How much does Medicare pay for CPT 76998?

Medicare allowed an average of $51.66 per service and paid $41.18 of that, the balance being the patient's coinsurance and deductible (2024 data). Providers submitted an average of $281.80, which is what they billed rather than what they received — Medicare pays its fee schedule regardless of the charge.

What is CPT code 76998?

Ultrasonic guidance during surgery. It was billed 15,527 times to 14,680 Medicare beneficiaries by 583 providers in 2024.

Does 76998 pay differently in an office than a hospital?

Yes. The allowed amount averaged $125.06 in an office setting and $46.16 in a facility. The office rate is generally higher because the practice supplies the room, staff and equipment out of that single payment; in a hospital those are billed separately by the facility.

Which specialty bills 76998 most?

General Surgery, with 6,477 services from 241 clinicians. Next are Surgical Oncology, Thoracic Surgery, Cardiac Surgery.

CPT 76998

Ultrasonic guidance during surgery

$51.66Medicare-allowed amount per service, averaged across 15,527 services

Providers submitted

$281.80

Asking price, not received

Medicare allowed

$51.66

The fee schedule figure

Medicare paid

$41.18

Balance is patient coinsurance

Providers submitted an average of $281.80 for this code and Medicare allowed $51.66 — 5.5× less. That gap is normal and means nothing on its own: Medicare pays its fee schedule regardless of what is billed, so the submitted figure describes a hospital chargemaster, not a price anyone paid. Of the allowed amount Medicare paid $41.18 (80%); the rest is the patient’s coinsurance and deductible.

Office pays differently to hospital

Office / non-facility: $125.06
Hospital / facility: $46.16

The office rate is higher because the practice supplies the room, staff and equipment out of that payment. In a hospital the facility bills those separately, so the clinician's share is smaller — the total cost to Medicare is usually higher, not lower. 1,083 services were billed in an office setting and 14,444 in a facility.

Services: 15,527
Beneficiaries: 14,680
Providers billing it: 583
Total allowed: $802,125

What Medicare pays for CPT 76998

Across 15,527 services billed by 583 providers to 14,680 beneficiaries, Medicare allowed an average of $51.66 per service. The allowed amount is the figure that matters: it is what Medicare and the patient together owe, set by the fee schedule and adjusted for local practice costs. What a provider chose to submit has no bearing on it.

Who bills 76998

Specialty	Services	Beneficiaries	Avg allowed	Providers
General Surgery	6,477	6,294	$48.72	241
Surgical Oncology	1,780	1,752	$45.14	76
Thoracic Surgery	1,282	1,192	$60.29	51
Cardiac Surgery	1,067	1,057	$45.93	38
Vascular Surgery	1,058	824	$57.16	21
Urology	1,019	994	$46.86	59
Neurosurgery	656	622	$45.79	31
Orthopedic Surgery	459	417	$68.32	16
Hand Surgery	382	336	$46.97	7
Otolaryngology	361	354	$47.13	10
Cardiology	198	157	$119.58	6
Sports Medicine	176	150	$44.90	5
Plastic and Reconstructive Surgery	112	96	$42.70	3
Podiatry	94	53	$174.58	1
Undefined Physician type	71	71	$44.37	2

76998 reimbursement by state

Two different numbers. Allowed is what Medicare actually allowed in that state, which includes the local practice-cost adjustment. Standardized strips that geographic adjustment out of the payment, so it is the column to use when comparing states — a difference there reflects how the code was billed, not what it costs to run a practice locally.

State	Services	Allowed	Standardized pmt	Providers
California	2,387	$50.80	$39.47	74
Texas	1,586	$66.81	$53.04	64
Florida	1,533	$57.56	$43.37	49
New York	955	$55.41	$39.39	36
Georgia	637	$45.68	$36.00	27
Massachusetts	605	$46.72	$35.91	23
Ohio	593	$44.31	$35.98	26
Illinois	498	$49.53	$36.00	15
Maryland	476	$93.91	$74.09	15
Indiana	451	$41.37	$36.00	13
Virginia	398	$45.09	$35.92	15
Tennessee	396	$43.00	$36.02	17
Arizona	394	$43.73	$36.02	16
Wisconsin	359	$42.75	$36.03	12
Oklahoma	353	$48.01	$40.45	8
Pennsylvania	323	$45.34	$36.31	16
South Carolina	296	$47.67	$39.59	10
North Carolina	264	$42.96	$35.91	12
Minnesota	218	$44.72	$35.90	12
Oregon	207	$44.93	$35.94	11
Missouri	202	$62.19	$49.38	9
Nevada	189	$44.40	$35.95	5
Nebraska	173	$40.44	$35.92	5
Arkansas	167	$41.18	$36.19	7
Michigan	166	$45.44	$35.99	7
Louisiana	162	$43.77	$36.02	7
New Hampshire	162	$45.32	$36.00	5
New Jersey	152	$47.97	$35.99	8
Washington	151	$45.37	$36.05	8
Iowa	149	$41.11	$35.94	7
Kentucky	137	$44.04	$35.93	6
Kansas	119	$42.99	$35.96	5
Colorado	89	$49.80	$40.37	5
Utah	80	$44.85	$35.92	4
Hawaii	67	$43.83	$36.02	2
Delaware	65	$44.96	$35.32	3
Alabama	59	$40.74	$36.05	4
District of Columbia	52	$48.98	$36.06	2
Connecticut	49	$46.92	$35.91	2
Vermont	49	$42.50	$35.91	2
Rhode Island	42	$44.57	$36.10	2
Alaska	23	$54.55	$36.27	1
West Virginia	19	$45.43	$35.92	1
Idaho	18	$42.53	$35.99	1
New Mexico	17	$43.83	$36.37	1
Mississippi	14	$42.23	$35.81	1
Montana	13	$27.04	$21.94	1
Maine	13	$42.38	$36.49	1

Related codes

76942Ultrasonic guidance for needle placement$45.45
76937Ultrasonic guidance for blood vessel access$17.11
76981Ultrasound scan of organ tissue for measuring elasticity$81.38
76982Ultrasound scan of growth for measuring elasticity$63.16
76965Ultrasonic guidance for administration of radiation therapy$69.84
76984Ultrasound of chest aorta during surgery$29.82
76983Ultrasound scan of growth for measuring elasticity$52.08

Billing this code is not the same as earning it

An allowed amount is revenue to a practice, not income to a clinician. It funds staff, premises, equipment and supplies before anyone is paid. What clinicians actually earn is published separately by the Department of Labor, and what industry pays them is published separately again by CMS — this site carries both.

What doctors are paid →·Look up a clinician →·All procedure codes →

Where this comes from. CMS Medicare Physician & Other Practitioners, by Provider and Service, 2024. It covers fee-for-service Original Medicare Part B only — not Medicare Advantage, not Medicaid, and not commercial insurance, which typically pays more for the same code.

How it is averaged. CMS publishes one average per provider per code. Every figure here is re-weighted by the number of services, so a clinician who billed the code 4,000 times counts 4,000 times more than one who billed it twice. CMS also suppresses any provider-code pair with fewer than 11 beneficiaries, so low-volume practice is missing from these totals by design.