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See a sample rate comparisonHealthcare providers use this code to document and receive reimbursement for visits that address moderate-level medical decision-making, often including multiple diagnoses or prescription management.
| Key Fact | Detail |
|---|---|
| Service Type | Radiology Procedures Diagnostic Ultrasound Procedures |
| Common Place of Service | 11 - Office 23 - Emergency Room |
| Common Modifiers | None 26 - Professional component TC - Technical component |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 76801 |
| Medicaid Fee Schedule | View Medicaid rates for 76801 |
National average reimbursement for CPT 76801 by major payers:

$143.68

$146.41

$157.87

$175.71
Choose a payer to see a sample of rates for CPT 76801.
Bend Memorial Clinic, PC
Vidant Medical Group LLC
Allergy & Asthma Of Dupage, S.C.
UPMC Western Maryland Corporation
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Rate Benchmarking
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See a sample rate comparisonPayer Contract Negotiation
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See a sample payer proposalCPT 76801 vs. Other Diagnostic Ultrasound Procedures Codes
The CPT 76801 code is part of the Radiology Procedures services used for Diagnostic Ultrasound Procedures. It represents a moderate-complexity encounter and is one of several codes that vary based on time spent, level of medical decision-making, and documentation requirements.
The CPT 76801 code involves more provider time and moderate medical decision-making, unlike lower-level codes that require less time and simpler assessments. It typically includes multiple diagnoses, medication management, or test interpretation, leading to higher reimbursement and more detailed documentation requirements.
| Code | Complexity | Description |
|---|---|---|
| 76801-CPT | Low | Ob Us 14 Wks Single Fetus, Ultrasound Pregnant Uterus Real Time With Image Documentation Fetal And Maternal Evaluation First Trimester 14 Weeks 0 Days Transabdominal Approach Single Or First Gestation |
| 76802-CPT | Low | Ob Us 14 Wks Addl Fetus, Ultrasound Pregnant Uterus Real Time With Image Documentation Fetal And Maternal Evaluation First Trimester 14 Weeks 0 Days Transabdominal Approach Each Additional Gestation List Separately In Addition To Code For Primary Procedure |
| 76805-CPT | Low | Pelvic Ultrasound, Ultrasound Pregnant Uterus Real Time With Image Documentation; (Fetal And Maternal Evaluation) After First Trimester (Greater Than Or = 14 Weeks 0 Days) Transabdominal Approach; Single Or First Gestation |
| 76810-CPT | Low | Ob Us 14 Wks Addl Fetus, Ultrasound Pregnant Uterus Real Time With Image Documentation Fetal And Maternal Evaluation After First Trimester Or 14 Weeks 0 Days Transabdominal Approach Each Additional Gestation List Separately In Addition To Code For Primary Procedure |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 76801. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 76801 fee schedule helps patients estimate costs and providers optimize billing for accurate reimbursements.
Factors that affect fee schedules
Medicare & Medicaid Rates
Government-set reimbursement amounts
Private Insurance Rates
Negotiated rates between providers and insurance companies
Geographic Location
Costs may be higher in urban areas.
Provider Type
Hospital providers may have different rates than private practice.
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