$109.34
76872 describes general transrectal ultrasound imaging. Choose 76873 when the service specifically measures prostate volume and includes image documentation.
On this page
CMS RVU26D · Effective 2026-10-01
76873 Prostate ultrasound Medicare reimbursement rates in Kentucky
Reports transrectal ultrasound measurement of prostate volume with image documentation, often used to assess enlargement or support prostate treatment planning. Compare 76873 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 76873 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
$164.53
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.
Ultrasound
About 76873: Transrectal prostate volume study
Reports transrectal ultrasound measurement of prostate volume with image documentation, often used to assess enlargement or support prostate treatment planning.
This study uses a transrectal ultrasound probe to measure prostate volume and retain images documenting the examination. Urologists and radiologists commonly perform it in an office or imaging setting when prostate size is needed to evaluate enlargement or plan treatment, including prostate brachytherapy. It is a volume-measurement service rather than simply documenting that transrectal imaging was performed.
Select the code when the record supports a prostate volume study and includes the required image documentation. The report should identify the measurement and provide the corresponding images; documentation of a general prostate ultrasound alone does not establish this specific service. CMS recognizes professional and technical components: modifier 26 identifies the interpretation, modifier TC identifies equipment and staff, and billing without either modifier represents the global service.
CMS billing rules for 76873
- 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 RVU1.51 · 28%
- Practice expense (office) RVU3.76 · 70%
- Malpractice RVU0.08 · 1%
3.8K
Medicare services in 2024 · #2033 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.
76873 compared with similar codes
Office rates for Kentucky, from the same CMS release.
$96.06
76856 is a complete pelvic ultrasound, not a dedicated transrectal prostate volume study. The approach and documented examination determine which service is represented.
Compare 76873 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
$164.53
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 76873 in Kentucky.
PPRRVU2026_Oct_nonQPP.csv
8,838
- Code
- 76873
- Physician work
- 1.51
- Practice expense
- 3.76
- Malpractice
- 0.08
GPCI2026.csv
55
- Locality
- Kentucky
- Physician work
- 1.000
- Practice expense
- 0.889
- Malpractice
- 0.915
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.51 | × 1.000 | 1.5100 |
| Practice expense | 3.76 | × 0.889 | 3.3426 |
| Malpractice | 0.08 | × 0.915 | 0.0732 |
| Total RVUs | 4.9258 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Kentucky$164.53
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.51 | 1 |
| Practice expense | 3.76 | 0.889 |
| Malpractice | 0.08 | 0.915 |
(1.51 × 1 + 3.76 × 0.889 + 0.08 × 0.915) × $33.4009 = $164.53
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.
76873 billing questions
How is this different from 76872?
Use 76873 for a documented prostate volume study. Code 76872 describes transrectal ultrasound imaging more generally; the record should support the specific volume measurement when reporting 76873.
What documentation supports 76873?
Document that a prostate volume study was performed, include the volume measurement, and retain the required images. A note stating only that transrectal ultrasound was performed does not explain the volume-study service.
When should modifier 26 or TC be used?
Use modifier 26 for the professional interpretation and modifier TC for the technical service, including equipment and staff. Submit the code without a component modifier when billing the global service.
Can 76873 be reported with another prostate ultrasound code?
The documentation should distinguish a prostate volume study from general transrectal imaging. Do not treat 76873 as a substitute for 76872 when the record supports only the broader ultrasound examination.
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.
8,83576872,,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
8,83676872,26,Us transrectal,A,,0.65,0.28,,0.28,,0.02,0.95,0.95,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
8,83776872,TC,Us transrectal,A,,0.00,2.63,,2.63,NA,0.02,2.65,2.65,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,01,0,99,3.17,3.17,0.02
8,83876873,,Echograp trans r pros study,A,,1.51,3.76,,3.76,NA,0.08,5.35,5.35,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,3.89,3.89,0.08
8,83976873,26,Echograp trans r pros study,A,,1.51,0.71,,0.71,,0.06,2.28,2.28,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
8,84076873,TC,Echograp trans r pros study,A,,0.00,3.05,,3.05,NA,0.02,3.07,3.07,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,02,0,99,3.18,3.18,0.02
8,84176881,,Us compl joint r-t w/img,A,,0.88,0.68,,0.68,NA,0.05,1.61,1.61,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,3.46,3.46,0.14
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