CPT Code 76145Complete Billing & Coding Guide (2026)Med physic dos eval rad exps
About CPT 76145
CPT 76145 is a Current Procedural Terminology code in the Radiology category maintained by the American Medical Association. The CMS short descriptor reads "Med physic dos eval rad exps". For the full AMA long descriptor and clinical guidance, refer to the current CPT code manual.
Documentation specificity, correct ICD-10 linkage, and modifier accuracy determine whether 76145 pays cleanly or triggers a denial. Verify CMS National Physician Fee Schedule status, applicable Medicare LCDs, and any payer-specific medical policies before submission.
76145 has 3 NCCI bundling edit pairs documented. Run your scrubber against the NCCI quarterly update before submission. When clinically warranted, use modifier 59 or the X-modifiers (XE, XS, XP, XU) to bypass an indicator-1 edit, with chart documentation supporting the distinct service.
Code Properties
RVU Breakdown
Every CPT code’s Medicare payment is calculated from three Relative Value Unit components: physician work, practice expense, and malpractice. Together they multiply by the conversion factor to produce the payment amount.
Payment = Total RVU × Conversion Factor ($33.4009) × Geographic Adjustment (GPCI). National averages shown. Actual payment varies by locality.
Medicare Payment by State
Medicare adjusts payment by locality based on GPCI (Geographic Practice Cost Index). Higher cost-of-living areas like California and New York pay more. Rural states pay less. Top 12 states shown.
Showing top 12 of 53 states. Full locality data available in CMS PFS Locality file.
NCCI Bundling Edits
3 pairsThese codes trigger National Correct Coding Initiative edits when billed with 76145. An indicator of 0 means the pair cannot be unbundled. Indicator 1 means modifier 59 or X-modifiers may allow separate billing with supporting documentation.
Billing 76145 alongside a bundled code without the correct modifier generates CARC 97 denials. Payers often flag these as audit risks. Document medical necessity for the separate service and apply modifier 59 or the appropriate X-modifier (XE, XS, XP, XU) only when clinically justified.
CPT Manual or CMS manual coding instruction
CPT Manual or CMS manual coding instruction
CPT Manual or CMS manual coding instruction
Radiology bundling traps usually involve component coding (TC/26 splits) plus contrast-with vs without coding pairs. CO-97 denials on 76145 often resolve once the right component modifier is appended on resubmission.
Applicable Modifiers
Modifiers commonly paired with 76145 based on its category. Apply only when the clinical circumstance warrants. Incorrect modifier use is a top audit target.
Component split modifiers (26 professional, TC technical) are the most under-applied modifiers in diagnostic billing. Practices that bill global on services where they only provided the read silently invite refund requests. We split components correctly at submission.
Supporting ICD-10 Diagnoses
These diagnosis codes commonly support medical necessity for CPT 76145. Using the correct ICD-10 prevents CARC 50 denials. Payer rejects when the diagnosis doesn’t support the procedure.
Imaging CO-50 denials trace to medical-policy criteria mismatches. Cardiac MRI, cardiac CT, nuclear cardiology, and advanced imaging all face strict commercial payer policies. We pre-verify the indication against the payer's policy before submission, not after the denial.
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Wrong modifier, missing documentation, bundling without justification, stale ICD-10 linkage: these are the silent revenue killers on Radiology claims. Our AAPC-certified team audits your last 90 days of 76145 claims, surfaces the recoverable dollars, and appeals them. Free, no obligation.
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Related CPT Codes
Codes in the same family as 76145
Everything about CPT 76145
What does CPT code 76145 cover?
CPT 76145 is a Current Procedural Terminology code in the Radiology category maintained by the American Medical Association. The CMS short descriptor reads "Med physic dos eval rad exps". For the full AMA long descriptor and clinical guidance, refer to the current CPT code manual.
What is the Medicare payment for CPT 76145?
The national average Medicare payment for CPT 76145 is approximately $1039.1 in a non-facility setting and $1039.1 in a facility setting. Actual payment varies by locality based on GPCI adjustments. Total RVU is 31.11 with a conversion factor of $33.4009.
What is the global period for CPT 76145?
CPT 76145 has no global period (indicator XXX). There are no post-operative day restrictions tied to this code. Refer to CMS National Physician Fee Schedule rules and any applicable NCCI edits when billing on the same date as other services.
What codes bundle with CPT 76145?
CPT 76145 has NCCI Procedure-to-Procedure edits with 3+ codes including 36591, 36592, 96523. Modifier indicator 0 means the edit cannot be bypassed. Indicator 1 means modifier 59 or X-modifiers may allow separate billing with documentation.
CPT codes and descriptions are copyright of the American Medical Association. RVU values reflect current CMS publications. Actual payment varies by locality. Commercial payer rates vary by contract.
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We audit your last 90 days of claims and surface the revenue leakage: wrong modifiers, missed bundling appeals, ICD-10 specificity gaps. AAPC-certified coders. 2.49% of collections. No setup fees.