OpenMedicare
Start Here
Explore
Fraud
Investigations
Data
Tools
About

Footer

OpenMedicare

Independent Medicare data journalism

Sister Sites

  • OpenMedicaid
  • OpenFeds
  • OpenSpending

Explore

  • Providers
  • Procedures
  • States
  • Specialties
  • Search

Fraud Analysis

  • Still Out There (AI)
  • Fraud Overview
  • Fraud Watchlist
  • Deep Dive Profiles
  • Impossible Numbers
  • Report Fraud

Investigations

  • The Algorithm Knows
  • How We Built the Model
  • Internal Medicine Crisis
  • Florida & California Fraud
  • Million Dollar Flagged
  • All Investigations

Tools

  • Provider Lookup
  • Compare
  • Cost Calculator
  • Your Medicare Dollar
  • Downloads

About

  • About OpenMedicare
  • Methodology
  • Glossary
  • Data Sources
  • API Docs
  • Updates
Data Sources: Centers for Medicare & Medicaid Services (CMS), Medicare Provider Utilization and Payment Data
Disclaimer: This site is an independent journalism project. Data analysis and editorial content are not affiliated with or endorsed by CMS or any government agency. All spending figures are based on publicly available Medicare payment records.
Sister Sites: OpenMedicaid · OpenFeds · OpenSpending

© 2026 OpenMedicare. Independent data journalism. Built by TheDataProject.ai

Methodology•Download Data
  1. Home
  2. Procedures
  3. 76642
  4. Cost Analysis

How Much Does Limited ultrasound scan of 1 breast Cost on Medicare?

Cost analysis for CPT 76642 — Limited ultrasound scan of 1 breast

Share:

Average Medicare Payment

$35.89

2023 data

Total Payments (2023)

$24.3M

Services (2023)

643.6K

Price Change (2015–2023)

-3.8%

📈 Year-over-Year Cost Trend

YearAvg PaymentTotal PaymentsServicesYoY Change
2015$37.31$26.4M685.6K—
2016$35.91$25.7M691.3K-3.8%
2017$35.52$25.6M697.9K-1.1%
2018$35.84$26.1M709.4K+0.9%
2019$36.39$27.2M725.9K+1.5%
2020$36.42$24.1M633.0K+0.1%
2021$36.87$26.5M688.8K+1.2%
2022$35.52$24.6M661.0K-3.7%
2023$35.89$24.3M643.6K+1.0%

🗺️ State-by-State Cost Variation

The most expensive state pays 2.5x more than the cheapest for this procedure. MD averages $58.86 vs WV at $23.20.

StateAvg PaymentTotal PaymentsServicesProviders
MD$58.86$1.2M20.1K179
NJ$53.87$1.3M23.6K296
DC$49.45$222.4K4.5K44
AZ$49.44$597.4K12.1K136
NV$48.96$163.5K3.3K61
CA$48.35$3.0M61.2K750
FL$47.09$2.0M43.0K526
NY$46.34$1.7M35.6K556
AP$44.64$4.6K1032
CO$42.57$482.3K11.3K134
AK$42.15$79.4K1.9K25
RI$41.57$148.3K3.6K37
CT$41.46$343.2K8.3K154
WA$40.07$637.5K15.9K173
NM$38.92$132.6K3.4K46
WY$38.68$36.4K94121
DE$38.38$127.2K3.3K34
AR$37.46$262.1K7.0K92
NC$37.43$900.1K24.0K361
MN$37.23$441.8K11.9K203
VA$37.18$799.1K21.5K270
HI$36.71$74.4K2.0K35
TX$36.31$1.0M28.4K466
GA$34.87$661.2K19.0K290
IA$34.52$263.6K7.6K123
TN$34.10$569.0K16.7K265
KS$33.34$234.9K7.0K102
AL$31.96$223.1K7.0K146
IL$31.82$1.0M32.8K409
MA$30.79$694.5K22.6K311
NH$29.93$87.9K2.9K61
OR$29.69$238.8K8.0K111
NE$29.51$152.2K5.2K86
MT$29.21$58.2K2.0K34
WI$29.18$285.1K9.8K237
SC$29.05$323.2K11.1K129
PA$28.75$925.5K32.2K414
LA$28.00$203.5K7.3K148
MO$27.51$436.2K15.9K225
MS$27.31$146.3K5.4K84
IN$27.28$317.1K11.6K169
SD$27.16$64.3K2.4K40
MI$27.15$467.5K17.2K262
KY$26.74$207.6K7.8K117
OK$26.65$231.2K8.7K100
OH$25.88$566.2K21.9K327
UT$25.58$74.5K2.9K58
ND$25.35$64.6K2.5K36
ME$24.67$67.8K2.8K64
VT$24.56$34.7K1.4K26
ID$23.46$62.3K2.7K48

💰 Who Bills the Most for This Procedure?

ProviderSpecialtyStatePaymentsServicesAvg/Service
Ronald MattisonGeneral SurgeryTN$52.6K797$66.03
Mary GoodwinGeneral SurgeryGA$42.3K635$66.60
Sergio DromiDiagnostic RadiologyFL$37.7K586$64.29
Joan BerkowitzDiagnostic RadiologyMD$37.6K519$72.39
Reema MunirDiagnostic RadiologyCA$37.3K486$76.85
Jon ForanDiagnostic RadiologyCA$36.9K470$78.43
Saint Barnabas Outpatient CentersIndependent Diagnostic Testing Facility (IDTF)NJ$35.8K713$50.28
Daniel AronsonDiagnostic RadiologyMD$35.7K490$72.92
Geraldine ChangDiagnostic RadiologyCA$35.2K581$60.53
Pia LuedtkeDiagnostic RadiologyCA$33.2K386$86.05
Omid BendavidDiagnostic RadiologyCA$31.1K397$78.33
Arpita SwamiDiagnostic RadiologyWA$28.2K458$61.62
Naomi KrautDiagnostic RadiologyMD$27.9K391$71.23
Thu NguyenDiagnostic RadiologyMD$27.3K382$71.57
Ewa BauerDiagnostic RadiologyCA$27.2K410$66.31
Steven NokesDiagnostic RadiologyTN$26.5K414$63.93
Cristina CampassiDiagnostic RadiologyMD$26.3K360$73.04
Khiet NguyenDiagnostic RadiologyMD$25.9K326$79.39
Jocelyn ScheinertDiagnostic RadiologyMD$25.4K326$77.79
Jason MckellopDiagnostic RadiologyNY$25.2K314$80.23

🤔 Is Limited ultrasound scan of 1 breast Overpriced?

The data suggests significant pricing inconsistencies for CPT 76642. With a 2.5x price gap between the most and least expensive states, geography plays an outsized role in what Medicare pays for this procedure.

Costs have remained relatively stable over time, but the geographic variation suggests Medicare's geographic adjustment factors may not fully capture the true cost differences across states.

This analysis is based on publicly available CMS data and does not account for patient complexity, comorbidities, or facility-specific factors that may justify pricing differences.

Data Sources

  • • Centers for Medicare & Medicaid Services (CMS)
  • • Medicare Provider Utilization and Payment Data (2014-2023)
  • • Medicare Physician Fee Schedule

Note: All data is from publicly available Medicare records. OpenMedicare is an independent journalism project not affiliated with CMS.