Ultrasound Thyroid and Neck price: Medicare anchor and facility lever
Anchor for Ultrasound Thyroid and Neck - CPT 76536
$106.36
Professional (26) $26.83 plus technical (TC) $79.53.
Hospital OPPS facility anchor, this code billed alone: $106.81 (APC 5522, Level 2 Imaging without Contrast; national unadjusted, before wage-index adjustment).
CPT 76536 is soft-tissue ultrasound of the head and neck, which in practice is mostly thyroid imaging. It is a single-study code with no composite, so a hospital quote is built from one facility APC and one reading. A biopsy guided by ultrasound would be a different procedure with its own codes.
CPT code
76536
Ultrasound, soft tissues of head and neck (for example thyroid, parathyroid, parotid), real time with image documentation
CPT 76536 covers soft-tissue ultrasound of the head and neck, commonly the thyroid. It is not an eye study (76510 to 76529) and not a chest study (76604).
The codes this visit can be billed under
| CPT | PFS office or global | PFS facility (professional) | Global period | Hospital single-service APC | Minimum Medicare copay at hospital |
|---|---|---|---|---|---|
| 76536 (this page) | $106.36 | $106.36 | not a surgical global | $106.81 (APC 5522) | $21.37 |
In CY2026 the hospital single-service APC for 76536 is 5522 at $106.81, with a minimum unadjusted copayment of $21.37. The global anchor at an office or imaging center is $106.36, of which $26.83 is the interpretation.
If a needle biopsy is planned or might be done at the same visit, the price question changes entirely: the biopsy and its imaging guidance are separate codes, and a pathology charge follows. Ask whether the appointment is for imaging only.
For a Medicare patient, a hospital-billed 76536 carries a minimum unadjusted facility copayment of $21.37, plus coinsurance on the $26.83 reading fee. In an office billing globally, coinsurance applies once to $106.36. Because the hospital APC amount and the office global amount are close for this code, the deciding question is usually whether the reading is included.
Thyroid imaging is often repeated over time, so the price of the same code at the same facility matters more than for a one-time study. A self-pay patient who expects follow-up imaging can ask whether the facility offers the same written cash price for repeat studies of 76536.
CMS Addendum B lists 76536 with status indicator Q1 at single-service APC 5522; no imaging composite figure is recorded for this code on this site.
Inside and outside the 76536 anchor
Covered by the anchor
- Sonographer time and image acquisition
- Interpreting physician interpretation and written report
- Standard image storage
Billed outside it
- A biopsy or aspiration billed under a separate code when performed
- The ordering visit and follow-up visit
- Repeat or limited follow-up scans billed separately
Why prices vary for CPT 76536
Head and neck ultrasound is paid at a single-service imaging APC in a hospital, with the professional fee billed separately. In an office the same study is usually one global amount. The technical component is most of the global anchor, so the setting drives the quote.
Ask whether the study can be done in the physician office or imaging center, and confirm the cash price for 76536 as one global amount versus a split hospital bill.
Questions specific to Thyroid/neck ultrasound
- Is the appointment for imaging only, or could a guided biopsy be added?
- Is the reading physician included in the quote?
- Is the location a hospital department or an office?
- If a follow-up study is expected later, will it be the same code and price?
- If a follow-up study is ordered in a few months, will it be billed under 76536 again at the same price?
Ultrasound Thyroid and Neck: billing questions
Is a thyroid ultrasound the same code as a neck ultrasound?
Yes. CPT 76536 covers soft-tissue ultrasound of the head and neck, including the thyroid. Eye and chest ultrasounds use other codes.
Does the price include a biopsy?
No. An ultrasound-guided biopsy uses separate procedure and guidance codes, and the tissue is examined under a separate pathology code. Ask for those prices separately if a biopsy is possible.
How close are the hospital and office anchors for this code?
In CY2026 the hospital single-service APC amount and the office global anchor are close. The reading fee and any hospital markup make most of the difference in a cash quote.
What is the minimum Medicare hospital copayment for a thyroid ultrasound?
In the CY2026 OPPS Addendum B, 76536 maps to APC 5522 with a minimum unadjusted copayment of $21.37, before wage-index adjustment. The reading physician's coinsurance is separate.