CPT 76814 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 |
National average reimbursement for CPT 76814 by major payers:
$93.94
$94.52
$97.78
$123.99
| 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 76814 | ||||||
United | 76814 | $97.91 | 1346507662 - ESOHE OHUOBA | 204923281 - MEMORIAL HERMANN MEDICAL GROUP | TX | Obstetrics & Gynecology Physician (207V00000X) |
United | 76814 | $92.12 | 1184761728 - PHYSICIANS EDUCATIONAL FOUNDATION, FAMILY MEDICAL CENTER-UT | 741896474 - (TX) PHYSICIANS EDUCATIONAL FOUNDATION | TX | Family Medicine Physician (207Q00000X) |
United | 76814 | $108.51 | 1285899237 - MARY TOLCHER | 741613878 - (TX) BAYLOR COLLEGE OF MEDICINE | TX | Maternal & Fetal Medicine Physician (207VM0101X) |
United | 76814 | $111.23 | 1235540154 - SHONTREL COOPER | 381358164 - SPECTRUM HEALTH PRIMARY CARE PARTNERS | MI | Maternal & Fetal Medicine Physician (207VM0101X) |
United | 76814 | $127.09 | 1730357039 - SINA HAERI | 431598353 - SAINT LUKES PHYSICIAN GROUP INC | CA | Maternal & Fetal Medicine Physician (207VM0101X) |
United | 76814 | $96.72 | 1922531755 - STEPHANIE GUO | 760459500 - U T PHYSICIANS | TX | Anesthesiologist Assistant (367H00000X) |
United | 76814 | $96.72 | 1568506210 - CHRISTOPHER STEPHENS | 760459500 - U T PHYSICIANS | MD | Anesthesiology Physician (207L00000X) |
United | 76814 | $92.12 | 1821293499 - HAILEY HALL | 260834681 - (TX) TEXAS CHILDRENS PHYSICIAN GROUP | TX | Maternal & Fetal Medicine Physician (207VM0101X) |
United | 76814 | $96.72 | 1134547680 - SEAN KELLY | 760459500 - U T PHYSICIANS | GA | Anesthesiology Physician (207L00000X) |
United | 76814 | $96.76 | 1477917870 - TOM VALIKODATH | 760459500 - U T PHYSICIANS | TX | Pediatric Cardiology Physician (2080P0202X) |
United | 76814 | $116.55 | 1740572361 - ERIC BERGH | 760459500 - U T PHYSICIANS | TX | Maternal & Fetal Medicine Physician (207VM0101X) |
United | 76814 | $92.12 | 1447330782 - TERESA DURYEA | 260834681 - (TX) TEXAS CHILDRENS PHYSICIAN GROUP | TX | Pediatrics Physician (208000000X) |
United | 76814 | $88.41 | 1316309560 - ASHLEY GIBSON | 760459500 - U T PHYSICIANS | TX | Pediatrics Physician (208000000X) |
United | 76814 | $92.12 | 1528441482 - JESSICA FRONTIERO | 260834681 - (TX) TEXAS CHILDRENS PHYSICIAN GROUP | TX | Nurse Practitioner (363L00000X) |
United | 76814 | $271.00 | 1235101106 - SUBHASHINI VALAVALKAR | 752740653 - (TX) MAGELLA MEDICAL ASSOCIATES BILLING INC | TX | Pediatrics Physician (208000000X) |
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 76814 vs. Other Diagnostic Ultrasound Procedures Codes
The CPT 76814 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 76814 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 |
|---|---|---|
| 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 |
| 76814-CPT | Low | 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) |
| 76815-CPT | Low | Ultrasound Pregnant Uterus Real Time With Image Documentation Limited (Eg Fetal Heart Beat Placental Location Fetal Position And/Or Qualitativeamniotic Fluid Volume) One Or More Fetuses. (Desc Rev 1/1/03) |
| 76816-CPT | Low | Ultrasound Pregnant Uterus Real Time With Image Documentation; Follow-Up (Eg Re-Evaluation Of Fetal Size By Measuring Standard Growth Parameters And Amniotic Fluid Volume Re-Evaluation Of Organ System(S) Suspected Or Confirmed To Be Abnormal On A Previous Scan) Transabdominal Approach Per Fetus (Desc Rev 1/1/03) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 76814. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 76814 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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