How can I find out the cost of a medical procedure before I get it?

You can often ask your healthcare provider for an estimate or a 'Good Faith Estimate' under the No Surprises Act. For more specific, localized pricing information based on CPT codes and your specific location, you can utilize tools like Payerprice, which offers a fee schedule lookup.

What is a CPT code, and why is it important for understanding costs?

CPT (Current Procedural Terminology) codes are standardized codes used by healthcare professionals to describe medical, surgical, and diagnostic services. They are crucial for understanding costs because they provide a universal identifier for specific procedures, allowing you to search for and compare prices accurately using tools like Payerprice.

Where can I compare prices for healthcare services?

To compare prices for healthcare services based on CPT codes and your specific location, you can use specialized tools like Payerprice, which has a fee schedule lookup tool. Many insurance companies also offer price comparison tools for their in-network providers, and some state health departments or non-profit organizations may provide general cost information.

Why are healthcare prices so difficult to understand?

Healthcare prices are complex due to several factors, including the involvement of multiple payers (insurers, government programs), varying negotiated rates between providers and insurers, lack of transparency in pricing data, and the intricate system of billing codes. Tools like Payerprice aim to bring more clarity by providing specific fee schedule data for CPT codes and locations.

What's the difference between a negotiated rate and a billed charge?

A 'billed charge' is the total amount a healthcare provider initially charges for a service. A 'negotiated rate' (or allowed amount) is the discounted price that an insurance company and a healthcare provider have agreed upon for a particular service. Patients with insurance typically pay a portion of the negotiated rate, while uninsured patients might be responsible for the billed charge or a discounted self-pay rate. For specific negotiated rates, tools like Payerprice can be valuable resources.

Can I get a good faith estimate for my medical care?

Yes, under the No Surprises Act, healthcare providers and facilities must provide you with a 'Good Faith Estimate' of expected charges if you are uninsured or choose not to use your insurance. You should request this estimate in advance of your service. For more granular detail on CPT code-specific pricing in your area, Payerprice can offer additional insights.

How can I look up specific fee schedules for medical procedures?

For specific fee schedules based on CPT codes and your location, you can use tools designed for this purpose. Payerprice offers a fee schedule lookup tool where you can search with a CPT code and specific location to find relevant pricing information.

CPT 76831 Fee Schedule

Q: What factors 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.

Last Verified: July 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.

Uterus Ultrasound Enhanced, Ultrasound (Sound Wave Images) Taken Of The Uterus. Saltwater (Saline) Is Given To Highlight Parts Of The Video.

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 19 - Off Campus Outpatient Hospital
Common Modifiers	None 26 - Professional component 59 - Distinct Procedural Service
Complexity Level	Low
Medicare Fee Schedule	View Medicare rates for 76831

National average reimbursement for CPT 76831 by major payers:

$140.47

$138.32

$151.53

$168.05

Preview provider-level rates for...

For billing codeCPT 76831

Payer	Code	Rate	NPI	Tax ID	State	Specialty
United	76831	$67.94	1811000177 - CHARLESTON RADIOLOGISTS PA	570634747 - CHARLESTON RADIOLOGISTS, P.A.	SC	Single Specialty Group (193400000X)
United	76831	$87.32	1073502985 - CHU CHEN	42484572 - MERRIMACK VALLEY PEDIATRIC ASSOCIATES, INC.	MA	Pediatrics Physician (208000000X)
United	76831	$162.05	1992199228 - GIANA CRAIG	61483728 - PHYSICIANS FOR WOMEN'S HEALTH, LLC	CT	Obstetrics & Gynecology Physician (207V00000X)
United	76831	$115.28	1851768337 - KELLY RIDGES	362925195 - ALLERGY & ASTHMA OF DUPAGE, S.C.	IL	Family Nurse Practitioner (363LF0000X)
United	76831	$58.81	1659633725 - GARY MORRIS	742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION	AZ	Neurology with Special Qualifications in Child Neurology Physician (2084N0402X)
United	76831	$139.78	1285160069 - MITCHELL SEMAN	742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION	AZ	Anesthesiology Physician (207L00000X)
United	76831	$44.88	1386721033 - JOHN BUTTARI	541383504 - TOWN CENTER ORTHOPAEDIC ASSOCIATES, P.C.	VA	Physical Therapist (225100000X)
United	76831	$44.53	1255478004 - CHRISTOPHER RAIO	113438973 - ST JOSEPH HOSPITAL	NY	Emergency Medicine Physician (207P00000X)
United	76831	$178.73	1811000177 - CHARLESTON RADIOLOGISTS PA	570634747 - CHARLESTON RADIOLOGISTS, P.A.	SC	Diagnostic Radiology Physician (2085R0202X)
United	76831	$114.16	1245778992 - SARAH BERNSTEIN	541383504 - TOWN CENTER ORTHOPAEDIC ASSOCIATES, P.C.	VA	Occupational Therapist (225X00000X)
United	76831	$476.10	1659427649 - MICHELLE UAJE	954377219	CA	Obstetrics & Gynecology Physician (207V00000X)
United	76831	$121.26	1508829912 - ALGIMANTAS JECIUS	742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION	AZ	Surgery Physician (208600000X)
United	76831	$155.05	1578653028 - TONJA HARRIS-STANSIL	680287629	CA	Obstetrics & Gynecology Physician (207V00000X)
United	76831	$37.93	1972530996 - PATRICIA WRIGHT	541383504 - TOWN CENTER ORTHOPAEDIC ASSOCIATES, P.C.	VA	Occupational Therapist (225X00000X)
United	76831	$198.60	1184912867 - NICOLAUS HAWBAKER	742410946 - NORTHERN ARIZONA HEALTHCARE CORPORATION	AZ	Emergency Medicine Physician (207P00000X)
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 76831 vs. Other Diagnostic Ultrasound Procedures of the Pelvis Codes

The CPT 76831 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 76831 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 76831. These prices vary depending on payer type (Medicare, Medicaid, private insurance), geographic location, and provider contracts.

Understanding the 76831 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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