Billing code 76391: MRI elastographyMedicare rate & RVUs in Washington
Reports MRI-based measurement of tissue stiffness, most often to assess liver fibrosis in patients with chronic liver disease.
Medicare pays $205.65–$234.79 for 76391 in the office in Washington, from Rest Of Washington to Seattle (King Cnty). 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 76391 covers
Magnetic resonance elastography uses MRI and externally generated vibrations to map how mechanical waves move through tissue and estimate its stiffness. It is most often performed to assess liver fibrosis in people with conditions such as chronic hepatitis or fatty liver disease, and can provide information that may help clinicians stage disease without a liver biopsy. The acquisition takes place in an MRI suite, with imaging staff performing the technical work and a radiologist interpreting the study.
Report the service for the elastography examination, supported by documentation of the clinical indication, body site, acquisition, and interpreted findings. When an abdominal MRI is also performed, the conventional MRI service may be separately reported when supported by the record and applicable coding guidance. Bill the global service without a component modifier, modifier 26 for the interpretation alone, or modifier TC for the technical service alone. CMS applies the diagnostic imaging multiple procedure reduction to both the professional and technical components when applicable.
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.
Where 76391 pays more and less in Washington
| Payment locality | Office | Facility |
|---|---|---|
| Rest Of Washington | $205.65 | Unavailable |
| Seattle (King Cnty) | $234.79 | Unavailable |
How the 76391 rate is calculated
Each of 76391’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 · 76391
RVUs × geographic indexes × conversion factor
Work1.07
1.07 RVUs× 1.000 GPCI
Practice expense4.76
4.76 RVUs× 1.000 GPCI
Malpractice0.08
0.08 RVUs× 1.000 GPCI
Adjusted RVUs
5.9100
Conversion factor
$33.4009
Medicare rate
$197.40
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 76391
The CMS indicators that decide how 76391 is paid alongside other services.
CMS payment indicators · 76391
MRI elastography
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| Multiple procedures | 4 | Diagnostic imaging reduction applies to the technical component (and professional component) of additional services. |
| 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
76391 without 26 · national office
$197.40
MRI elastography
76391-26 · Professional component
$50.10
Pays only the interpretation and report.
76391 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 76390Mr spectroscopy
- 76391 assesses tissue stiffness using MRI. Code 76390 is used for MR spectroscopy, which analyzes tissue chemistry.
- 74181Abdominal MRI
- 74181 reports abdominal MRI without contrast for anatomic imaging. Code 76391 reports the elastography service that assesses tissue stiffness; both may be performed in one examination.
- 91200Liver elastography
- 91200 reports liver transient elastography using a non-MRI technique. Choose 76391 when stiffness is assessed with MRI elastography.
- 76981Ultrasound elastography
- 76981 reports ultrasound elastography of parenchymal tissue. Code 76391 is the MRI-based method.
76391 billing questions
How does this differ from MR spectroscopy?
Code 76391 reports MRI-based assessment of tissue stiffness. MR spectroscopy, reported with 76390, analyzes tissue chemistry rather than mechanical properties.
Can an abdominal MRI be reported on the same date?
Yes, when a conventional abdominal MRI is also performed and separately supported. The elastography service measures tissue stiffness; the MRI provides anatomic imaging.
Which modifier should be used for a radiologist's interpretation?
Use modifier 26 for the professional interpretation alone. Use modifier TC for the technical service alone, or report the global service without either modifier.
Does the multiple procedure reduction affect both components?
Yes. CMS applies the diagnostic imaging multiple procedure reduction to the professional and technical components when applicable.
How does MRI elastography differ from transient elastography?
Code 76391 uses MRI to map tissue stiffness. Code 91200 reports liver transient elastography using a different, non-MRI method.
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
Show the CMS file lines behind this rate
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