he CPT code for FibroScan is 91200, which the AMA defines as liver elastography, mechanically induced shear wave (e.g., vibration), without imaging, with interpretation and report. Bill it when your team runs a standard FibroScan exam that produces a stiffness number in kPa. In 2026, Medicare pays about $33.73 nationally for the global service, before geographic adjustment.
That’s the short answer. The longer one matters more, because FibroScan claims fail for reasons the code number alone won’t explain. Vendors push 76981. Payers cap how often you can scan. Some plans still list a code the AMA deleted in 2019. This guide walks your billing team through every decision point, from code choice to the denial reason codes you’ll see on the ERA. Accurate coding and claim follow-up are also important parts of Medical Billing and Coding Services, while practices managing liver-related procedures can benefit from specialized Revenue Cycle Management Services.
What is the CPT code for FibroScan?
CPT 91200 is the code for a FibroScan exam. It covers liver stiffness measurement through vibration controlled transient elastography, plus the physician’s interpretation and written report. The phrase “without imaging” is the deciding detail, since a standard FibroScan returns numbers, not pictures.
Here’s what happens during the exam. A probe sits between the patient’s ribs over the right lobe of the liver. It sends a low frequency vibration into the tissue and tracks how fast the resulting shear wave travels. Stiffer tissue moves the wave faster, and the device converts that speed into a stiffness score in kilopascals (kPa).
Clinicians use that score to estimate fibrosis stage without a needle biopsy. Most FibroScan units also report a controlled attenuation parameter (CAP) in dB/m, which estimates fat in the liver. No separate CPT code exists for CAP. You report the whole exam, stiffness and CAP together, with one unit of 91200.
One more point trips up new billers. The AMA wrote 91200 to describe the technique, not a brand. FibroScan dominates the market, but any device that measures liver stiffness with a mechanically induced shear wave and no image guidance fits the same code. The AMA’s CPT code set governs that descriptor, and payers follow it.
What does CPT 91200 cover, and what does it leave out?
CPT 91200 covers the full liver elastography service: the scan, the measurement set, and the interpretation with a signed report. It leaves out any imaging, any organ other than the liver, and any separate visit work.
Services that fall inside 91200
- Patient positioning and probe placement over the right liver lobe
- The full series of valid stiffness measurements (most protocols aim for 10)
- CAP measurement, when the device supports it
- Selection of the M or XL probe based on body habitus
- The physician’s interpretation and written report
Services that fall outside 91200
- Ultrasound images or image guided targeting (that work belongs to 76981 or 76982)
- Elastography of any organ besides the liver, since the descriptor restricts 91200 to the liver
- A separately identifiable office visit, which you bill with its own E/M code when the record supports it
Because 91200 carries an XXX global indicator, the surgical package rules don’t bundle a same day visit into it. Your provider still needs a visit note that stands on its own, apart from the scan interpretation.
Is the CPT code for liver FibroScan 91200 or 76981?
For a standard FibroScan exam that returns a number without saved ultrasound images, bill 91200. Code 76981 describes ultrasound elastography of an organ’s parenchyma with imaging, so it only fits when your team performs, saves, and interprets real ultrasound images as part of the exam.
This question shows up in billing forums almost every month. Device representatives sometimes tell practices to switch to 76981 or to bill both codes. Echosens itself now describes two options: 76981 when the exam includes ultrasound image guidance, interpretation, and documentation, and 91200 when it doesn’t. The deciding factor sits in your documentation, not in the device brochure.
Our view? 91200 remains the safer default for most FibroScan workflows. A practice that switches to 76981 without saved images and a documented image interpretation invites an audit finding, and the recoupment math rarely favors the gamble. If your device and workflow truly produce imaging, document it every time and then bill 76981. Not sure which side of that line your workflow falls on? A certified medical coding review of a few recent exam notes usually settles it.
Liver elastography and related CPT codes compared
Can you bill 91200 and 76981 on the same day?
No. Both codes describe the same liver stiffness measurement, one without imaging and one with it, so you report only one per session. Billers who follow vendor advice to stack them often see Medicare Advantage and Medicaid plans deny 91200 as included in 76981.
A formal liver ultrasound works differently. When your provider performs non imaging elastography (91200) and a full diagnostic ultrasound (76700 or 76705) at the same encounter, the ACR ultrasound coding guidance recommends a distinct procedure modifier such as 59 on the ultrasound line. Check the current CMS NCCI procedure to procedure edits each quarter before you apply 59 or an X modifier, since CMS updates those tables four times a year.
How much does Medicare pay for CPT 91200 in 2026?
Medicare pays about $33.73 nationally for the global 91200 service in 2026. That figure comes from 1.01 total RVUs multiplied by the 2026 conversion factor of $33.4009 for clinicians outside a qualifying APM. Your local rate moves up or down with your locality’s GPCI.
Look up your exact locality figure in the CMS Physician Fee Schedule look up tool, which also splits the 26 and TC amounts. Commercial payers set their own rates, often as a percentage of Medicare.
Small per scan payments add up with volume. Say your hepatology clinic runs 40 Medicare FibroScan exams a month. At the national rate, that’s $1,349.20 a month and $16,190.40 a year. Lose 15 percent of those claims to avoidable denials and you leave about $2,430 on the table each year, from one low dollar code.
2026 national Medicare estimates for liver fibrosis tests
Optimize Your Gastroenterology and Hepatology Claims
Small coding choices on FibroScan claims, like 91200 versus 76981 or a missing 26 modifier, decide whether the payer pays you at all. Our certified coders review elastography claims against payer specific rules before submission, which improves coding accuracy and keeps clean claims moving. Explore how we support gastroenterology and hepatology teams.
Estimates use the 2026 non APM conversion factor of $33.4009 and exclude GPCI, sequestration, and patient cost sharing.
Which modifiers apply to FibroScan claims?
Most FibroScan claims need no modifier at all. When one entity owns the device and its physician reads the scan, you bill 91200 globally. Modifiers 26 and TC only come into play when the scan and the interpretation belong to different parties.
Modifier selection for CPT 91200 by setting
The second row causes the most trouble. A physician who bills the global 91200 for a scan done on hospital equipment can expect a denial, and repeat errors draws attention from payment integrity teams.
Which ICD-10 codes support a FibroScan?
Payers want a chronic liver disease diagnosis that explains why the provider needs a fibrosis estimate. Viral hepatitis, MASLD, MASH, cirrhosis, and a few genetic liver conditions cover most covered FibroScan claims. Symptom codes on their own rarely earn payment.
Common ICD-10-CM pairings for CPT 91200
Watch for weak pairings. Nextcare’s FibroScan guidance, for example, lists abnormal liver function results and autoimmune hepatitis among indications where it doesn’t consider the test appropriate. If your provider orders a scan for high liver enzymes alone, expect a CO-50 medical necessity denial unless the note documents a chronic liver disease workup. For a refresher on how diagnosis and procedure codes work together, see our guide on the difference between ICD-10 and CPT codes.
How often will payers cover a FibroScan?
Most commercial payers cover up to two FibroScan exams per patient per year. Medicare has no national coverage determination for liver elastography, so your Medicare Administrative Contractor’s local rules and general medical necessity standards apply.
Published policies show how tight the limits get:
- Aetna (Clinical Policy Bulletin 0690) calls transient elastography more than twice per year not medically necessary, and it excludes routine followup of liver transplant recipients.
- Premera Blue Cross treats testing more than twice a year, or within six months after a liver biopsy or prior elastography, as not medically necessary.
- Medical Mutual requires that TE happen no more than twice per year, and it accepts either 76981 or 91200 when the exam is transient elastography.
- Vermont Medicaid limits vibration controlled transient elastography to two exams per year.
- Some plans, including Nextcare, require pre authorization before every FibroScan.
Read the Aetna noninvasive hepatic fibrosis policy to see how one national payer lists covered indications, CPT codes, and diagnosis codes side by side. Then build those limits into your scheduling system. A front desk alert that flags a third scan in 12 months saves your team an appeal it would probably lose.
What documentation does a FibroScan claim need?
Your record needs an order with a clear indication, the measurement data, and a signed interpretation that states what the result means for care. Payers and auditors look for these seven elements:
- The ordering provider’s indication, tied to a specific chronic liver diagnosis
- The probe used (M or XL) and the number of valid measurements
- The median liver stiffness in kPa
- The interquartile range to median ratio (IQR/M), with 30 percent or lower as the common reliability threshold
- The CAP score in dB/m, if the device measured it
- A written interpretation with an estimated fibrosis stage
- A note on how the result changes management, such as avoiding a biopsy or adjusting followup
Skip the last item and you weaken your appeal position. Auditors want to see that the test changed a clinical decision, not that someone ran it because the device sat in the hallway.
What causes FibroScan claim denials?
FibroScan denials trace back to six repeat causes, and each one leaves a recognizable reason code on the ERA. Match the code to the cause and the fix becomes obvious.
Common FibroScan denial causes and CARC codes
Picture a three physician GI practice in Tampa that adds a FibroScan in January. The device rep suggests billing 76981 and 91200 together. Commercial plans pay for a few weeks, then the Medicare Advantage and Medicaid ERAs start arriving with CO-97 on every 91200 line. By March, the billing manager faces 60 denied lines, an open question about overpayments on the commercial side, and a provider asking why the new machine isn’t paying for itself.
That story repeats across the country. If your practice bills more than a handful of elastography exams a month, run a quick look back at your last 90 days of 91200 and 76981 claims. Our denial management team sorts this kind of pattern by CARC code, corrects the root cause, and appeals what qualifies. For broader prevention habits, our post on cutting claim denials before they happen covers the front end checks that stop most of these errors.
Did the FibroScan CPT code change in 2025 or 2026?
No. The 2025 and 2026 CPT code sets kept 91200 and its descriptor unchanged. What changes each year is the payment, since CMS revalues RVUs and resets the conversion factor in every Physician Fee Schedule final rule.
A short history helps explain the confusion you still see on payer forms:
- Before 2015: practices reported FibroScan with unlisted code 91299, and payment varied wildly.
- January 1, 2015: the AMA created 91200 for liver elastography without imaging.
- 2015 to 2018: Category III code 0346T covered ultrasound elastography.
- January 1, 2019: the AMA deleted 0346T and added 76981, 76982, and +76983 for ultrasound elastography with imaging.
- 2025 and 2026: no descriptor change for 91200; only RVU and conversion factor updates.
So when someone searches “fibroscan cpt code 2025,” the answer stays the same as 2026: 91200 for a non imaging exam. Any payer document that still cites 0346T is out of date, and your team should ask the payer for its current policy in writing.
FibroScan coding sits inside a bigger revenue cycle picture. Our medical billing services for US practices cover coding, claim submission, payment posting, and followup for gastroenterology, hepatology, and internal medicine teams across all 50 states.
Stop FibroScan Denials and Recover Your Elastography Revenue
FibroScan claims look simple until the denials stack up on your ERAs. Medicotech’s coding and billing specialists check your last 90 days of 91200 and 76981 claims, find the modifier, diagnosis, and frequency errors, and fix them so payers pay you on the first pass. Schedule a free consultation to see where your elastography revenue stands.
FibroScan CPT code FAQs
What is the CPT code for FibroScan?
The CPT code for FibroScan is 91200: liver elastography, mechanically induced shear wave (e.g., vibration), without imaging, with interpretation and report. It covers the stiffness measurement, the CAP reading if taken, and the physician’s report.
What is the CPT code for liver FibroScan with ultrasound imaging?
When the exam includes saved ultrasound images, image guidance, and a documented image interpretation, CPT 76981 (ultrasound elastography, parenchyma) may fit instead. Without that imaging work, bill 91200.
Can I bill CPT 91200 and 76981 together?
No. Both describe the same liver stiffness measurement, so you report one per session. Payers routinely deny the second line as included in the first.
Does CAP have its own CPT code?
No. The controlled attenuation parameter comes from the same FibroScan exam, and you report it within 91200. Don’t add an unlisted code for it.
How much does Medicare reimburse for CPT 91200 in 2026?
About $33.73 nationally for the global service, based on 1.01 total RVUs and a $33.4009 conversion factor. Your local rate depends on your GPCI locality.
Do I need modifier 26 for a FibroScan?
Only when the reading physician doesn’t own the equipment, such as a scan done on hospital equipment at POS 22. If your practice owns the device and interprets the scan, bill 91200 globally with no modifier.
How many FibroScan exams per year will insurance cover?
Most commercial policies, including Aetna, Premera, and Medical Mutual, cap coverage at two per year. Medicare relies on local MAC rules and medical necessity.
Which diagnosis codes support CPT 91200?
Common pairings include K76.0 (MASLD), K75.81 (NASH or MASH), B18.2 (chronic hepatitis C), B18.1 (chronic hepatitis B), K74.0x (hepatic fibrosis), and K74.60 (cirrhosis). Check each payer’s covered code list.
Did the FibroScan CPT code change in 2025?
No. CPT 91200 kept the same descriptor in 2025 and 2026. Only the RVUs and the Medicare conversion factor changed.
Who can perform a FibroScan for billing purposes?
A trained medical assistant, nurse, or technologist can run the scan in many practices, while a physician or qualified provider interprets and signs the report. Check your MAC’s supervision rules and state scope of practice before you staff the exam.
