Summary & Overview
CPT 76800: Intraoperative and Diagnostic Spinal Ultrasound
CPT code 76800 represents intraoperative and diagnostic ultrasound imaging of the spinal canal. The code covers ultrasound studies that visualize the spinal cord, vertebrae, intervertebral discs and canal contents, used both intraoperatively for guidance and localization of lesions or foreign bodies and diagnostically for evaluation of newborns and infants. Nationally, this procedure supports surgical navigation, reduces risk of retained fragments, and informs early neonatal care.
Key payers included in the analysis are Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise explanation of the clinical indications, typical sites of service, and payer coverage landscape. The publication also presents benchmarks and utilization context, coding and billing considerations, and policy or coverage updates relevant to hospitals, surgical centers, and pediatric imaging programs.
This summary is intended to provide clinicians, coding specialists, and policy analysts a clear, national-level view of the clinical role and payer context for CPT code 76800, along with topics to explore in greater detail such as utilization patterns, documentation expectations, and applicable coverage policies.
Billing Code Overview
CPT code 76800 describes an intraoperative and diagnostic ultrasound examination of the spinal canal. The provider uses sound waves to capture images of the entire spinal canal, including the spinal cord, vertebrae, and intervertebral discs. The service is performed intraoperatively to identify and locate spinal tumors, small bony fragments, herniated disc material, or bullet fragments within the canal, or to guide surgical instruments to their target during the procedure. The exam also evaluates newborns and infants for various spinal disorders.
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Service type: Diagnostic and intraoperative ultrasound imaging of the spine
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Typical site of service: Operative suite for intraoperative guidance; neonatal or pediatric imaging suite for evaluation of newborns and infants
Clinical & Coding Specifications
Clinical Context
A neonate is born with an enlarged head circumference and > Grade 2 intraventricular hemorrhage on prenatal imaging; the neonatal team proceeds to bedside ultrasound of the spine to evaluate for tethered cord or intradural lesions. Alternatively, an adult patient is undergoing lumbar microdiscectomy for a large herniated nucleus pulposus. Intraoperatively, the surgeon requests real-time spinal ultrasound to locate herniated disc fragments and confirm decompression through visualization of the spinal canal and nerve roots. The procedure is performed by an operative team in the operating room or by a neonatology team in the neonatal intensive care unit (NICU). The workflow includes patient positioning, sterile preparation of the operative field (or neonatal spine), intraoperative ultrasound scanning by the surgeon or an ultrasound-trained provider, image interpretation to guide instrument placement or confirm removal of material, and documentation of findings and images in the medical record. The service may be billed with only the technical component when performed by ultrasound technologists with image routing, or with the professional component when the interpreting surgeon documents real-time findings.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | When the reporting provider performs and interprets the ultrasound and bills for the physician component |