Imaging · General

Fluoroscopic imaging lasting under one hour, performed and supervised by a physician or other qualified health professional during a diagnostic or therapeutic procedure.

Verified May 8, 2026 · 9 sources ↓

Medicare: $44.09
Total RVUs: 1.32
Global, days
Region: General

Drawn from CMSAAPCOrthoprovidersPabau

Documentation requirements

What must appear in the operative or office note to support the claim.

Source · Editorial brief grounded in 9 cited references ↓

Indication for fluoroscopy — why real-time imaging was medically necessary for this specific encounter
Duration of fluoroscopy in minutes (must be under one hour for 76000)
Radiation dose or dose area product recorded in the procedure record
Separate written interpretation report if billing modifier 26 — a phrase in the operative note is insufficient
Clear identification of the anatomic site imaged and its distinction from any bundled primary procedure if modifier 59 or XS is appended
Supervising physician identity and presence documented when technical and professional components are split billed

Applicable modifiers

Modifiers commonly billed with this code.

Source · AMA CPT modifier descriptors · CMS NCCI Policy Manual

26 Professional component 59 Distinct service XS Separate structure

What this code covers

Source · Editorial summary grounded in 9 cited references ↓

76000 covers real-time fluoroscopic imaging under one hour when a physician or qualified health professional supervises and interprets the guidance. It carries the 'separate procedure' designation in CPT, meaning it is payable only when it is not integral to the primary procedure being performed.

NCCI bundling is the central billing challenge. CMS is explicit: 76000 is not separately reportable with arthroscopic procedures, spinal procedures, laparoscopic procedures, most injection procedures, fluoroscopic guidance codes (e.g., 77002, 77003), or any procedure whose descriptor already includes imaging guidance. When a procedure code's descriptor or CPT instruction states radiologic guidance is included, billing 76000 on top of it is incorrect regardless of modifier use. Modifier 59 or XS can override a bundling edit only if the fluoroscopy served a distinct, anatomically separate procedure performed at the same encounter — not the same procedure from a different angle or at a contiguous site.

Component billing applies: modifier 26 covers the professional component (supervision and interpretation) and TC covers the technical component. If you bill modifier 26, the documentation must include a formal, separate written interpretation report — a one-liner in the operative note stating 'fluoroscopy was used' does not satisfy that requirement. Duration of fluoroscopy, clinical indication, and radiation dose must be documented regardless of whether full or split billing is used.

RVU & reimbursement

Component RVUs and Medicare national rate. Actual payment varies by GPCI locality.

Source · CMS Physician Fee Schedule, RVU26A · January 2026

Work RVU	0.3
Practice expense RVU	0.98
Malpractice RVU	0.04
Total RVU	1.32
Medicare national rate	$44.09
Global period	days

Payment by site of service

Medicare pays different rates by setting. HOPD typically pays substantially more than ASC for the same procedure.

Source · CMS OPPS Addendum B·ASC HCPCS payment rates·2026

Setting	Medicare rate (national)
Office (PFS non-facility) Procedure performed in physician's office	$44.09
HOPD (APC 5523) Hospital outpatient department	$243.77

Common denial reasons

The recurring reasons claims for CPT 76000 get rejected.

Source · Editorial brief grounded in CMS NCCI edits, AAOS coding appeals, and cited references ↓

NCCI bundle: 76000 is integral to the primary procedure (arthroscopy, spinal procedure, laparoscopy, injection) — no modifier override available
Modifier 26 billed without a separate formal written interpretation report in the record
Modifier 59 applied to override a bundle where the fluoroscopy served the same procedure rather than a distinct anatomic service
Primary procedure descriptor already includes imaging guidance, making 76000 redundant and non-payable
Fluoroscopy duration exceeded one hour, requiring 76001 — though note 76001 was deleted January 1, 2019, leaving no valid code for that scenario under the 76000 series

Frequently asked questions

Source · Generated from the editorial pipeline, verified against 9 cited references ↓

01Can I bill 76000 with a knee arthroscopy if fluoroscopy was used?

No. CMS NCCI policy states fluoroscopy is an integral component of all arthroscopic procedures. 76000 is not separately reportable with any arthroscopic code, and no modifier overrides that edit.

02Can I bill 76000 with a spinal injection like an epidural (62321)?

No. Epidural injection codes 62321, 62323, 62325, and 62327 already include fluoroscopic guidance. 76000 is not separately reportable. Use 77003 only when specified by the applicable injection code's instructions.

03When is modifier 59 actually valid on 76000?

Only when the fluoroscopy guided a distinct procedure at a separate anatomic site during the same encounter — for example, fluoroscopy for an ankle injection performed the same day as a knee arthroscopy. The two services must be clinically and anatomically separate, and documentation must make that explicit.

04What does billing modifier 26 on 76000 require in the documentation?

A formal, separate written interpretation report signed by the supervising physician. A notation in the operative report that fluoroscopy was used does not satisfy this requirement and will trigger audit recoupment.

05Is 76000 billable with percutaneous pinning?

Generally no. AAOS policy treats intraoperative fluoroscopy during surgical procedures as bundled into the global service. Appending modifier 26 to extract a professional component payment is considered inappropriate billing by most payers and AAOS guidance.

06Are there spinal procedures where 76000 is separately reportable?

Only when a specific CPT Professional codebook instruction explicitly states it is separately reportable for that procedure. Otherwise, NCCI Chapter 4 and Chapter 8 both prohibit separate reporting of 76000 with spinal procedures.

Sources & references

Editorial content was developed using the following public sources. Last verified May 8, 2026.

Mira AI Scribe

Mira's AI scribe captures fluoroscopy duration in minutes, the clinical indication, radiation dose, and the specific anatomic site imaged — directly from dictation. It flags when the primary procedure code carries a built-in NCCI bundle against 76000, alerting the coder before claim submission rather than after a denial. When modifier 26 is indicated, the scribe prompts for a separate interpretation note, preventing the most common audit trigger for this code.

See how Mira captures CPT 76000 documentation