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See a sample rate comparisonCPT 76811 Fee Schedule
Last Verified: September 2026
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.
Ob Us Detailed Sngl Fetus, Ultrasound Pregnant Uterus Real Time With Image Documentation Fetal And Maternal Evaluation Plus Detailed Fetal Anatomic Examination Transabdominal Approach Single Or First Gestation
| 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 TC - Technical component |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 76811 |
| Medicaid Fee Schedule | View Medicaid rates for 76811 |
National average reimbursement for CPT 76811 by major payers:
$211.76
$224.94
$239.03
$267.59
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CPT 76811
5 of 25 sample ratesHigher to lower in this preview
Jeannine Schuman Mccoy
Magella Medical Associates Billing Inc
$692.92Published rateBrian Andrew
Northern Arizona Healthcare Corporation
$207.38Published rateJohn Mougin
Northern Arizona Healthcare Corporation
$180.80Published rateTamarah Fratianni
Northern Arizona Healthcare Corporation
$156.00Published rateHarsh Singh
Northern Arizona Healthcare Corporation
$84.08Published rate
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See a sample payer proposalCPT 76811 vs. Other Diagnostic Ultrasound Procedures Codes
The CPT 76811 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 76811 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 |
|---|---|---|
| 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 |
| 76811-CPT | Moderate | Ob Us Detailed Sngl Fetus, Ultrasound Pregnant Uterus Real Time With Image Documentation Fetal And Maternal Evaluation Plus Detailed Fetal Anatomic Examination Transabdominal Approach Single Or First Gestation |
| 76815-CPT | Low | Ob Us Limited Fetus S, Ultrasound Pregnant Uterus Real Time With Image Documentation Limited Eg Fetal Heart Beat Placental Location Fetal Position And Or Qualitative Amniotic Fluid Volume 1 Or More Fetuses |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 76811. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 76811 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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