The use of ultrasound (US) to assist in liverbiopsy for nonfocal liver disease has been shown tosignificantly decrease the incidence of minorcomplications (defined as pain requiring treatment,hypotension, or bleeding). In this study, decision analysiswas used to estimate the average additional net chargefor US guidance. The risks for minor and majorcomplications were extracted from the literature. The incidence of minor complications such as painand bleeding not requiring hospitalization has beenreported as 49% for blind liver biopsy and 39% forUS-guided liver biopsy. Major complications requiring hospital admission occur in 4% of blind liverbiopsies and 2% of US-guided liver biopsies. A decisiontree was used to calculate the total charges of liverbiopsy and its associated complications. The charge for treating an episode of minor complicationswas estimated at $605. The charge related to an episodeof major complications was estimated at $1533. The totalcharge for an ultrasoundguided liver biopsy (except the added charge for the use ofultrasound) was $1770, or $102 less than the same chargefor blind liver biopsy. The addition of ultrasound inperforming liver biopsies for diffuse parenchymal liver disease is cost-saving if the additional chargeof US is less than $102.