$123.36
20501 reports diagnostic injection of a sinus tract. Use 76080 for the radiologic study and interpretation; both services may be reported when each is performed.
On this page
CMS RVU26D · Effective 2026-10-01
76080 Fistula imaging Medicare reimbursement rates in Kentucky
Reports radiologic evaluation of an abscess, fistula, or sinus tract, such as imaging contrast through a draining tract to define its course. Compare 76080 office and facility rates across CMS payment localities in Kentucky.
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 76080 in Kentucky?
Kentucky has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$54.27
1 of 1 localities have a supported rate.
Payment area: Kentucky
One mapped payment locality.
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.
Radiology
About 76080: Radiologic fistula tract study
Reports radiologic evaluation of an abscess, fistula, or sinus tract, such as imaging contrast through a draining tract to define its course.
This service covers the radiologist’s imaging evaluation of an abscess, fistula, or sinus tract, commonly after contrast is introduced into an opening or tract. X-ray imaging, often with fluoroscopy, can show the tract’s course, branches, or communication with another structure. A typical situation is evaluating a postoperative draining sinus or an enterocutaneous fistula. The study is commonly performed in a hospital radiology or interventional radiology department, with the radiologist interpreting the images and reporting the findings.
Report 76080 for the radiologic study and interpretation, not merely for injecting contrast or using fluoroscopy as procedural guidance. The record should identify the tract or collection studied, describe the imaging performed, and include the radiologist’s findings. CMS recognizes professional and technical components: modifier 26 reports the interpretation, modifier TC reports the equipment and staff, and no modifier represents the global service. The injection may have its own applicable procedure code, such as 20501, when performed and supported by the documentation.
CMS billing rules for 76080
- 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.
Where the value comes from
- Work RVU0.53 · 30%
- Practice expense (office) RVU1.18 · 67%
- Malpractice RVU0.05 · 3%
14.5K
Medicare services in 2024 · #1270 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.
76080 compared with similar codes
Office rates for Kentucky, from the same CMS release.
$154.83
49424 concerns radiologic evaluation through an existing percutaneous drainage catheter. 76080 describes imaging an abscess, fistula, or sinus tract.
$40.34
76000 describes general fluoroscopy. 76080 is the specific radiologic study and interpretation for an abscess, fistula, or sinus tract.
Compare 76080 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.
1 of 1 payment localities
Kentucky →
Office / nonfacility
$54.27
Facility
Unavailable
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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 76080 in Kentucky.
PPRRVU2026_Oct_nonQPP.csv
8,659
- Code
- 76080
- Physician work
- 0.53
- Practice expense
- 1.18
- Malpractice
- 0.05
GPCI2026.csv
55
- Locality
- Kentucky
- Physician work
- 1.000
- Practice expense
- 0.889
- Malpractice
- 0.915
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.53 | × 1.000 | 0.5300 |
| Practice expense | 1.18 | × 0.889 | 1.0490 |
| Malpractice | 0.05 | × 0.915 | 0.0458 |
| Total RVUs | 1.6248 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Kentucky$54.27
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.53 | 1 |
| Practice expense | 1.18 | 0.889 |
| Malpractice | 0.05 | 0.915 |
(0.53 × 1 + 1.18 × 0.889 + 0.05 × 0.915) × $33.4009 = $54.27
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.
76080 billing questions
When should 76080 be reported instead of 20501?
76080 represents the radiologic study and interpretation of an abscess, fistula, or sinus tract. 20501 represents diagnostic injection of a sinus tract; both may be reported when both services are performed and documented.
Can the professional and technical components be billed separately?
Yes. Use modifier 26 for the professional interpretation and modifier TC for the technical service. Without either modifier, the claim represents the global service.
Does contrast injection alone support 76080?
No. The record should support a radiologic evaluation and interpretation of the tract or collection, not just the injection.
How does 76080 differ from 49424?
76080 is for radiologic evaluation of an abscess, fistula, or sinus tract. 49424 describes radiologic evaluation through an existing percutaneous drainage catheter.
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.
8,65676019,,Mr safety implt pos&/immoblj,A,,0.59,3.93,,3.93,NA,0.07,4.59,4.59,1,XXX,0.00,0.00,0.00,4,0,0,0,0,9,,33.4009,09,0,88,0.00,0.00,0.00
8,65776019,26,Mr safety implt pos&/immoblj,A,,0.59,0.19,,0.19,,0.06,0.84,0.84,1,XXX,0.00,0.00,0.00,4,0,0,0,0,9,,33.4009,09,0,88,0.00,0.00,0.00
8,65876019,TC,Mr safety implt pos&/immoblj,A,,0.00,3.74,,3.74,NA,0.01,3.75,3.75,1,XXX,0.00,0.00,0.00,4,0,0,0,0,9,,33.4009,01,0,88,0.00,0.00,0.00
8,65976080,,X-ray exam of fistula,A,,0.53,1.18,,1.18,NA,0.05,1.76,1.76,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,16.70,16.70,0.20
8,66076080,26,X-ray exam of fistula,A,,0.53,0.15,,0.15,,0.04,0.72,0.72,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
8,66176080,TC,X-ray exam of fistula,A,,0.00,1.03,,1.03,NA,0.01,1.04,1.04,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,03,0,99,16.55,16.55,0.16
8,66276098,,X-ray exam surgical specimen,A,,0.30,0.96,,0.96,NA,0.03,1.29,1.29,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,16.64,16.64,0.22
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136
5707202,LA,99,REST OF LOUISIANA,1.000,0.885,0.958
5814112,ME,03,SOUTHERN MAINE,1.000,0.991,0.631