not a substitute for a scrotal study.
When should modifier 26 or TC be used?
Use modifier 26 when billing only the professional interpretation, or TC for the technical service, including equipment and staff. Billing without either modifier represents the global service.
Can a duplex code be reported with 76870?
A separate duplex code may be appropriate when a distinct, medically necessary vascular duplex study is performed and documented. Color-flow images alone do not establish that a separate duplex service was performed.
How does the imaging multiple-procedure reduction affect 76870?
When applicable diagnostic imaging services are reported together, CMS applies the multiple-procedure reduction to both the technical and professional components.
What documentation supports 76870?
Document the reason for the examination, the scrotal structures evaluated, the sonographic findings, and the interpreting professional's report.
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.
8,82976857,,Us exam pelvic limited,A,,0.49,1.00,,1.00,NA,0.04,1.53,1.53,1,XXX,0.00,0.00,0.00,4,0,0,0,0,9,,33.4009,09,0,88,3.35,3.35,0.07
8,83076857,26,Us exam pelvic limited,A,,0.49,0.19,,0.19,,0.03,0.71,0.71,1,XXX,0.00,0.00,0.00,4,0,0,0,0,9,,33.4009,09,0,88,0.00,0.00,0.00
8,83176857,TC,Us exam pelvic limited,A,,0.00,0.81,,0.81,NA,0.01,0.82,0.82,1,XXX,0.00,0.00,0.00,4,0,0,0,0,9,,33.4009,01,0,88,3.16,3.16,0.04
8,83276870,,Us exam scrotum,A,,0.62,2.28,,2.28,NA,0.05,2.95,2.95,1,XXX,0.00,0.00,0.00,4,0,0,0,0,9,,33.4009,09,0,88,3.41,3.41,0.06
8,83376870,26,Us exam scrotum,A,,0.62,0.23,,0.23,,0.04,0.89,0.89,1,XXX,0.00,0.00,0.00,4,0,0,0,0,9,,33.4009,09,0,88,0.00,0.00,0.00
8,83476870,TC,Us exam scrotum,A,,0.00,2.05,,2.05,NA,0.01,2.06,2.06,1,XXX,0.00,0.00,0.00,4,0,0,0,0,9,,33.4009,01,0,88,3.18,3.18,0.02
8,83576872,,Us transrectal,A,,0.65,2.91,,2.91,NA,0.04,3.60,3.60,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,3.45,3.45,0.04