Summary & Overview

CPT 76982: Ultrasound Elastography for Suspicious Lesion Evaluation

CPT code 76982 designates ultrasound elastography for evaluation of an initial suspicious lesion by measuring tissue deformation and recovery to assess stiffness—an adjunctive diagnostic tool that helps distinguish benign from malignant pathology. Nationally, adoption of elastography can influence imaging pathways, biopsy decisions, and utilization patterns as clinicians seek noninvasive methods to improve diagnostic accuracy.

Key payers discussed in this analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare. Readers will find an overview of clinical context for the procedure, typical sites of service, and the types of benchmarks and policy considerations commonly reported for emerging diagnostic imaging services. The publication covers reimbursement and coverage benchmark themes, common modifier and billing considerations provided in the input, and how payers typically position elastography in coverage policies.

This summary provides clinical framing and what to expect from the full content: coverage and payment benchmarks, relevant policy language trends, and operational notes for coding and claim submission. Data not available in the input are noted where applicable; the focus remains national in scope and intended for billing, coding, and revenue cycle stakeholders seeking a concise reference for CPT code 76982.

AetnaBlue Cross Blue ShieldCigna HealthUnitedHealthcareMedicare76982CPTultrasound-elastographydiagnostic-imaginglesion-evaluationimaging-billingradiology-coding

Billing Code Overview

CPT code 76982 describes ultrasound elastography of an initial suspicious lesion, a diagnostic ultrasound procedure that measures tissue stiffness by observing the lesion's return to shape after distortion by high–intensity ultrasound waves. The service assists in differentiating benign from malignant lesions based on mechanical properties rather than conventional grayscale imaging alone.

Service type: Diagnostic imaging — ultrasound elastography

Typical site of service: Outpatient imaging center or hospital outpatient department, and ambulatory clinics where ultrasound equipment and trained personnel are available.

Data not available in the input.

Clinical & Coding Specifications

Clinical Context

A 52-year-old woman presents to a breast imaging clinic after screening mammography identified a 1.2 cm irregular lesion in the upper outer quadrant of the right breast. The radiologist orders targeted ultrasound elastography to characterize tissue stiffness and help distinguish a benign fibroadenoma from a suspicious malignant mass. The patient is positioned supine with the ipsilateral arm raised; the sonographer performs gray-scale targeted ultrasound to localize the lesion, then performs shear-wave or strain elastography using high-frequency transducer technology while applying standardized minimal compression. Multiple measurements are obtained, documented, and correlated with prior mammography and clinical exam. Images and quantitative stiffness values are saved to the PACS, a radiology report is generated describing lesion morphology and elastography metrics, and the provider documents rationale for the procedure, findings, and any recommendation for biopsy or surveillance. Typical site of service is an outpatient radiology department, breast imaging center, or ambulatory surgical center when performed as a diagnostic adjunct. Typical modifiers that may apply include professional component, technical component, laterality, and modifiers indicating unrelated circumstances such as reduced services or assistant-at-surgery when relevant.

Coding Specifications

Modifier	Description	When to Use
`26`	Professional component	Use when billing only the physician interpretation/report for the elastography study.
`TC`	Technical component	Use when billing only the equipment, technologist, and facility resources for the study.
`RT`	Right side	Use to indicate the procedure was performed on the right-sided lesion.
`LT`	Left side	Use to indicate the procedure was performed on the left-sided lesion.
`59`	Distinct procedural service	Use when elastography is performed on a separate lesion or during a separate session distinct from another imaging procedure.
`52`	Reduced services	Use when the procedure is partially reduced or not completed as originally described.
`53`	Discontinued procedure	Use when the procedure is started but discontinued for patient safety or other documented reasons.
`76`*	Repeat procedure by same physician	Not in provided list — omitted.
`78`	Unplanned return to operating/procedure room by same physician following initial procedure	Use when an unplanned repeat elastography is required in the same encounter (rare).
`59`	Distinct procedural service	Duplicate entry avoided — see above.
`62`	Two surgeons	Use when two surgeons are simultaneously performing procedures and billing requires indicating co-surgery (rare for imaging).
`22`	Increased procedural services	Use when documentation justifies substantially greater effort or complexity for the elastography beyond typical service.
`52`	Reduced services	Duplicate entry avoided — see above.
`XU`	Unusual non-overlapping service	Use when demonstrating that the elastography is distinct and separate from another procedure when required by payer edits.

Taxonomy Code	Specialty	Notes
`208600000X`	Diagnostic Radiology	Radiologists commonly perform and interpret breast elastography.
`207Q00000X`	Radiology & Diagnostic Imaging	Imaging specialists who perform ultrasound elastography.
`207RC0000X`	Radiologist - Breast Imaging	Subspecialists in breast imaging who commonly request and interpret elastography.
`261QM0800X`	General Surgery	Breast surgeons may request elastography as part of pre-biopsy assessment.
`207V00000X`	Vascular Surgery (Ultrasound-trained)	Less common; includes clinicians skilled in ultrasound elastography techniques.

*Note: Only modifiers from the supplied list were considered; where closely related CMS modifiers were not in the provided list, standard clinical applicability is described.

Related Diagnoses

ICD-10 Code	Description	Clinical Relevance
Data not available in the input.	Data not available in the input.	Data not available in the input.

Related CPT Codes

CPT Code	Description	Relationship to This Procedure
`76641`	Ultrasound, breast, unilateral, real-time with image documentation, including axilla when performed; complete	Performed before or alongside elastography to localize and characterize the lesion on gray-scale imaging.
`76642`	Ultrasound, breast, unilateral, real-time with image documentation, limited	Used when a targeted limited ultrasound is performed to evaluate a specific palpable or imaging-detected lesion prior to elastography.
`76942`	Ultrasonic guidance for needle placement (e.g., for biopsy)	If elastography leads to decision for percutaneous biopsy, ultrasound guidance codes are used for needle placement during core biopsy.
`19101`	Biopsy of breast, percutaneous, needle core, using imaging guidance	Follows elastography when lesion appears suspicious and tissue diagnosis is required; often performed under ultrasound guidance.
`77046`	Ultrasound elastography, liver (transient elastography)	Different anatomic application of elastography—listed for conceptual relation to modality but not billed with breast elastography.
`76000`	Fluoroscopy (radiologic guidance)	Occasionally used in combined imaging-guided procedures; not typical for breast elastography but included as related imaging guidance resource.