$167.79
Choose 76873 for a dedicated prostate volume study. Use 76872 for diagnostic transrectal imaging that is not specifically a volume study.
On this page
CMS RVU26D · Effective 2026-10-01
76872 Transrectal ultrasound Medicare reimbursement rates in Ohio
Transrectal ultrasound images the prostate and nearby structures to evaluate abnormalities or support clinical assessment of prostate disease. Compare 76872 office and facility rates across CMS payment localities in Ohio.
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 76872 in Ohio?
Ohio 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
$111.80
1 of 1 localities have a supported rate.
Payment area: Ohio
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.
Diagnostic ultrasound
About 76872: Transrectal prostate ultrasound
Transrectal ultrasound images the prostate and nearby structures to evaluate abnormalities or support clinical assessment of prostate disease.
A transrectal ultrasound uses an ultrasound probe placed in the rectum to image the prostate and nearby structures, including the seminal vesicles. Urologists and radiologists commonly perform it to assess prostate size, contour, or focal abnormalities in patients with findings such as an abnormal digital rectal examination or elevated prostate-specific antigen. It may also be performed during a session that includes prostate needle biopsy.
Report 76872 for the diagnostic transrectal examination, supported by documentation of the structures examined, imaging findings, and a written interpretation. A dedicated prostate volume study is distinguished by code 76873. CMS recognizes professional and technical components: report modifier 26 for the interpretation, modifier TC for the equipment and staff, or neither modifier when billing the global service. The record should identify which component the billing entity performed.
CMS billing rules for 76872
- 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 RVU0.65 · 18%
- Practice expense (office) RVU2.91 · 81%
- Malpractice RVU0.04 · 1%
234.2K
Medicare services in 2024 · #354 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.
76872 compared with similar codes
Office rates for Ohio, from the same CMS release.
$91.92
76870 images the scrotum and its contents. 76872 images the prostate through a transrectal approach.
$98.16
76856 describes a complete pelvic ultrasound, generally using an external approach. 76872 is specifically transrectal imaging of the prostate and nearby structures.
Compare 76872 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
Ohio →
Office / nonfacility
$111.80
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.
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 76872 in Ohio.
PPRRVU2026_Oct_nonQPP.csv
8,835
- Code
- 76872
- Physician work
- 0.65
- Practice expense
- 2.91
- Malpractice
- 0.04
GPCI2026.csv
85
- Locality
- Ohio
- Physician work
- 1.000
- Practice expense
- 0.913
- Malpractice
- 1.008
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.65 | × 1.000 | 0.6500 |
| Practice expense | 2.91 | × 0.913 | 2.6568 |
| Malpractice | 0.04 | × 1.008 | 0.0403 |
| Total RVUs | 3.3472 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Ohio$111.80
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.65 | 1 |
| Practice expense | 2.91 | 0.913 |
| Malpractice | 0.04 | 1.008 |
(0.65 × 1 + 2.91 × 0.913 + 0.04 × 1.008) × $33.4009 = $111.80
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.
76872 billing questions
How does 76872 differ from 76873?
76872 represents diagnostic transrectal ultrasound imaging. Use 76873 for a dedicated transrectal prostate volume study.
Can 76872 be reported with a prostate biopsy?
It may be reported for diagnostic prostate imaging performed during a session that also includes a separately documented needle biopsy. The imaging record should support the ultrasound service rather than only the biopsy.
Which modifier identifies the ultrasound interpretation?
Append modifier 26 when billing the professional component, meaning the interpretation. Modifier TC identifies the technical component, including equipment and staff; billing without either modifier represents the global service.
What documentation supports 76872?
Document the transrectal examination, the anatomy imaged, the findings, and the interpretation. If a biopsy is performed in the same session, document that procedure separately.
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.
8,83276870,,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
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
8213282,NY,99,REST OF NEW YORK,1.000,0.950,0.703
8311502,NC,00,NORTH CAROLINA,1.000,0.933,0.639
8403302,ND,01,NORTH DAKOTA**,1.000,1.000,0.406
8515202,OH,00,OHIO,1.000,0.913,1.008
8604312,OK,00,OKLAHOMA,1.000,0.893,0.777
8702302,OR,01,PORTLAND,1.016,1.111,0.744
8802302,OR,99,REST OF OREGON,1.000,0.996,0.703