CPT 76098
Global XXX ActiveX-ray exam surgical specimen
CPT 76098 Billing & Documentation Guide
CPT code 76098 (X-ray exam surgical specimen) is classified under Radiology with a global period indicator of XXX. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 0.3, a non-facility practice expense RVU of 0.96, and a malpractice RVU of 0.03, a total non-facility RVU of 1.29 and facility RVU of 1.29. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $44.55, though rates vary from $38.08 to $57.9 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 76098, ensure documentation supports medical necessity and the specific components required for the code's level of service. For E/M codes, document MDM (medical decision-making) elements: problems addressed, data reviewed, and risk. For procedural codes, document the indication, technique, and any complications. Always verify NCCI edits before bundling 76098 with related codes; this code has 10 PTP bundling relationships on file (see table below).
Payment Status & Global Period
Active code (paid under MPFS)
No global period (E/M and other non-procedural services)
MUE Limit (Medically Unlikely Edits)
Submitting more than 3 units of 76098 for the same patient on the same date triggers automatic line denial unless an appropriate modifier and supporting documentation justify the higher quantity.
RVU Breakdown, CPT 76098
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 0.3 | 0.3 |
| Practice Expense RVU | 0.96 | 0.96 |
| Malpractice RVU | 0.03 | 0.03 |
| Total RVU | 1.29 | 1.29 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 76098
State-level averages across all MAC localities. Non-facility rates typically apply to office-based services; facility rates apply to hospital outpatient / inpatient.
| State | Non-Facility | Facility | Range (Non-Fac) | Localities |
|---|---|---|---|---|
| California | $48.86 | $48.86 | $45.87 - $57.9 | 29 |
| Florida | $44.14 | $44.14 | $42.18 - $45.93 | 3 |
| Georgia | $41.83 | $41.83 | $39.82 - $43.83 | 2 |
| Illinois | $42.96 | $42.96 | $40.86 - $44.8 | 4 |
| Michigan | $41.54 | $41.54 | $40.43 - $42.65 | 2 |
| North Carolina | $40.58 | $40.58 | $40.58 - $40.58 | 1 |
| New York | $47.63 | $47.63 | $41.19 - $50.65 | 5 |
| Ohio | $40.31 | $40.31 | $40.31 - $40.31 | 1 |
| Pennsylvania | $42.59 | $42.59 | $40.4 - $44.78 | 2 |
| Texas | $42.57 | $42.57 | $40.13 - $44.85 | 8 |
Source: CMS PFSRVU 2026 · Updated 2026-04-01. Full locality-level detail available for all 53 states, contact us for custom reports.
NCCI Bundling Edits, CPT 76098
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 76098 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 36591 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 36592 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 96523 | Column 1 (primary), can be billed with modifier | No | CPT Manual or CMS manual coding instruction |
| 0083U | Column 2 (secondary), bundled into primary | Yes | Misuse of Column Two code with Column One code |
| 0248U | Column 2 (secondary), bundled into primary | Yes | Misuse of Column Two code with Column One code |
| 0495T | Column 2 (secondary), bundled into primary | Yes | Misuse of Column Two code with Column One code |
| 0496T | Column 2 (secondary), bundled into primary | Yes | Misuse of Column Two code with Column One code |
| 0694T | Column 2 (secondary), bundled into primary | Yes | CPT Manual or CMS manual coding instruction |
| 19081 | Column 2 (secondary), bundled into primary | Yes | CPT Manual or CMS manual coding instruction |
| 19082 | Column 2 (secondary), bundled into primary | Yes | CPT Manual or CMS manual coding instruction |
Frequently Asked Questions, CPT 76098
What does CPT code 76098 mean? +
CPT code 76098 represents: X-ray exam surgical specimen. It's in the Radiology category with a global period of XXX.
What is the Medicare reimbursement for CPT 76098? +
The 2026 Medicare national average non-facility payment for CPT 76098 is $44.55. Rates range from $38.08 to $57.9 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 76098? +
Radiology codes rely heavily on the professional/technical split: modifier 26 (professional component only) and TC (technical component only). Also common: 50 (bilateral imaging), 76 (repeat by same physician), 77 (repeat by different physician), and LT/RT for laterality.
What bundling edits apply to CPT 76098? +
This code has 10 NCCI PTP bundling relationships. See the NCCI Bundling section below for full list.
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Reviewed by the PayerReady Medical Coding Team
Verified against the CMS 2026 code set on June 1, 2026.
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