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CPT CODERadiologyStatus C

CPT Code 76945Complete Billing & Coding Guide (2026)Echo guide villus sampling

Reviewed by AAPC-Certified Coders2026 Medicare Fee ScheduleCMS + AMA Sources
Medicare Payment
$0
Non-facility · National avg
Facility
$0
Total RVU
0.00
Global
XXX
Payment
$0
non-facility
Work RVU
0.00
physician effort
Global Period
XXX
no post-op
Bundling Edits
10
NCCI pairs

About CPT 76945

CPT 76945 is a Current Procedural Terminology code in the Radiology category maintained by the American Medical Association. The CMS short descriptor reads "Echo guide villus sampling". 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 76945 pays cleanly or triggers a denial. Verify CMS National Physician Fee Schedule status, applicable Medicare LCDs, and any payer-specific medical policies before submission.

Pro Tip

76945 has 10 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

Global Period
XXX
Not applicable (E/M, diagnostic, etc.)
Status Indicator
C
Carriers price the code.
Conversion Factor
$33.4009
CMS national rate
Effective Date
2026-04-01
per CMS publication

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.

RVU Composition
0.00 total RVU
Work RVU
0.00 · 0%
Physician time + skill
Practice Expense
0.00 · 0%
Office & equipment
Malpractice
0.00 · 0%
Liability insurance
Non-Facility
Private office · urgent care · ambulatory
Most billed
$0.00
0.00 RVU × $33.4009 CF
Facility
Hospital · ASC · nursing home
$0.00
0.00 RVU × $33.4009 CF

Payment = Total RVU × Conversion Factor ($33.4009) × Geographic Adjustment (GPCI). National averages shown. Actual payment varies by locality.

NCCI Bundling Edits

10 pairs

These codes trigger National Correct Coding Initiative edits when billed with 76945. 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.

Common Denial Risk

Billing 76945 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.

0689T
Modifier OK

Misuse of Column Two code with Column One code

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0690T
Modifier OK

CPT Manual or CMS manual coding instruction

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36591
Hard bundle

CPT Manual or CMS manual coding instruction

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36592
Hard bundle

CPT Manual or CMS manual coding instruction

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76000
Modifier OK

Misuse of Column Two code with Column One code

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76942
Modifier OK

Standards of medical/surgical practice

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76946
Modifier OK

Standards of medical/surgical practice

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76998
Modifier OK

Misuse of Column Two code with Column One code

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77001
Modifier OK

Misuse of Column Two code with Column One code

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77002
Modifier OK

Misuse of Column Two code with Column One code

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AR Recovery Note

Radiology bundling traps usually involve component coding (TC/26 splits) plus contrast-with vs without coding pairs. CO-97 denials on 76945 often resolve once the right component modifier is appended on resubmission.

Applicable Modifiers

Modifiers commonly paired with 76945 based on its category. Apply only when the clinical circumstance warrants. Incorrect modifier use is a top audit target.

26
Professional component — physician interpretation/report only (no technical component)
When to use · When the physician only interprets/reads a diagnostic test performed by another entity (e.g., reading an echo performed at a hospital).
33
Preventive services — when the primary purpose is delivery of an evidence-based service per USPSTF A or B recommendation
When to use · Screening services (colonoscopy, mammography, etc.) to indicate the primary purpose is preventive. Waives cost-sharing under ACA.
76
Repeat procedure or service by same physician
When to use · When the same physician repeats the exact same procedure on the same day (e.g., repeat EKG after treatment, repeat X-ray after reduction).
77
Repeat procedure by another physician
When to use · When a different physician repeats the same procedure on the same day.
91
Repeat clinical diagnostic laboratory test on the same day for the same patient
When to use · When the same lab test is repeated on the same day for clinical reasons (not equipment malfunction).
GA
Waiver of liability statement issued as required by payer policy (ABN on file)
When to use · Medicare: when an Advance Beneficiary Notice (ABN) has been signed by the patient for services that may not be covered.
GY
Item or service statutorily excluded or does not meet the definition of any Medicare benefit
When to use · Service is never covered by Medicare (e.g., cosmetic procedures). May bill patient directly.
GZ
Item or service expected to be denied as not reasonable and necessary — no ABN on file
When to use · When a service is expected to be denied by Medicare and no ABN was obtained. Provider cannot bill the patient.
AR Recovery Note

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.

Free 90-Day AR Recovery Audit

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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 76945 claims, surfaces the recoverable dollars, and appeals them. Free, no obligation.

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FAQ

Everything about CPT 76945

What does CPT code 76945 cover?

CPT 76945 is a Current Procedural Terminology code in the Radiology category maintained by the American Medical Association. The CMS short descriptor reads "Echo guide villus sampling". For the full AMA long descriptor and clinical guidance, refer to the current CPT code manual.

What is the Medicare payment for CPT 76945?

The national average Medicare payment for CPT 76945 is approximately $0 in a non-facility setting and $0 in a facility setting. Actual payment varies by locality based on GPCI adjustments. Total RVU is 0 with a conversion factor of $33.4009.

What is the global period for CPT 76945?

CPT 76945 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 76945?

CPT 76945 has NCCI Procedure-to-Procedure edits with 10+ codes including 0689T, 0690T, 36591. Modifier indicator 0 means the edit cannot be bypassed. Indicator 1 means modifier 59 or X-modifiers may allow separate billing with documentation.

CMS Medicare Physician Fee ScheduleNCCI Edits · Current QuarterAMA CPT Code Set

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.

Free 90-Day AR Recovery Audit

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.

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