`76536` Us exam of head and neck

What 76536 is

CMS fee schedule short descriptor: Us exam of head and neck.

Full CPT long descriptions are licensed by the American Medical Association and are not published on this site; the short descriptor above is the one CMS prints in its own fee schedule file. See About CPT.

Medicare payment for 76536 (CY2026)

	Work RVU	Practice expense RVU	Malpractice RVU	Total	Medicare rate
Non-facility (office)	0.55	2.66	0.04	3.25	$108.55
Facility (hospital, ASC)	0.55	2.66	0.04	3.25	$108.55

National rates: total RVUs x the CY2026 conversion factor of 33.4009 (non-QP), before geographic adjustment. Actual Medicare payment is 80% of the rate shown after the deductible; the patient or secondary payer owes the 20% coinsurance.

Adjust for a Medicare locality:

Status: Active - payable under the Physician Fee Schedule. Global period: Global concept does not apply.

Medically Unlikely Edit (MUE)

Medicare caps 76536 at 1 unit per date of service for practitioner claims (MAI 3 - date of service edit (clinical): units above the MUE may pay with documentation on appeal), rationale: Anatomic Consideration. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.

Billed with 76536? These codes are bundled into it

76536 is a Column 1 code in 11 active NCCI PTP edits. When one of these Column 2 codes is reported on the same date of service, it is denied as bundled - unless the edit's modifier indicator is 1 and documentation supports a distinct service with an NCCI-associated modifier.

Column 2 code	Short description	Modifier indicator
`0689T`	Quan us tis charac w/o dx us	1 - modifier may bypass	Check pair
`36591`	Draw blood off venous device	0 - no modifier bypass	Check pair
`36592`	Collect blood from picc	0 - no modifier bypass	Check pair
`76942`	Echo guide for biopsy	1 - modifier may bypass	Check pair
`76981`	Use parenchyma	1 - modifier may bypass	Check pair
`76982`	Use 1st target lesion	1 - modifier may bypass	Check pair
`76983`	Use ea addl target lesion	1 - modifier may bypass	Check pair
`76998`	Us guide intraop	1 - modifier may bypass	Check pair
`93880`	Extracranial bilat study	1 - modifier may bypass	Check pair
`93895`	Carotid intima atheroma eval	1 - modifier may bypass	Check pair
`96523`	Irrig drug delivery device	0 - no modifier bypass	Check pair

76536 is bundled into these codes

76536 appears as a Column 2 code in 2 active edits. Reported with one of these Column 1 codes on the same date of service, 76536 is the code that denies.

Column 1 code	Short description	Modifier indicator
`76978`	Us trgt dyn mbubb 1st les	1	Check pair
`76979`	Us trgt dyn mbubb ea addl	1	Check pair

Data: CMS CY2026 Physician Fee Schedule RVU file (October release, RVU26D) and Medicare NCCI PTP practitioner edits v32.3 (2026 Q4). Verify against the official files before billing or contracting decisions.