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CPT 76977: Peripheral Bone Density Measurement by Ultrasound

CPT code 76977 identifies an ultrasound-based bone density measurement of one or more peripheral sites (for example, wrist or knee) and includes both measurement and interpretation. This procedure is a focused, non-central densitometry service that can support osteoporosis screening, fracture risk assessment, and monitoring of bone health where central dual-energy X-ray absorptiometry (DXA) is not used or accessible. Nationally, peripheral ultrasound testing is a relevant diagnostic option for outpatient settings and ambulatory imaging centers.

Key payers discussed include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of clinical context for peripheral bone density ultrasound, typical sites of service, and the kinds of benchmarks and reimbursement categories often associated with this service. The publication outlines payer coverage patterns, common billing modifiers, and how this service fits within diagnostic imaging and bone health workflows.

This analysis provides practical reference material: a technical description of the service, payer coverage landscape, coding considerations, and points of comparison to central DXA testing. Data not available in the input is noted where necessary; the focus remains on clarifying what CPT code 76977 represents and how it is positioned within national diagnostic imaging and bone health services.

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Billing Code Overview

CPT code 76977 describes a bone density measurement of one or more peripheral sites using ultrasound. The procedure includes both the measurement and interpretation of peripheral bone density, commonly performed on sites such as the wrist or knee.

Service type: Diagnostic imaging — peripheral bone density measurement (ultrasound)

Typical site of service: Outpatient clinic, physician office, or ambulatory imaging center (peripheral site such as wrist or knee)

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CPT 76977: Peripheral Bone Density Measurement by Ultrasound

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Get alerted when payer policies referencing 76977 are released or updated.

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Billing Code Overview

Service type: Diagnostic imaging — peripheral bone density measurement (ultrasound)

Typical site of service: Outpatient clinic, physician office, or ambulatory imaging center (peripheral site such as wrist or knee)

Clinical & Coding Specifications

Clinical Context

A typical patient is a postmenopausal woman or older adult referred for peripheral bone density screening after risk assessment or a fragility fracture. The patient arrives at an outpatient diagnostic imaging clinic or a primary care office equipped with a peripheral quantitative ultrasound device. The technologist explains the procedure, confirms laterality and the specific peripheral site (commonly calcaneus, distal radius/wrist, or tibia), and positions the limb in the ultrasound cradle. The device performs the measurement, capturing bone ultrasound parameters; the technologist ensures image quality and repeats measurement if artifact or positioning error occurs. The interpreting clinician (often a radiologist, endocrinologist, or primary care physician with bone health expertise) reviews the measurements, generates a brief report with device-specific T-score or broadband ultrasound attenuation values, and documents interpretation and clinical impression. Results are communicated to the ordering provider for osteoporosis risk stratification, treatment decisions, or need for central DXA referral. Typical site of service: outpatient diagnostic imaging center, ambulatory clinic, or physician office with point-of-care peripheral ultrasound bone densitometry equipment.

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	When reporting only the interpretation by the physician separate from the technical component
`TC`	Technical component	When reporting only the technical component (equipment and technologist) without physician interpretation
`52`	Reduced services	When the procedure is partially reduced or not completed as originally planned
`53`	Discontinued procedure	When the procedure is started but discontinued for patient safety or other valid reason
`56`	Preoperative management only	When only preoperative care is billed by the reporting provider (rare for this service)
`59`	Distinct procedural service	When another unrelated service is performed on the same day (Note: `59` is not in the provided list; therefore do not use — Data not available in the input.)
`76`	Repeat procedure by same provider	When the same ultrasound measurement is repeated by the same provider because of technical failure (Note: `76` not in provided list)
`50`	Bilateral procedure	When measurements are performed bilaterally during the same encounter
`52`	Reduced services	When the ultrasound measurement is partially performed (duplicate entry avoided)

Taxonomy Code	Specialty	Notes
`207Q00000X`	Radiology	Radiologists frequently interpret peripheral bone density ultrasound when performed in imaging settings
`208000000X`	Family Medicine	Primary care physicians may perform or order point-of-care peripheral bone densitometry for screening and follow-up
`207L00000X`	Endocrinology	Endocrinologists interpret results in the context of metabolic bone disease
`261QM0802X`	Nurse Practitioner	NPs in primary care or specialty clinics may perform or request the test
`363LP0800X`	Physician Assistant	PAs often perform or assist with point-of-care measurements in ambulatory settings

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`M80.00XA`	Age-related osteoporosis with current pathological fracture, unspecified site, initial encounter for fracture	Peripheral ultrasound may be used in assessment following fragility fractures as part of bone health evaluation
`M81.0`	Age-related osteoporosis without current pathological fracture	Common indication for screening with peripheral bone density measures to assess fracture risk
`M85.8`	Other specified disorders of bone density and structure	Used when bone density abnormality is suspected but does not meet classic osteoporosis coding
`Z13.820`	Encounter for osteoporosis screening	Administrative code used when the visit is specifically for screening evaluation
`Z79.51`	Long term (current) use of bisphosphide	Used in longitudinal care when bone density monitoring is performed during therapy

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`76977`	Ultrasound bone density measurement and interpretation of one or more peripheral sites (e.g., heel, wrist, knee)	This is the primary code describing peripheral ultrasound bone density measurement and interpretation
`77080`	Dual-energy X-ray absorptiometry (DXA), bone density study, one or more sites; axial skeleton (eg, hips, pelvis, spine)	Often performed when peripheral ultrasound results indicate abnormal bone density or when central DXA is needed for diagnostic confirmation
`77085`	Dual-energy X-ray absorptiometry (DXA), bone density study, peripheral site(s) (e.g., heel), single or bilateral	Alternative densitometry modality for peripheral sites; may be used instead of or in conjunction with ultrasound
`99401`	Preventive counseling, individual, approximately 15 minutes (Note: this is a CPT preventive counseling code)	Counseling on osteoporosis prevention or bone health frequently accompanies testing and management discussions
`99000`	Handling and/or conveyance of specimen for transfer from patient to laboratory (if applicable)	Not typically used for imaging but listed here for workflows that include specimen handling (Note: use only when applicable)

CPT 76975: Endoscopic Ultrasound Supervision and Interpretation

CPT-76978-CONTRAST-ENHANCED-MICROBUBBLE-ULTRASOUND-LESION-ASSESSMENT

CPT 76978: Microbubble Contrast-Enhanced Ultrasound for Lesion and Perfusion Assessment

CPT-76979-TARGETED-CONTRAST-ENHANCED-ULTRASOUND-MICROBUBBLE

CPT 76979: Targeted Microbubble Contrast–Enhanced Ultrasound

CPT-76981-ULTRASOUND-ELASTOGRAPHY-ORGAN-BASELINE-ASSESSMENT

CPT 76981: Ultrasound Elastography for Organ Baseline Assessment

CPT-76982-ULTRASOUND-ELASTOGRAPHY-SUSPICIOUS-LESION

CPT 76982: Ultrasound Elastography for Suspicious Lesion Evaluation

CPT-76983-ULTRASOUND-ELASTOGRAPHY-SUSPICIOUS-LESION

CPT 76983: Ultrasound Elastography of Additional Suspicious Lesion

CPT-76984-INTRAOPERATIVE-THORACIC-AORTA-ULTRASOUND

CPT 76984: Intraoperative Diagnostic Ultrasound of Thoracic Aorta

CPT-76987-INTRAOPERATIVE-CARDIAC-ULTRASOUND-CONGENITAL-HEART-DISEASE

CPT 76987: Intraoperative Cardiac Ultrasound for Congenital Heart Disease

CPT-76988-INTRAOPERATIVE-ULTRASOUND-CONGENITAL-HEART-EVALUATION

CPT 76988: Intraoperative Ultrasound for Congenital Heart Evaluation

CPT-76989-INTRAOPERATIVE-CARDIAC-ULTRASOUND-INTERPRETATION-REPORT

CPT 76989: Intraoperative Cardiac Ultrasound Interpretation for Congenital Heart Disease

Showing 1–10 of 12

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Jul 29, 2026.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.

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Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

Trek Health ingests and normalizes Transparency in Coverage data and payer policy updates to give provider organizations a clear view of how commercial reimbursement behaves across markets, payers, and services. Our platform transforms raw payer disclosures into structured intelligence that supports contract evaluation, payer negotiations, and service line strategy. By combining market benchmarks with ongoing policy visibility, Trek helps teams identify variability, risk, and opportunity in commercial reimbursement. The result is faster insight, stronger negotiating positions, and more informed financial decisions.

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	When reporting only the interpretation by the physician separate from the technical component
`TC`	Technical component	When reporting only the technical component (equipment and technologist) without physician interpretation
`52`	Reduced services	When the procedure is partially reduced or not completed as originally planned
`53`	Discontinued procedure	When the procedure is started but discontinued for patient safety or other valid reason
`56`	Preoperative management only	When only preoperative care is billed by the reporting provider (rare for this service)
`59`	Distinct procedural service	When another unrelated service is performed on the same day (Note: `59` is not in the provided list; therefore do not use — Data not available in the input.)
`76`	Repeat procedure by same provider	When the same ultrasound measurement is repeated by the same provider because of technical failure (Note: `76` not in provided list)
`50`	Bilateral procedure	When measurements are performed bilaterally during the same encounter
`52`	Reduced services	When the ultrasound measurement is partially performed (duplicate entry avoided)

Taxonomy Code	Specialty	Notes
`207Q00000X`	Radiology	Radiologists frequently interpret peripheral bone density ultrasound when performed in imaging settings
`208000000X`	Family Medicine	Primary care physicians may perform or order point-of-care peripheral bone densitometry for screening and follow-up
`207L00000X`	Endocrinology	Endocrinologists interpret results in the context of metabolic bone disease
`261QM0802X`	Nurse Practitioner	NPs in primary care or specialty clinics may perform or request the test
`363LP0800X`	Physician Assistant	PAs often perform or assist with point-of-care measurements in ambulatory settings

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`M80.00XA`	Age-related osteoporosis with current pathological fracture, unspecified site, initial encounter for fracture	Peripheral ultrasound may be used in assessment following fragility fractures as part of bone health evaluation
`M81.0`	Age-related osteoporosis without current pathological fracture	Common indication for screening with peripheral bone density measures to assess fracture risk
`M85.8`	Other specified disorders of bone density and structure	Used when bone density abnormality is suspected but does not meet classic osteoporosis coding
`Z13.820`	Encounter for osteoporosis screening	Administrative code used when the visit is specifically for screening evaluation
`Z79.51`	Long term (current) use of bisphosphide	Used in longitudinal care when bone density monitoring is performed during therapy

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`76977`	Ultrasound bone density measurement and interpretation of one or more peripheral sites (e.g., heel, wrist, knee)	This is the primary code describing peripheral ultrasound bone density measurement and interpretation
`77080`	Dual-energy X-ray absorptiometry (DXA), bone density study, one or more sites; axial skeleton (eg, hips, pelvis, spine)	Often performed when peripheral ultrasound results indicate abnormal bone density or when central DXA is needed for diagnostic confirmation
`77085`	Dual-energy X-ray absorptiometry (DXA), bone density study, peripheral site(s) (e.g., heel), single or bilateral	Alternative densitometry modality for peripheral sites; may be used instead of or in conjunction with ultrasound
`99401`	Preventive counseling, individual, approximately 15 minutes (Note: this is a CPT preventive counseling code)	Counseling on osteoporosis prevention or bone health frequently accompanies testing and management discussions
`99000`	Handling and/or conveyance of specimen for transfer from patient to laboratory (if applicable)	Not typically used for imaging but listed here for workflows that include specimen handling (Note: use only when applicable)

CPT 76975: Endoscopic Ultrasound Supervision and Interpretation

CPT-76978-CONTRAST-ENHANCED-MICROBUBBLE-ULTRASOUND-LESION-ASSESSMENT

CPT 76978: Microbubble Contrast-Enhanced Ultrasound for Lesion and Perfusion Assessment

CPT-76979-TARGETED-CONTRAST-ENHANCED-ULTRASOUND-MICROBUBBLE

CPT 76979: Targeted Microbubble Contrast–Enhanced Ultrasound

CPT-76981-ULTRASOUND-ELASTOGRAPHY-ORGAN-BASELINE-ASSESSMENT

CPT 76981: Ultrasound Elastography for Organ Baseline Assessment

CPT-76982-ULTRASOUND-ELASTOGRAPHY-SUSPICIOUS-LESION

CPT 76982: Ultrasound Elastography for Suspicious Lesion Evaluation

CPT-76983-ULTRASOUND-ELASTOGRAPHY-SUSPICIOUS-LESION

CPT 76983: Ultrasound Elastography of Additional Suspicious Lesion

CPT-76984-INTRAOPERATIVE-THORACIC-AORTA-ULTRASOUND

CPT 76984: Intraoperative Diagnostic Ultrasound of Thoracic Aorta

CPT-76987-INTRAOPERATIVE-CARDIAC-ULTRASOUND-CONGENITAL-HEART-DISEASE

CPT 76987: Intraoperative Cardiac Ultrasound for Congenital Heart Disease

CPT-76988-INTRAOPERATIVE-ULTRASOUND-CONGENITAL-HEART-EVALUATION

CPT 76988: Intraoperative Ultrasound for Congenital Heart Evaluation

CPT-76989-INTRAOPERATIVE-CARDIAC-ULTRASOUND-INTERPRETATION-REPORT

CPT 76989: Intraoperative Cardiac Ultrasound Interpretation for Congenital Heart Disease

Showing 1–10 of 12

Frequently Asked Questions

References

1.CPT® Codes and Descriptions. AAPC. Retrieved Jul 29, 2026.
2.HCPCS Quarterly Update. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.
3.ICD-10-CM Full Code List. Centers for Medicare & Medicaid Services (CMS). Retrieved Jul 29, 2026.

Published by

Trek Health powers OpenPayer with a leading commercial payer intelligence platform, seamlessly converting fragmented payer data into actionable insights for provider organizations.

OpenPayer

CPT 76977: Peripheral Bone Density Measurement by Ultrasound

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Billing Code Overview

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CPT 76977: Peripheral Bone Density Measurement by Ultrasound

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Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

References

CPT 76977: Peripheral Bone Density Measurement by Ultrasound

Sign up for cpt 76977 policy alerts

Billing Code Overview

CPT 76977: Peripheral Bone Density Measurement by Ultrasound

Sign up for cpt 76977 policy alerts

Billing Code Overview

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

What does CPT 76977 cover?

Which anatomical sites and clinical settings are typical for this procedure?

What billing modifiers apply to CPT 76977?

How does CPT 76977 relate to DXA codes and further testing?

Which ICD-10 diagnosis codes are commonly associated with billing CPT 76977?

References

Clinical & Coding Specifications

Clinical Context

Coding Specifications

Related Diagnoses

Related CPT Codes

Related Codes

What does CPT 76977 cover?

Which anatomical sites and clinical settings are typical for this procedure?

What billing modifiers apply to CPT 76977?

How does CPT 76977 relate to DXA codes and further testing?

Which ICD-10 diagnosis codes are commonly associated with billing CPT 76977?

References