Rate Benchmarking
Compare your rates with similar providers.
Select a published rate, define comparable providers, and see where that rate falls in your market.
See a sample rate comparisonCPT 76813 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.
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.
| 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 76813 |
| Medicaid Fee Schedule | View Medicaid rates for 76813 |
National average reimbursement for CPT 76813 by major payers:
$145.43
$144.92
$154.15
$181.16
Compare published rates across providers.
Choose a payer to see a sample of rates for CPT 76813.
CPT 76813
5 of 25 sample ratesHigher to lower in this preview
Jennie Garcia
$371.45Published ratePhilippa Ribbink
The Oregon Clinic, P.C.
$203.58Published rateJessica Bracken
Physicians Clinic Inc
$139.83Published rateMarissa Liveris
Allergy & Asthma Of Dupage, S.C.
$82.34Published rateLynikka Bernard-Roberts
$41.72Published rate
Get a free rate benchmark for your specialty.
Choose your state and specialty to build a report from payer-published rates.
Use market rates to prepare your payer proposal.
Payer Contract Negotiation
Draft a fee schedule renegotiation letter.
Use your fee schedule and market benchmarks to set target rates and draft a letter for your payer.
See a sample payer proposalCPT 76813 vs. Other Diagnostic Ultrasound Procedures Codes
The CPT 76813 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 76813 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 |
|---|---|---|
| 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. |
| 76814-CPT | Low | Ob Us Nuchal Meas Add On, Ultrasound Pregnant Uterus Real Time With Image Documentation First Trimester Fetal Nuchal Translucency Measurement Transabdominal Or Transvaginal 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 76813. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 76813 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.
FREE SAMPLE MARKET COMPARISON
Let's review your payer contracts side-by-side with the market.
Bring your top codes (like CPT 76813) and we'll show you how you compare in 15 minutes or less.