CPT 76981 Ultrasound Elastography Reimbursement | OpenPayer

Summary & Overview

CPT 76981: Ultrasound Elastography for Organ Baseline Assessment

CPT code 76981 represents ultrasound elastography performed to assess an organ’s functional tissue by measuring its return to shape after distortion with high‑intensity ultrasound. As a diagnostic imaging modality, elastography provides noninvasive quantification of tissue stiffness that can support evaluation of conditions such as chronic liver disease and other organ‑specific disorders. Nationally, the code is important as imaging technology and clinical guidelines evolve, affecting utilization, coding guidance, and payer coverage policies.

Key payers in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find a concise overview of reimbursement and coverage considerations across major national payers, clinical context for when ultrasound elastography is typically used, and benchmarking content where available. The publication explains typical service settings and the clinical rationale for baseline elastography measurements, and it highlights common billing modifiers and coding considerations that appear with this procedure. Data not available in the input is noted where applicable.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare76981CPTultrasound elastographydiagnostic imagingradiologyliver elastographyimaging baselinenoninvasive assessmentmedical billing

Billing Code Overview

CPT code 76981 describes ultrasound elastography of an organ, a diagnostic ultrasound procedure that measures tissue elasticity by assessing how the organ returns to its normal shape after being distorted by high‑intensity ultrasound waves. The procedure is used to establish a baseline assessment of an organ’s functional (nonconnective, nonstructural) tissue characteristics.

Service type: Diagnostic ultrasound elastography
Typical site of service: Imaging suite or radiology department (commonly performed in outpatient imaging centers, hospital radiology departments, or specialized liver clinics)

Clinical & Coding Specifications

Clinical Context

A 56-year-old patient with chronic hepatitis C is referred to hepatology for noninvasive assessment of liver fibrosis. The clinician orders ultrasound elastography to quantify liver stiffness as a baseline and to monitor progression of hepatic fibrosis. On arrival, the patient is registered, consent is confirmed, and relevant history (alcohol use, prior imaging, labs including liver function tests and platelet count) is reviewed. The procedure is performed in an outpatient radiology or gastroenterology clinic equipped with ultrasound elastography-capable equipment. The provider places the patient supine with the right arm overhead, identifies the right hepatic lobe using grayscale ultrasound, and performs multiple elastography measurements avoiding large vessels and bile ducts. Results documenting median liver stiffness in kilopascals and quality metrics are entered into the radiology report. Images and stiffness measurements are saved to the PACS and communicated to the referring hepatologist for care planning and follow-up surveillance.

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	Use when billing only the physician’s interpretation and report separate from the technical component.
`TC`

CPT 76984: Intraoperative Diagnostic Ultrasound of Thoracic Aorta

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-76998-INTRAOPERATIVE-ULTRASOUND-GUIDANCE

CPT 76998: Intraoperative Ultrasound Guidance to Examine Organs/Tissues

CPT-76977-PERIPHERAL-BONE-DENSITY-ULTRASOUND

CPT 76977: Peripheral Bone Density Measurement by Ultrasound

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

CPT 76979: Targeted Microbubble Contrast–Enhanced Ultrasound

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

CPT 76989: Intraoperative Cardiac Ultrasound Interpretation for Congenital Heart Disease

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

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

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

CPT 76988: Intraoperative Ultrasound for Congenital Heart Evaluation

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

CPT 76987: Intraoperative Cardiac Ultrasound for Congenital Heart Disease

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Taxonomy Code	Specialty	Notes
207RC0000X	Radiology	Imaging specialists performing ultrasound elastography and interpretation.
2080P0206X	Gastroenterology	Hepatology-focused gastroenterologists ordering and sometimes performing liver elastography.
207L00000X	Diagnostic Radiology	Physicians providing diagnostic ultrasound services in outpatient and inpatient settings.
207RH0000X	Interventional Radiology	When elastography is performed in conjunction with interventional liver procedures or consultations.
207V00000X	Vascular & Interventional Radiology	Applicable when combined vascular assessment accompanies elastography.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
`K74.60`	Unspecified cirrhosis of liver	Elastography assesses liver stiffness to evaluate degree of fibrosis/cirrhosis.
`K76.0`	Fatty (change of) liver, not elsewhere classified	Nonalcoholic fatty liver disease assessed for fibrosis severity with elastography.
`B18.2`	Chronic viral hepatitis C without hepatic coma	Used to monitor fibrosis progression in chronic hepatitis C with elastography.
`Z87.01`	Personal history of malignant neoplasm of digestive organs	Surveillance of liver parenchymal changes after treatment may include elastography.
`R16.0`	Hepatomegaly	Elastography used adjunctively when hepatomegaly prompts evaluation of underlying fibrosis.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`76700`	Ultrasound, abdominal, real time with image documentation; limited (e.g., single organ, quadrant, follow-up)	May be performed before elastography to localize liver anatomy or to document limited grayscale evaluation.
`76705`	Ultrasound, abdominal, real time with image documentation; complete	Often performed in conjunction with elastography if a comprehensive anatomic survey is needed.
`76942`	Ultrasonic guidance for needle placement (e.g., biopsy, aspiration), imaging supervision and interpretation	May be used when elastography leads to targeted biopsy; guidance code documents real-time needle placement.
`76937`	Ultrasound guidance for vascular access requiring ultrasound evaluation and localization	Used when vascular access or Doppler evaluation is required in the same encounter.
`93010`	Electrocardiogram, interpretation and report only (example ancillary monitoring)	Occasionally billed when procedural monitoring documentation is required; not routinely paired but may appear on complex cases.

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