Ultrasound guidance for placing a needle, used to direct biopsies, aspirations, and injections, including the imaging supervision and interpretation.
- Medicare
- $64.13
- Work RVU
- 0.65
- Global, days
- Region
- General
Documentation requirements
What must appear in the operative or office note to support the claim.
Source · Editorial brief grounded in 3 cited references ↓
- Procedure being guided and its target
- Recorded image showing the needle at the target
- Description of the guidance in the procedure note
- Laterality and site
- Reason imaging guidance was needed
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 ↓
Ultrasound guidance for needle placement is billed in addition to the procedure it guides with 76942, when that procedure code does not already include guidance. In orthopedics, that means things like an ultrasound-guided soft tissue biopsy, aspiration of a ganglion cyst, or a tendon sheath injection, depending on the payer's edits for that pair.
The most common mistake is billing 76942 with joint injections. CPT built ultrasound guidance into 20604, 20606, and 20611, and it instructs against reporting 76942 with 20600, 20605, or 20610. If the injection was guided, use the guided joint code. Do not use the unguided code plus 76942.
Medicare expects a permanently recorded image showing the needle at the target and a note describing the guidance. Before billing 76942 with any non-joint procedure, check the current NCCI table for that code pair, since some procedure codes already include imaging guidance. Report it once per procedure session unless separate procedures at separate sites were each guided.
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 (0.65) is the surgeon's own effort — the figure physician pay and productivity targets are built on. The total RVU (1.92) adds practice overhead and malpractice, and is what drives the Medicare payment below.
| Work RVU | 0.65 |
| Practice expense RVU | 1.23 |
| Malpractice RVU | 0.04 |
| Total RVU | 1.92 |
| Medicare national rate | $64.13 |
| 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 | $64.13 |
Common denial reasons
The recurring reasons claims for CPT 76942 get rejected.
Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓
- Billed with 20600, 20605, or 20610 instead of the guided joint codes
- Billed with 20604, 20606, or 20611, which already include guidance
- No recorded image of needle placement
- Billed with a procedure code that includes imaging guidance
- Multiple units without separate guided procedures
Frequently asked questions
Source · Generated from the editorial pipeline, verified against 3 cited references ↓
01Can I bill 76942 with 20610?
02Does 76942 require a saved image?
03Can I bill 76942 with a ganglion cyst aspiration?
Sources & references
Editorial content was developed using the following public sources.
Mira Scribe
Mira Scribe notes capture the target, the approach, and the physician's statement of guided needle placement, so the guidance is documented alongside the procedure.
See how Mira captures CPT 76942 documentation