CPT 76830 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 | Diagnostic Ultrasound Procedures of the Pelvis Non-Obstetrical Diagnostic Ultrasound Procedures of the Pelvis |
| 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 76830 |
National average reimbursement for CPT 76830 by major payers:
$140.66
$139.62
$154.37
$168.01
| Payer | Code | Rate | NPI | Tax ID | State | Specialty |
|---|---|---|---|---|---|---|
United | 76830 | $64.43 | 1649275249 - MARLYNN NUNEZ | 593443182 - WOMENS CARE FLORIDA, LLP | FL | Obstetrics & Gynecology Physician (207V00000X) |
United | 76830 | $47.15 | 1477520039 - VIVIAN SONE | 264709927 - WESTCHESTER MEDICAL CENTER ADVANCED PHYSICIAN SERVICES, P.C | NY | Obstetrics & Gynecology Physician (207V00000X) |
United | 76830 | $47.18 | 1386613891 - SUSAN ROITMAN | 223693606 - REGIONAL WOMEN'S HEALTH GROUP, LLC | PA | Obstetrics & Gynecology Physician (207V00000X) |
United | 76830 | $67.36 | 1568769180 - MARTIN HALLAM | 273276948 - (FL) LAKEWOOD RANCH URGENT CARE PA / MANATEE PHYSICIAN ALLIANCE LLC / NORTH RIVER FAMILY HEALTH CENTER PA | FL | Obstetrics & Gynecology Physician (207V00000X) |
United | 76830 | $61.54 | 1609122449 - SHEREEN VILLAMOR | 274174339 - CINDY BROWN CNM LLC / HYGGE WELLNESS PLLC / KELLY A PALUMBO MD PC | VA | Obstetrics Physician (207VX0000X) |
United | 76830 | $130.07 | 1649272972 - CAROLYN QUIST | 752945483 - CAROLYN W QUIST, DO, PA | TX | Obstetrics & Gynecology Physician (207V00000X) |
United | 76830 | $36.72 | 1508177718 - SOLAFA ELSHATANOUFY | 822768899 - BEAUMONT MEDICAL GROUP - HOSPITAL-BASED SERVICES | TX | Female Pelvic Medicine and Reconstructive Surgery (Obstetrics & Gynecology) Physician (207VF0040X) |
United | 76830 | $100.05 | 1366510844 - ROBERT DARROW | 830368785 - (TX) GLEN LAKES OB GYN PA | TX | Obstetrics & Gynecology Physician (207V00000X) |
United | 76830 | $366.23 | 1689682015 - ANTONIO CARLOS WESTPHALEN | 912047402 | WA | Diagnostic Radiology Physician (2085R0202X) |
United | 76830 | $102.20 | 1275987406 - ANITA MADISON | 520595110 - JOHNS HOPKINS UNIVERSITY | TX | Obstetrics & Gynecology Physician (207V00000X) |
United | 76830 | $47.31 | 1063995710 - TEMPLE FACULTY PRACTICE PLAN, INC, TEMPLE FACULTY GYN/ONCOLOGY ASSOCIATES | 831002191 - TEMPLE FACULTY PRACTICE PLAN INC | PA | Gynecologic Oncology Physician (207VX0201X) |
United | 76830 | $125.23 | 1417055476 - COREY JUDD | 916001009 | WA | Diagnostic Radiology Physician (2085R0202X) |
United | 76830 | $235.27 | 1073502985 - CHU CHEN | 42484572 - MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC. | MA | Pediatrics Physician (208000000X) |
United | 76830 | $55.45 | 1851397954 - JOSEPH MALONEY | 231352152 - ABINGTON MEMORIAL HOSPITAL | PA | Gynecology Physician (207VG0400X) |
United | 76830 | $71.94 | 1730395179 - PAUL KIDDER | 542183222 | MO | Obstetrics & Gynecology Physician (207V00000X) |
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 76830 vs. Other Diagnostic Ultrasound Procedures of the Pelvis Codes
The CPT 76830 code is part of the Diagnostic Ultrasound Procedures of the Pelvis Non-Obstetrical services used for Diagnostic Ultrasound Procedures of the Pelvis. 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 76830 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 |
|---|---|---|
| 76830-CPT | Low | Vaginal Ultrasound, Ultrasound (Sound Wave Images) Of The Reproductive System Taken By Inserting A Hand-Held Probe Into The Vagina. |
| 76831-CPT | Low | Uterus Ultrasound Enhanced, Ultrasound (Sound Wave Images) Taken Of The Uterus. Saltwater (Saline) Is Given To Highlight Parts Of The Video. |
| 76856-CPT | Low | Ultrasou Pelvic (Nonobstetric) Real Time W/ Image Documnt;, Ultrasound Pelvic (Nonobstetric) Real Time With Image Documentation; |
| 76857-CPT | Low | Echography Pelvic (Nonobstetr, Echography Pelvic (Nonobstetric) B-Scan Andor Real Timewith Image Documentation Limited Or Follow-Up (Eg For Follicles) |
What is a fee schedule?
A fee schedule is a list of fixed prices that healthcare providers charge for specific services, including CPT 76830. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.
Understanding the 76830 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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