Practice economics · Family medicine · CY2026

What is a POCUS program actually worth to your practice?

The POCUS Revenue Estimator models annual reimbursement and work RVUs from your practice setting, code mix, payer mix and exam volume — built on CY2026 Medicare benchmarks and negotiated rates pooled from a national sample of U.S. hospitals.

Answer four questions and walk away with a spreadsheet, or a printable business-case document with the ranges already in it.

Get started Open the Revenue Estimator How it works

Runs entirely in your browser. Nothing you enter is uploaded or stored.

Why we built this

We know POCUS improves patient care. We also know POCUS requires real infrastructure investment — machines, training, image storage, workflow, protected time. Those two facts have to meet somewhere.

This tool exists so local family medicine leaders can plan that investment and make the business case for it. The clinical argument is usually the easy part; the question that stalls a program is the one asked across a table by someone holding a budget. It deserves an answer built from published fee schedules and real negotiated rates rather than a guess.

How it works

Everything recalculates as you go, so you can watch what actually moves the number — which is usually the practice setting and the payer mix, not the volume.

Pick a billing model

Where the scan happens decides who bills what, and it is the biggest lever in the whole model.

System-owned clinic — the hospital bills the technical component, the physician bills the professional
Independent clinic — you bill the global rate, both components together
Inpatient

Then set national or state-specific rates, a contract position across the P10–P90 range, and your payer mix — or start from a preset: young suburban 70/20/10, community FM 50/30/20, rural / safety-net 30/35/35.

Pick codes, or pick exams

Two ways in, depending on whether you think in CPT codes or in clinical work.

Codes first — choose from the 27-code panel directly; hover any code for its full descriptor and the POCUS applications that use it
Applications first — pick the studies you actually perform and the matching codes are added for you

Handy when the person you are presenting to thinks in exams and the person approving it thinks in codes.

Set your volume

Again two ways, so you can model a program you already run or one you are proposing.

Volume + share — one annual total, split across codes by percentage
Count per code — an explicit yearly count for each code

A revenue-versus-volume curve shows the whole range at once, so "what if we only hit half of that?" is answered before anyone asks it.

What you walk out with

On screen: projected professional revenue, technical revenue and work RVUs per year, broken out by CPT code and by payer, with P10–P90 ranges shown alongside every estimate. Then export it in whichever form the conversation needs.

A spreadsheet

CSV of the full per-code projection — volumes, professional and technical fees, payer split, work RVUs. Open it in Excel or Sheets and keep modelling, or hand it to a finance office that would like to check the arithmetic itself.

A business-case document

Print or save as PDF and you get a formatted report rather than a screenshot: scenario assumptions, the clinical applications selected, revenue by payer, the code mix, the revenue-versus-volume curve, and the full methodology and data sources appended — so the document holds up when you are not in the room to explain it.

If billing is not your world

Three ideas carry most of the model. The tool explains each of them in place, but they are worth having before you start.

modifier TC

Technical component

The cost of performing the scan — equipment, supplies, sonographer or staff time, facility overhead. Billed by whoever owns the equipment and the site. In a hospital-owned clinic that is the hospital, not you.

modifier 26

Professional component

The physician's interpretation of the images, plus the documented, retrievable report. Billed by the interpreting physician — this is the part that follows you regardless of who owns the machine.

no modifier

Global

Technical and professional together, billed when one party both performs and interprets the study — an independent office practice, typically. This is why the practice-setting question changes the answer so much.

POCUS has no billing code set of its own. The same diagnostic ultrasound CPT codes used in radiology — commonly the "limited" studies — are used for point-of-care ultrasound, so the same technical / professional split applies. That is the whole reason a model like this can be built at all.

Where the numbers come from

Every figure traces to a published source. The tool carries the full methodology in its own FAQ — per-state multipliers, contract distributions, and the hospitals contributing data in each state. This is the short version.

2,619

hospitals contributing commercial-contract rates

1,617

hospitals contributing Medicaid-contract rates

961,703

distinct negotiated-rate observations behind the percentiles

ultrasound CPT codes in the panel

Component	Vintage	Source
Hospital negotiated technical (facility) rates national, state and hospital level	2025	Trilliant Health price-transparency (MRF) dataset
Medicare professional (PFS, modifier 26) and technical (OPPS) benchmarks	CY2026	Current Medicare fee schedules; RVU × $33.4009 conversion factor
Commercial professional fees	2022	State commercial-to-Medicare price ratios — Blavin & Holahan, JAMA Health Forum — applied to the current CY2026 PFS
Medicaid professional fees	2024	Medicaid-to-Medicare fee index ("other services") — Urban Institute / KFF — applied to the current CY2026 PFS

Read the ranges, not the point estimate

Individual hospital contracts vary substantially — one hospital's average technical rate can sit well below the Medicare OPPS benchmark while another's sits several times above it. Medians are the defaults, but the contract-position slider exists precisely so you can model where your institution actually sits, and P10–P90 ranges are shown with every estimate. Two of the sources are applied as ratios against a current base rather than as raw dollars, so the dollar base is current while the underlying state-level relationships carry their own vintage and may have shifted since. All figures are national-unadjusted (geographic index = 1.0). This is a planning tool, not a reimbursement guarantee.