Diagnostic ultrasound of the soft tissues of the head and neck, such as the thyroid, parathyroid, salivary glands, or a palpable neck mass.
- Medicare
- $108.55
- Work RVU
- 0.55
- Global, days
- Region
- Other
Documentation requirements
What must appear in the operative or office note to support the claim.
Source · Editorial brief grounded in 3 cited references ↓
- Reason for the study (incidental thyroid nodule, palpable neck mass)
- Structures examined
- Permanently recorded images
- Signed interpretation
- Separate documentation if a guided biopsy followed
Applicable modifiers
Modifiers commonly billed with this code.
Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual
What this code covers
Source · Editorial summary grounded in 3 cited references ↓
76536 is a soft tissue ultrasound of the head and neck. It is mainly a radiology, endocrinology, and ENT code. Spine surgeons and ortho practices see it in two situations: a thyroid nodule or neck mass noticed on a cervical spine MRI or CT that needs workup before an anterior cervical approach, and a soft tissue lump in the neck that the patient raises during a spine visit.
Code from the radiology report. The structures named in the report decide whether 76536 fits.
The practice ordering it does not bill it unless it performs the scan. Diagnostic ultrasound requires permanently recorded images and a written report. If ultrasound is only used to guide a fine needle aspiration, the guidance is built into the ultrasound-guided FNA codes (10005, 10006), and 76536 is not added unless a separate diagnostic study was done and documented.
RVU & reimbursement
Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.
Source · CMS Physician Fee Schedule, RVU26A · January 2026
Work RVU vs. total RVU
The work RVU (0.55) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (3.25) adds practice overhead and malpractice, and is what drives the Medicare payment below.
| Work RVU | 0.55 |
| Practice expense RVU | 2.66 |
| Malpractice RVU | 0.04 |
| Total RVU | 3.25 |
| Medicare national rate | $108.55 |
| Global period | days |
Payment by site of service
Medicare pays different rates by setting. HOPD typically pays substantially more than ASC for the same procedure.
Source · CMS OPPS Addendum B·ASC HCPCS payment rates·2026
| Setting | Medicare rate (national) |
|---|---|
Office (PFS non-facility) Procedure performed in physician's office | $108.55 |
HOPD (APC 5522) Hospital outpatient department | $106.81 |
Common denial reasons
The recurring reasons claims for CPT 76536 get rejected.
Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓
- Billed for ultrasound used only to guide a needle
- No retained images
- Spine diagnosis only, with no neck soft tissue finding
- Billed by the ordering practice without performing the scan
- Missing 26 modifier on a facility read
Frequently asked questions
Source · Generated from the editorial pipeline, verified against 3 cited references ↓
01Why would a spine surgeon order 76536?
02Does the spine practice bill 76536?
03Can I bill 76536 with a guided thyroid biopsy?
Sources & references
Editorial content was developed using the following public sources.
Mira Scribe
Mira Scribe notes capture incidental neck findings discussed during a spine visit, giving the follow-up ultrasound a documented reason.
See how Mira captures CPT 76536 documentation