76965 Echo guidance radiotherapy
What 76965 is
CMS fee schedule short descriptor: Echo guidance radiotherapy.
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 76965 (CY2026)
| Work RVU | Practice expense RVU | Malpractice RVU | Total | Medicare rate | |
|---|---|---|---|---|---|
| Non-facility (office) | 1.31 | 1.52 | 0.06 | 2.89 | $96.53 |
| Facility (hospital, ASC) | 1.31 | 1.52 | 0.06 | 2.89 | $96.53 |
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.
Status: Active - payable under the Physician Fee Schedule. Global period: Global concept does not apply.
Medically Unlikely Edit (MUE)
Medicare caps 76965 at 2 units 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: Clinical: Data. Units above the cap are denied unless the edit's adjudication rules allow an appeal with documentation.
Billed with 76965? These codes are bundled into it
76965 is a Column 1 code in 25 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 | |
|---|---|---|---|
00860 | Anes xtrprtl px lwr abd nos | 0 - no modifier bypass | Check pair |
0600T | Ablt ire 1+ o/t lv/prst8 prq | 1 - modifier may bypass | Check pair |
0601T | Abltj ire 1+tumors open | 1 - modifier may bypass | Check pair |
0689T | Quan us tis charac w/o dx us | 1 - modifier may bypass | Check pair |
0690T | Quan us tis charac w/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 |
55873 | Cryoablate prostate | 1 - modifier may bypass | Check pair |
55880 | Abltj mal prst8 tiss hifu | 1 - modifier may bypass | Check pair |
76000 | Fluoroscopy <1 hr phys/qhp | 1 - modifier may bypass | Check pair |
76872 | Us transrectal | 1 - modifier may bypass | Check pair |
76873 | Echograp trans r pros study | 1 - modifier may bypass | Check pair |
76942 | Echo guide for biopsy | 1 - modifier may bypass | Check pair |
76998 | Us guide intraop | 1 - modifier may bypass | Check pair |
77001 | Fluoroguide for vein device | 1 - modifier may bypass | Check pair |
77002 | Needle localization by xray | 1 - modifier may bypass | Check pair |
77012 | Ct scan for needle biopsy | 1 - modifier may bypass | Check pair |
77021 | Mri guidance ndl plmt rs&i | 1 - modifier may bypass | Check pair |
96523 | Irrig drug delivery device | 0 - no modifier bypass | Check pair |
99446 | Ntrprof ph1/ntrnet/ehr 5-10 | 1 - modifier may bypass | Check pair |
99447 | Ntrprof ph1/ntrnet/ehr 11-20 | 1 - modifier may bypass | Check pair |
99448 | Ntrprof ph1/ntrnet/ehr 21-30 | 1 - modifier may bypass | Check pair |
99449 | Ntrprof ph1/ntrnet/ehr 31/> | 1 - modifier may bypass | Check pair |
99451 | Ntrprof ph1/ntrnet/ehr 5/> | 1 - modifier may bypass | Check pair |
99452 | Ntrprof ph1/ntrnet/ehr rfrl | 1 - modifier may bypass | Check pair |
76965 is bundled into these codes
76965 appears as a Column 2 code in 3 active edits. Reported with one of these Column 1 codes on the same date of service, 76965 is the code that denies.
| Column 1 code | Short description | Modifier indicator | |
|---|---|---|---|
19296 | Place po breast cath for rad | 1 | Check pair |
19297 | Place breast cath for rad | 1 | Check pair |
19298 | Place breast rad tube/caths | 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.