CPT 76536
Global XXX ActiveUs exam of head and neck
CPT 76536 Billing & Documentation Guide
CPT code 76536 (Us exam of head and neck) is classified under Radiology with a global period indicator of XXX. The 2026 Medicare Physician Fee Schedule assigns a work RVU of 0.55, a non-facility practice expense RVU of 2.66, and a malpractice RVU of 0.04, a total non-facility RVU of 3.25 and facility RVU of 3.25. With the current conversion factor of $33.4009, the national average non-facility reimbursement is approximately $112.61, though rates vary from $95.38 to $149.22 based on MAC locality and Geographic Practice Cost Indices (GPCIs).
When billing 76536, 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 76536 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 1 units of 76536 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 76536
| Component | Non-Facility | Facility |
|---|---|---|
| Work RVU | 0.55 | 0.55 |
| Practice Expense RVU | 2.66 | 2.66 |
| Malpractice RVU | 0.04 | 0.04 |
| Total RVU | 3.25 | 3.25 |
| Conversion Factor | $33.4009 | |
2026 Medicare Reimbursement by State, CPT 76536
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 | $124.88 | $124.88 | $116.77 - $149.22 | 29 |
| Florida | $110.12 | $110.12 | $105.32 - $114.24 | 3 |
| Georgia | $104.76 | $104.76 | $99.21 - $110.3 | 2 |
| Illinois | $106.84 | $106.84 | $101.58 - $112.11 | 4 |
| Michigan | $103.68 | $103.68 | $101 - $106.36 | 2 |
| North Carolina | $102.12 | $102.12 | $102.12 - $102.12 | 1 |
| New York | $120.17 | $120.17 | $103.71 - $127.67 | 5 |
| Ohio | $100.83 | $100.83 | $100.83 - $100.83 | 1 |
| Pennsylvania | $106.99 | $106.99 | $101.19 - $112.78 | 2 |
| Texas | $107.18 | $107.18 | $100.46 - $113.59 | 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 76536
Procedure-to-procedure (PTP) edits. If you bill any of these codes with 76536 on the same date of service, review the modifier indicator and payer policy before submission.
| Partner Code | Relationship | Modifier Allowed | Rationale |
|---|---|---|---|
| 0689T | Column 1 (primary), can be billed with modifier | Yes | CPT Manual or CMS manual coding instruction |
| 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 |
| 76942 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 76970 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 76981 | Column 1 (primary), can be billed with modifier | Yes | Mutually exclusive procedures |
| 76982 | Column 1 (primary), can be billed with modifier | Yes | Mutually exclusive procedures |
| 76983 | Column 1 (primary), can be billed with modifier | Yes | Mutually exclusive procedures |
| 76986 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
| 76998 | Column 1 (primary), can be billed with modifier | Yes | Misuse of Column Two code with Column One code |
Frequently Asked Questions, CPT 76536
What does CPT code 76536 mean? +
CPT code 76536 represents: Us exam of head and neck. It's in the Radiology category with a global period of XXX.
What is the Medicare reimbursement for CPT 76536? +
The 2026 Medicare national average non-facility payment for CPT 76536 is $112.61. Rates range from $95.38 to $149.22 across 53 states depending on MAC locality and GPCIs.
What modifiers can I use with CPT 76536? +
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 76536? +
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 May 31, 2026.
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