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See a sample rate comparisonCPT 76812 Fee Schedule
CPT 76812 is classified under Radiology Procedures, in the Diagnostic Ultrasound Procedures subgroup.
Ob Us Detailed Addl Fetus, Ultrasound Pregnant Uterus Real Time With Image Documentation Fetal And Maternal Evaluation Plus Detailed Fetal Anatomic Examination Transabdominal Approach Each Additional Gestation List Separately In Addition To Code For Primary Procedure
| Key Fact | Detail |
|---|---|
| Service Type | Radiology Procedures Diagnostic Ultrasound Procedures |
| Common Place of Service | 11 - Office 22 - On Campus Outpatient Hospital |
| Common Modifiers | 26 - Professional component 59 - Distinct Procedural Service |
| Complexity Level | Moderate |
| Medicare Fee Schedule | View Medicare rates for 76812 |
| Medicaid Fee Schedule | $157.275 median of the 8 states in the free preview · View Medicaid rates for 76812 |
National average reimbursement for CPT 76812 by major payers:
$218.96
BCBS / Anthem
$229.99
UnitedHealthcare
$234.13
Aetna
$278.53
Cigna
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CPT 76812
5 of 25 sample ratesHigher to lower in this preview
Perlita Sambrano-Tandoc
Magella Medical Associates Billing Inc
$915.60Published rateGustavo Grieco
Memorial Hermann Medical Group
$254.89Published rateBrandon Okeefe Rafaeli
U T Physicians
$244.41Published rateAbsalon Gutierrez
U T Physicians
$215.77Published rateMedina Oikeh
Texas Childrens Physician Group
$204.28Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 76812 vs. Other Diagnostic Ultrasound Procedures Codes
The table lists codes related to 76812. Select one to see its fee schedule.
| Code | Complexity | Description |
|---|---|---|
| 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 |
| 76812-CPT | Moderate | Ob Us Detailed Addl Fetus, Ultrasound Pregnant Uterus Real Time With Image Documentation Fetal And Maternal Evaluation Plus Detailed Fetal Anatomic Examination Transabdominal Approach Each Additional Gestation List Separately In Addition To Code For Primary Procedure |
| 76813-CPT | Low | Ultrasound Fetal Development, An Ultrasound (Sound Wave) Image Of The Developing Fetus Inside The Uterus Done Either On The Moms Belly Or Inserted Into The Vagina To Measure The Amount Of Fluid Behind The Fetus Neck Which Is An Early Indicator For Fetal Abnormalities. |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 76812. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 76812 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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