CPT 76811 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 • TC - Technical component |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 76811 |
National average reimbursement for CPT 76811 by major payers:
$211.76
$224.94
$239.03
$276.83
| 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 76811 | ||||||
United | 76811 | $156.00 | 1518450113 - JOHN WILLIAMS | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Hospitalist Physician (208M00000X) |
United | 76811 | $345.00 | 1356755433 - PETER LASATER | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | MI | Orthopaedic Surgery Physician (207X00000X) |
United | 76811 | $189.00 | 1881909315 - BRENT MORROW | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Physical Therapist (225100000X) |
United | 76811 | $84.08 | 1952350001 - LORI MCNEAL | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Obstetrics & Gynecology Physician (207V00000X) |
United | 76811 | $96.72 | 1093751091 - STEPHEN TANN | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | NV | Cardiovascular Disease Physician (207RC0000X) |
United | 76811 | $156.00 | 1922379023 - BOCEIFUS MEDLIN | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Certified Registered Nurse Anesthetist (367500000X) |
United | 76811 | $345.00 | 1780930172 - RAM NARAYAN | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Neurology Physician (2084N0400X) |
United | 76811 | $84.08 | 1801888433 - HARSH SINGH | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Neurology Physician (2084N0400X) |
United | 76811 | $189.00 | 1821377607 - DANIEL CHOW | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | ID | Certified Registered Nurse Anesthetist (367500000X) |
United | 76811 | $156.00 | 1376017459 - NICHOLAS FINLINSON | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | IL | Certified Registered Nurse Anesthetist (367500000X) |
United | 76811 | $180.80 | 1679845531 - DANA HEMSTREET | 451471722 - (AL) BAMA HEART DOC, PC DBA ALABAMA HEART & VASCULAR MEDICINE | AL | Family Nurse Practitioner (363LF0000X) |
United | 76811 | $692.92 | 1558577676 - JEANNINE SCHUMAN MCCOY | 752740653 - (TX) MAGELLA MEDICAL ASSOCIATES BILLING INC | TX | Pediatric Cardiology Physician (2080P0202X) |
United | 76811 | $156.00 | 1992851828 - YU HUANG | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Critical Care Medicine (Internal Medicine) Physician (207RC0200X) |
United | 76811 | $345.00 | 1518645563 - DANIELLE SWEETS | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | AZ | Occupational Therapist (225X00000X) |
United | 76811 | $156.00 | 1477993103 - MAGDY HANNA | 742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION | MI | Cardiovascular Disease Physician (207RC0000X) |
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 |
Want to see your competitors' rates?
Start your trial today to unlock complete access to provider rates and fee schedules in your area.
Here's what you can do with PayerPrice
Renegotiate your managed care contracts
Benchmark your current rates against market averages to identify opportunities for rate optimization.
Prospect for new business using fee schedules
Access every provider's negotiated rates for every billing code in your market to inform your prospecting strategies.
Integrate real-time payer data into your workflows
Automatically keep fee schedules up-to-date without adding yet another log-in to your insurance systems. Connect via API or SQL.
PayerPrice shows you the exact negotiated rates that insurers publish under federal transparency rules.
We display the raw data directly from insurers' files, giving you the same information they make public. Learn more about Price Transparency.
CPT 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 | Ultrasound Pregnant Uterus Real Time With Image Documentation Fetal And Maternal Evaluation After First Trimester (> Or = 14 Weeks 0 Days) Transabdominal Approach; Single Or First Gestation. (Desc Rev 1/1/03). |
| 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 |
| 76813-CPT | Low | Ultrasound, Pregnant Uterus, Real Time With Image Documentation, First Trimester Fetal Nuchal Translucency Measurement, Transabdominal Or Transvaginal 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 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.
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 76811) and we'll show you how you compare in 15 minutes or less.