Summary & Overview
CPT 76983: Ultrasound Elastography of Additional Suspicious Lesion
CPT code 76983 captures ultrasound elastography performed on an additional suspicious lesion to assess tissue stiffness and aid differentiation between benign and malignant pathology. As an imaging adjunct, this targeted elastography technique matters nationally because it supports diagnostic decision-making, can reduce unnecessary biopsies, and may influence downstream imaging and treatment pathways. Payers evaluated in the analysis include Aetna, Blue Cross Blue Shield, Cigna Health, UnitedHealthcare, and Medicare.
Readers will find a concise explanation of the clinical intent and common settings for CPT code 76983, benchmark payment and utilization patterns across major payers, and policy considerations that affect coverage and coding practice. The publication summarizes typical service lines and sites of service, common claims modifiers used with imaging services, and where consensus or variation exists in payer handling of elastography procedures. This resource provides clinicians, billing professionals, and policy analysts a clear national overview of the code’s purpose, payer landscape, and practical context for incorporation into imaging workflows.
Billing Code Overview
CPT code 76983 describes an ultrasound elastography procedure performed on an additional suspicious lesion to assess tissue stiffness and help differentiate benign from malignant findings. The service involves applying high–intensity ultrasound waves to deform the lesion and measuring the lesion’s return to normal shape, providing information about lesion elasticity.
Service type: Diagnostic ultrasound elastography
Typical site of service: Imaging center, hospital outpatient department, or specialized radiology clinic
Clinical & Coding Specifications
Clinical Context
A 52-year-old woman presents to a breast imaging center after screening mammography identified a focal area of architectural distortion. Diagnostic targeted ultrasound demonstrates a 9 mm hypoechoic lesion with suspicious features. The radiologist recommends ultrasound elastography to evaluate tissue stiffness and help stratify the lesion as more likely benign or malignant prior to deciding on biopsy. The patient is consented and positioned for targeted breast ultrasound. The sonographer performs conventional B‑mode imaging to localize the lesion, then the provider performs ultrasound elastography by applying high‑intensity acoustic pulses and measuring the lesion’s return to shape. Findings are recorded in the radiology report and images are stored in the PACS. The provider documents indication, technique, lesion size and location, elastography measurements (strain ratio or shear wave velocity as applicable), and interpretation (e.g., increased stiffness suggesting higher suspicion). Billing is submitted using 76983 with an appropriate diagnosis code for the breast lesion or abnormal screening result and modifiers as indicated by payer rules and service circumstances.
Coding Specifications
| Modifier | Description | When to Use |
|---|---|---|
26 | Professional component | Use when billing only the physician interpretation component separate from technical component. |