# CPT 76642

> Medicare paid $86.75 for CPT 76642 in the office (non-facility) setting and $86.75 in a facility under the Q3 2023 Physician Fee Schedule, effective July 2023. These are the national allowed amounts before the ~2% sequestration cut and before locality (GPCI) adjustment. This price has been unchanged since Q1 2023, when it decreased 1.3%.

## What it is

A focused ultrasound of part of one breast rather than the whole thing - typically the single area where a lump was felt or where a mammogram flagged something. The difference from the complete breast study is scope: this one answers a question about a specific region and does not survey every quadrant. It is the workhorse study for characterizing one finding and for follow-up of a known spot.

## Selected release

- Release: Q3 2023 (2023 C)
- Effective: July 1 – September 30, 2023
- Status indicator: A
- Office (non-facility) national allowed amount: $86.75
- Facility national allowed amount: $86.75
- Sequestration: not applied

## RVUs and formula

- Work RVU: 0.68
- Office (non-facility) practice expense RVU: 1.83
- Facility practice expense RVU: 1.83
- Malpractice RVU: 0.05
- Conversion factor: 33.8872
- Formula: `(work_rvu × work_gpci + pe_rvu × pe_gpci + mp_rvu × mp_gpci) × conversion_factor`

## Source and citation

- Source: Physician relative value file (Q3 2023)
- CMS file: https://www.cms.gov/files/zip/rvu23c.zip
- Parsed file: PPRRVU23_JUL.csv, row 13,812
- Canonical page: https://localishealth.com/cpt/76642/2023/A
- Release-specific citation URL: https://localishealth.com/cpt/76642/2023/C
- Last significant update: 2026-08-04T03:12:57+00:00