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See a sample rate comparisonCPT 76816 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 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
| 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 76816 |
| Medicaid Fee Schedule | View Medicaid rates for 76816 |
National average reimbursement for CPT 76816 by major payers:
$130.20
$130.11
$140.78
$157.41
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CPT 76816
5 of 25 sample ratesHigher to lower in this preview
Audra Meadows
Healing The Soul
$435.44Published rateAmir Fassihi
$182.00Published rateChristopher Raio
Good Samaritan Hosptial Medical Center
$104.28Published rateRussell Perry Md, A Medical Corporation
Russell Perry Md A Medical Corporation
$79.00Published rateStephanie Bousquet
Rochester General Hospital
$37.25Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 76816 vs. Other Diagnostic Ultrasound Procedures Codes
The CPT 76816 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 76816 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 |
| 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 |
| 76817-CPT | Low | Ultrasou Pregnant Uterus Real Time W/ Image Documnt Trans, Ultrasound Pregnant Uterus Real Time With Image Documentation Trans |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 76816. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 76816 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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