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Official Description

Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; complete

© Copyright 2025 American Medical Association. All rights reserved.

Common Language Description

A complete retroperitoneal ultrasound, designated by CPT® Code 76770, is a diagnostic imaging procedure that utilizes real-time ultrasound technology to visualize the retroperitoneal space. This area is located behind the peritoneum, which is the lining of the abdominal cavity, and includes critical structures such as the kidneys, abdominal aorta, common iliac artery origins, and inferior vena cava. During the procedure, the patient is positioned supine, allowing optimal access to the abdomen. Acoustic coupling gel is applied to the skin to enhance the transmission of ultrasound waves. A transducer is then placed firmly against the skin and moved across the abdomen to capture images of the retroperitoneal structures. The ultrasound machine emits high-frequency sound waves that penetrate the body and reflect off internal structures, creating echoes that are converted into visual images. These images are crucial for identifying any abnormalities within the retroperitoneal area, which may assist in diagnosing various medical conditions. After the imaging is completed, the physician reviews the captured images and provides a comprehensive written interpretation of the findings. This procedure is essential for evaluating conditions affecting the kidneys and surrounding structures, and it is important to note that a complete examination includes thorough imaging of the specified retroperitoneal organs.

© Copyright 2025 Coding Ahead. All rights reserved.

1. Indications

Ultrasound, retroperitoneal (CPT® Code 76770) is indicated for various clinical scenarios where visualization of the retroperitoneal structures is necessary. The following conditions may warrant this procedure:

  • Evaluation of Renal Pathology Assessment of kidney abnormalities such as tumors, cysts, or hydronephrosis.
  • Assessment of Vascular Structures Examination of the abdominal aorta and inferior vena cava for aneurysms, thrombosis, or other vascular conditions.
  • Investigation of Lymphadenopathy Identification of enlarged lymph nodes in the retroperitoneal space, which may indicate malignancy or infection.
  • Trauma Evaluation Detection of internal bleeding or organ injury following abdominal trauma.

2. Procedure

The procedure for a complete retroperitoneal ultrasound involves several key steps to ensure accurate imaging of the targeted structures. The following procedural steps are performed:

  • Patient Positioning The patient is positioned supine on the examination table to provide optimal access to the abdomen for imaging.
  • Application of Acoustic Coupling Gel A layer of acoustic coupling gel is applied to the skin of the abdomen. This gel is essential for facilitating the transmission of ultrasound waves and ensuring clear image quality.
  • Transducer Placement The ultrasound transducer is placed firmly against the skin. The technician or physician moves the transducer back and forth across the abdomen, directing ultrasonic waves into the retroperitoneal space.
  • Image Acquisition As the transducer is moved, it captures real-time images of the retroperitoneal structures. The ultrasound machine records the echoes produced by the sound waves reflecting off the organs and tissues.
  • Evaluation of Abnormalities Any abnormalities detected during the imaging process are carefully evaluated. The characteristics of these abnormalities are analyzed to assist in forming a definitive diagnosis.
  • Image Review and Interpretation After the imaging is completed, the physician reviews the ultrasound images and provides a written interpretation of the findings, detailing any abnormalities or concerns identified during the examination.

3. Post-Procedure

Post-procedure care for a retroperitoneal ultrasound is generally minimal, as the procedure is non-invasive and does not typically require recovery time. Patients may resume normal activities immediately following the examination. However, it is important for the physician to discuss the results of the ultrasound with the patient, including any necessary follow-up actions or additional testing that may be required based on the findings. Patients should be advised to contact their healthcare provider if they experience any unusual symptoms following the procedure.

Short Descr US EXAM ABDO BACK WALL COMP
Medium Descr US RETROPERITONEAL REAL TIME W/IMAGE COMPLETE
Long Descr Ultrasound, retroperitoneal (eg, renal, aorta, nodes), real time with image documentation; complete
Status Code Active Code
Global Days XXX - Global Concept Does Not Apply
PC/TC Indicator (26, TC) 1 - Diagnostic Tests for Radiology Services
Multiple Procedures (51) 4 - Special payment adjustment rules on the technical component (TC) of multiple diagnostic imaging procedures apply...
Bilateral Surgery (50) 0 - 150% payment adjustment for bilateral procedures does NOT apply.
Physician Supervisions 09 - Concept does not apply.
Assistant Surgeon (80, 82) 0 - Payment restriction for assistants at surgery applies to this procedure...
Co-Surgeons (62) 0 - Co-surgeons not permitted for this procedure.
Team Surgery (66) 0 - Team surgeons not permitted for this procedure.
Diagnostic Imaging Family 88 -
APC Status Indicator Codes That May Be Paid Through a Composite APC
ASC Payment Indicator Radiology service paid separately when provided integral to a surgical procedure on ASC list; payment based on OPPS relative payment weight.
Type of Service (TOS) 4 - Diagnostic Radiology
Berenson-Eggers TOS (BETOS) I3B - Echography/ultrasonography - abdomen/pelvis
MUE 1
CCS Clinical Classification 196 - Diagnostic ultrasound of abdomen or retroperitoneum

This is a primary code that can be used with these additional add-on codes.

0690T Add-on Code MPFS Status: Carrier Priced APC N Quantitative ultrasound tissue characterization (non-elastographic), including interpretation and report, obtained with diagnostic ultrasound examination of the same anatomy (eg, organ, gland, tissue, target structure) (List separately in addition to code for primary procedure)
26 Professional component: certain procedures are a combination of a physician or other qualified health care professional component and a technical component. when the physician or other qualified health care professional component is reported separately, the service may be identified by adding modifier 26 to the usual procedure number.
X5 Diagnostic services requested by another clinician: for reporting services by a clinician who furnishes care to the patient only as requested by another clinician or subsequent and related services requested by another clinician; this modifier is reported for patient relationships that may not be adequately captured by the above alternative categories; reporting clinician service examples include but are not limited to, the radiologist's interpretation of an imaging study requested by another clinician
TC Technical component; under certain circumstances, a charge may be made for the technical component alone; under those circumstances the technical component charge is identified by adding modifier 'tc' to the usual procedure number; technical component charges are institutional charges and not billed separately by physicians; however, portable x-ray suppliers only bill for technical component and should utilize modifier tc; the charge data from portable x-ray suppliers will then be used to build customary and prevailing profiles
59 Distinct procedural service: under certain circumstances, it may be necessary to indicate that a procedure or service was distinct or independent from other non-e/m services performed on the same day. modifier 59 is used to identify procedures/services, other than e/m services, that are not normally reported together, but are appropriate under the circumstances. documentation must support a different session, different procedure or surgery, different site or organ system, separate incision/excision, separate lesion, or separate injury (or area of injury in extensive injuries) not ordinarily encountered or performed on the same day by the same individual. however, when another already established modifier is appropriate it should be used rather than modifier 59. only if no more descriptive modifier is available, and the use of modifier 59 best explains the circumstances, should modifier 59 be used. note: modifier 59 should not be appended to an e/m service. to report a separate and distinct e/m service with a non-e/m service performed on the same date, see modifier 25.
51 Multiple procedures: when multiple procedures, other than e/m services, physical medicine and rehabilitation services or provision of supplies (eg, vaccines), are performed at the same session by the same individual, the primary procedure or service may be reported as listed. the additional procedure(s) or service(s) may be identified by appending modifier 51 to the additional procedure or service code(s). note: this modifier should not be appended to designated "add-on" codes (see appendix d).
GC This service has been performed in part by a resident under the direction of a teaching physician
XU Unusual non-overlapping service, the use of a service that is distinct because it does not overlap usual components of the main service
GA Waiver of liability statement issued as required by payer policy, individual case
Q6 Service furnished under a fee-for-time compensation arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area
CR Catastrophe/disaster related
XS Separate structure, a service that is distinct because it was performed on a separate organ/structure
AQ Physician providing a service in an unlisted health professional shortage area (hpsa)
XE Separate encounter, a service that is distinct because it occurred during a separate encounter
GW Service not related to the hospice patient's terminal condition
X4 Episodic/focused services: for reporting services by clinicians who provide focused care on particular types of treatment limited to a defined period and circumstance; the patient has a problem, acute or chronic, that will be treated with surgery, radiation, or some other type of generally time-limited intervention; reporting clinician service examples include but are not limited to, the orthopedic surgeon performing a knee replacement and seeing the patient through the postoperative period
Q5 Service furnished under a reciprocal billing arrangement by a substitute physician or by a substitute physical therapist furnishing outpatient physical therapy services in a health professional shortage area, a medically underserved area, or a rural area
77 Repeat procedure by another physician or other qualified health care professional: it may be necessary to indicate that a basic procedure or service was repeated by another physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 77 to the repeated procedure or service. note: this modifier should not be appended to an e/m service.
GV Attending physician not employed or paid under arrangement by the patient's hospice provider
GZ Item or service expected to be denied as not reasonable and necessary
LT Left side (used to identify procedures performed on the left side of the body)
Q1 Routine clinical service provided in a clinical research study that is in an approved clinical research study
RT Right side (used to identify procedures performed on the right side of the body)
52 Reduced services: under certain circumstances a service or procedure is partially reduced or eliminated at the discretion of the physician or other qualified health care professional. under these circumstances the service provided can be identified by its usual procedure number and the addition of modifier 52, signifying that the service is reduced. this provides a means of reporting reduced services without disturbing the identification of the basic service. note: for hospital outpatient reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well-being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use).
53 Discontinued procedure: under certain circumstances, the physician or other qualified health care professional may elect to terminate a surgical or diagnostic procedure. due to extenuating circumstances or those that threaten the well being of the patient, it may be necessary to indicate that a surgical or diagnostic procedure was started but discontinued. this circumstance may be reported by adding modifier 53 to the code reported by the individual for the discontinued procedure. note: this modifier is not used to report the elective cancellation of a procedure prior to the patient's anesthesia induction and/or surgical preparation in the operating suite. for outpatient hospital/ambulatory surgery center (asc) reporting of a previously scheduled procedure/service that is partially reduced or cancelled as a result of extenuating circumstances or those that threaten the well being of the patient prior to or after administration of anesthesia, see modifiers 73 and 74 (see modifiers approved for asc hospital outpatient use).
56 Preoperative management only: when 1 physician or other qualified health care professional performed the preoperative care and evaluation and another performed the surgical procedure, the preoperative component may be identified by adding modifier 56 to the usual procedure number.
57 Decision for surgery: an evaluation and management service that resulted in the initial decision to perform the surgery may be identified by adding modifier 57 to the appropriate level of e/m service.
58 Staged or related procedure or service by the same physician or other qualified health care professional during the postoperative period: it may be necessary to indicate that the performance of a procedure or service during the postoperative period was: (a) planned or anticipated (staged); (b) more extensive than the original procedure; or (c) for therapy following a surgical procedure. this circumstance may be reported by adding modifier 58 to the staged or related procedure. note: for treatment of a problem that requires a return to the operating/procedure room (eg, unanticipated clinical condition), see modifier 78.
76 Repeat procedure or service by same physician or other qualified health care professional: it may be necessary to indicate that a procedure or service was repeated by the same physician or other qualified health care professional subsequent to the original procedure or service. this circumstance may be reported by adding modifier 76 to the repeated procedure or service. note: this modifier should not be appended to an e/m service.
79 Unrelated procedure or service by the same physician or other qualified health care professional during the postoperative period: the individual may need to indicate that the performance of a procedure or service during the postoperative period was unrelated to the original procedure. this circumstance may be reported by using modifier 79. (for repeat procedures on the same day, see modifier 76.)
93 Synchronous telemedicine service rendered via telephone or other real-time interactive audio-only telecommunications system : synchronous telemedicine service is defined as a real-time interaction between a physician or other qualified health care professional and a patient who is located away at a distant site from the physician or other qualified health care professional. the totality of the communication of information exchanged between the physician or other qualified health care professional and the patient during the course of the synchronous telemedicine service must be of an amount and nature that is sufficient to meet the key components and/or requirements of the same service when rendered via a face-to-face interaction.
95 Synchronous telemedicine service rendered via a real-time interactive audio and video telecommunications system: synchronous telemedicine service is defined as a real-time interaction between a physician or other qualified health care professional and a patient who is located at a distant site from the physician or other qualified health care professional. the totality of the communication of information exchanged between the physician or other qualified health care professional and the patient during the course of the synchronous telemedicine service must be of an amount and nature that would be sufficient to meet the key components and/or requirements of the same service when rendered via a face-to-face interaction. modifier 95 may only be appended to the services listed in appendix p. appendix p is the list of cpt codes for services that are typically performed face-to-face, but may be rendered via a real-time (synchronous) interactive audio and video telecommunications system.
AM Physician, team member service
CC Procedure code change (use 'cc' when the procedure code submitted was changed either for administrative reasons or because an incorrect code was filed)
ET Emergency services
FY X-ray taken using computed radiography technology/cassette-based imaging
GF Non-physician (e.g. nurse practitioner (np), certified registered nurse anesthetist (crna), certified registered nurse (crn), clinical nurse specialist (cns), physician assistant (pa)) services in a critical access hospital
GK Reasonable and necessary item/service associated with a ga or gz modifier
GQ Via asynchronous telecommunications system
GX Notice of liability issued, voluntary under payer policy
GY Item or service statutorily excluded, does not meet the definition of any medicare benefit or, for non-medicare insurers, is not a contract benefit
JZ Zero drug amount discarded/not administered to any patient
KX Requirements specified in the medical policy have been met
MA Ordering professional is not required to consult a clinical decision support mechanism due to service being rendered to a patient with a suspected or confirmed emergency medical condition
MC Ordering professional is not required to consult a clinical decision support mechanism due to the significant hardship exception of electronic health record or clinical decision support mechanism vendor issues
ME The order for this service adheres to appropriate use criteria in the clinical decision support mechanism consulted by the ordering professional
MG The order for this service does not have applicable appropriate use criteria in the qualified clinical decision support mechanism consulted by the ordering professional
MH Unknown if ordering professional consulted a clinical decision support mechanism for this service, related information was not provided to the furnishing professional or provider
PD Diagnostic or related non diagnostic item or service provided in a wholly owned or operated entity to a patient who is admitted as an inpatient within 3 days
Q0 Investigational clinical service provided in a clinical research study that is in an approved clinical research study
Q3 Live kidney donor surgery and related services
QJ Services/items provided to a prisoner or patient in state or local custody, however the state or local government, as applicable, meets the requirements in 42 cfr 411.4 (b)
SA Nurse practitioner rendering service in collaboration with a physician
U2 Medicaid level of care 2, as defined by each state
U6 Medicaid level of care 6, as defined by each state
UD Medicaid level of care 13, as defined by each state
UH Services provided in the evening
X1 Continuous/broad services: for reporting services by clinicians, who provide the principal care for a patient, with no planned endpoint of the relationship; services in this category represent comprehensive care, dealing with the entire scope of patient problems, either directly or in a care coordination role; reporting clinician service examples include, but are not limited to: primary care, and clinicians providing comprehensive care to patients in addition to specialty care
XP Separate practitioner, a service that is distinct because it was performed by a different practitioner
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2011-01-01 Changed Short description changed.
2007-01-01 Changed Code description changed.
2002-01-01 Changed Code description changed.
Pre-1990 Added Code added.
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