CPT 76802 Fee Schedule
Healthcare 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 • 22 - On Campus Outpatient Hospital |
| Common Modifiers | • None • 26 - Professional component • 59 - Distinct Procedural Service |
| Complexity Level | Low |
| Medicare Fee Schedule | View Medicare rates for 76802 |
National average reimbursement for CPT 76802 by major payers:
$75.84
$79.45
$83.47
$95.78
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
Select a payer to view fee schedule data Choose a payer from the options above to see rates for CPT 76802 | ||||||
United | 76802 | $91.83 | 1184783516 - HASSAN HARIRAH | 760010407 | TX | Maternal & Fetal Medicine Physician (207VM0101X) |
United | 76802 | $85.47 | 1467904797 - WILLIAM TANNER | 260834681 - (TX) TEXAS CHILDRENS PHYSICIAN GROUP | TX | Surgical Physician Assistant (363AS0400X) |
United | 76802 | $85.47 | 1477513174 - WESLEY LEE | 260834681 - (TX) TEXAS CHILDRENS PHYSICIAN GROUP | TX | Maternal & Fetal Medicine Physician (207VM0101X) |
United | 76802 | $72.66 | 1942381926 - BAHA SIBAI | 311405915 | TX | Maternal & Fetal Medicine Physician (207VM0101X) |
United | 76802 | $85.47 | 1346673530 - BRANDY WELLS | 260834681 - (TX) TEXAS CHILDRENS PHYSICIAN GROUP | TX | Nurse Practitioner (363L00000X) |
United | 76802 | $186.02 | 1083768576 - JENNIFER JONES | 752740653 - (TX) MAGELLA MEDICAL ASSOCIATES BILLING INC | TX | Pediatrics Physician (208000000X) |
United | 76802 | $62.50 | 1982692984 - JOY SHEPPARD | 550853118 - CENTRAL TEXAS COMMUNITY HEALTH CENTERS | TX | Maternal & Fetal Medicine Physician (207VM0101X) |
United | 76802 | $85.47 | 1982380333 - JULIA MOORHEAD | 260834681 - (TX) TEXAS CHILDRENS PHYSICIAN GROUP | TX | Medical Physician Assistant (363AM0700X) |
United | 76802 | $111.58 | 1326120734 - ANGELA EARHART | 452820649 - (TX) ANGELA EARHART PA | TX | Maternal & Fetal Medicine Physician (207VM0101X) |
United | 76802 | $85.47 | 1740465830 - DEBORAH MITCHELL | 260834681 - (TX) TEXAS CHILDRENS PHYSICIAN GROUP | TX | Neonatal Nurse Practitioner (363LN0000X) |
United | 76802 | $85.47 | 1144957440 - CASEY FONTENOT | 260834681 - (TX) TEXAS CHILDRENS PHYSICIAN GROUP | TX | Family Nurse Practitioner (363LF0000X) |
United | 76802 | $221.38 | 1679769392 - AMY BIRCHFIELD | 752740653 - (TX) MAGELLA MEDICAL ASSOCIATES BILLING INC | TX | Neonatal Nurse Practitioner (363LN0000X) |
United | 76802 | $69.16 | 1902875958 - ERIN KOSTER | 260256863 - (TX) ERIN L KOSTER MD PA | TX | Maternal & Fetal Medicine Physician (207VM0101X) |
United | 76802 | $85.47 | 1811936941 - ERIK SHULTZ | 260834681 - (TX) TEXAS CHILDRENS PHYSICIAN GROUP | TX | Obstetrics & Gynecology Physician (207V00000X) |
United | 76802 | $158.11 | 1083981021 - STACEY COLE | 752740653 - (TX) MAGELLA MEDICAL ASSOCIATES BILLING INC | LA | Nurse Practitioner (363L00000X) |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
United | 99202 | $100.00 | 1234567890 | 1234567890 | CA | Cardiologist |
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CPT 76802 vs. Other Diagnostic Ultrasound Procedures Codes
The CPT 76802 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 76802 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 | 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 | 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) |
| 76810-CPT | Low | 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 (Listseparately In Addition To Code For Primary Procedure Performed (Desc Rev 1/1/03) |
| 76811-CPT | Moderate | Ultrasound, Pregnant Uterus, Real Time With Image Documentation, Fetal And Maternal Evaluation Plus Detailed Fetal Anatomic Examination, Transabdominal Approach; Single Or First Gestation |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 76802. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 76802 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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