CPT 76825 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 | Moderate |
| Medicare Fee Schedule | View Medicare rates for 76825 |
National average reimbursement for CPT 76825 by major payers:

$302.61

$291.87

$320.62

$372.95
| 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 76825 | ||||||
United | 76825 | $213.46 | 1871971440 - KATHERINE GUESS | 260834681 - (TX) TEXAS CHILDRENS PHYSICIAN GROUP | TX | Pediatric Emergency Medicine (Pediatrics) Physician (2080P0204X) |
United | 76825 | $420.75 | 1396906517 - BANI RATAN | 260834681 - (TX) TEXAS CHILDRENS PHYSICIAN GROUP | TX | Obstetrics & Gynecology Physician (207V00000X) |
United | 76825 | $306.07 | 1083765226 - GARY DILDY | 237246265 - SAINT FRANCIS MEDICAL CENTER | TX | Maternal & Fetal Medicine Physician (207VM0101X) |
United | 76825 | $213.46 | 1811084940 - PETER GRUBB | 260834681 - (TX) TEXAS CHILDRENS PHYSICIAN GROUP | UT | Neonatal-Perinatal Medicine Physician (2080N0001X) |
United | 76825 | $420.75 | 1861589806 - CLAUDEL JEAN-PIERRE | 260834681 - (TX) TEXAS CHILDRENS PHYSICIAN GROUP | TX | Maternal & Fetal Medicine Physician (207VM0101X) |
United | 76825 | $420.75 | 1982784245 - SHELDON KAPLAN | 260834681 - (TX) TEXAS CHILDRENS PHYSICIAN GROUP | TX | Pediatric Infectious Diseases Physician (2080P0208X) |
United | 76825 | $213.46 | 1417239484 - JANAI BUXTON | 260834681 - (TX) TEXAS CHILDRENS PHYSICIAN GROUP | TX | Surgical Physician Assistant (363AS0400X) |
United | 76825 | $213.46 | 1194729897 - ELLEN FRIEDMAN | 260834681 - (TX) TEXAS CHILDRENS PHYSICIAN GROUP | TX | Pediatric Otolaryngology Physician (207YP0228X) |
United | 76825 | $870.47 | 1144703463 - AUSTI ROBERTS | 752740653 - (TX) MAGELLA MEDICAL ASSOCIATES BILLING INC | TX | Family Nurse Practitioner (363LF0000X) |
United | 76825 | $213.46 | 1891099578 - OPAL WILLMON | 260834681 - (TX) TEXAS CHILDRENS PHYSICIAN GROUP | TX | Physician Assistant (363A00000X) |
United | 76825 | $281.75 | 1225318512 - AMIR SHAMSHIRSAZ | 300791563 | TX | Maternal & Fetal Medicine Physician (207VM0101X) |
United | 76825 | $213.46 | 1033532700 - VALERIE DEGREGORIO | 260834681 - (TX) TEXAS CHILDRENS PHYSICIAN GROUP | TX | Physician Assistant (363A00000X) |
United | 76825 | $420.75 | 1437352614 - AMARYLLIS ARRAUT | 650816256 - (TX) OBSTETRIX MEDICAL GROUP OF TEXAS BILLING INC | TX | Maternal & Fetal Medicine Physician (207VM0101X) |
United | 76825 | $420.75 | 1992234710 - HAYLEY CESTAFE | 260834681 - (TX) TEXAS CHILDRENS PHYSICIAN GROUP | TX | Physician Assistant (363A00000X) |
United | 76825 | $420.75 | 1215227475 - BLOSSOM ONAGHISE | 752740653 - (TX) MAGELLA MEDICAL ASSOCIATES BILLING INC | TX | Neonatal-Perinatal Medicine Physician (2080N0001X) |
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 76825 vs. Other Diagnostic Ultrasound Procedures Codes
The CPT 76825 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 76825 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 |
|---|---|---|
| 76818-CPT | Low | Fetal Biophysical Profile |
| 76819-CPT | Low | Fetal Biophysical Profile; Without Stress Or Non-Stress Testing |
| 76825-CPT | Moderate | Echocardiography, Fetal, Cardiovascular System, Real Time With Image Documentation (2d), With Or Without M-Mode Recording; |
| 76826-CPT | Low | Echocardiography, Fetal, Cardiovascular System, Real Time With Image Documentation (2d), With Or Without M-Mode Recording; Follow-Up Or Repeat Study |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 76825. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 76825 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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