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See a sample rate comparisonCPT 76815 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 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
| 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 | Low |
| Medicare Fee Schedule | View Medicare rates for 76815 |
| Medicaid Fee Schedule | View Medicaid rates for 76815 |
National average reimbursement for CPT 76815 by major payers:
$98.78
$101.51
$110.75
$120.81
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CPT 76815
5 of 25 sample ratesHigher to lower in this preview
Alexander Lin
Washington University Physicians In Illinois Inc
$357.16Published rateAnthony Richmond
$102.01Published rateChu Chen
Merrimack Valley Pediatric Associates, Inc.
$78.69Published rateTown Center Orthopaedic Associates, P.C.
$66.43Published rateNatalia Castro
Town Center Orthopaedic Associates, P.C.
$34.21Published rate
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See a sample payer proposalCPT 76815 vs. Other Diagnostic Ultrasound Procedures Codes
The CPT 76815 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 76815 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 |
| 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. |
| 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 |
| 76816-CPT | Low | Ob Us Follow Up Per Fetus, 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 |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 76815. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 76815 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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