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See a sample rate comparisonCPT 76831 Fee Schedule
Medicare rates as of October 2026
CPT 76831 is classified under Radiology Procedures, in the Diagnostic Ultrasound Procedures subgroup.
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 | Radiology Procedures Diagnostic Ultrasound Procedures |
| Common Place of Service | 11 - Office 19 - Off Campus Outpatient Hospital |
| Common Modifiers | 26 - Professional component 59 - Distinct Procedural Service |
| Complexity Level | Low |
| Medicare Fee Schedule | $117.24 national non-facility rate (2026) · View Medicare rates for 76831 |
| Medicaid Fee Schedule | $94.615 median of the 8 states in the free preview · View Medicaid rates for 76831 |
National average reimbursement for CPT 76831 by major payers:
$140.47
BCBS / Anthem
$138.32
UnitedHealthcare
$151.53
Aetna
$168.05
Cigna
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CPT 76831
5 of 25 sample ratesHigher to lower in this preview
Michelle Uaje
$476.10Published rateGiana Craig
Physicians For Women'S Health, LLC
$162.05Published rateBenjamin Kuo
Northern Arizona Healthcare Corporation
$119.37Published rateJennifer Burke
Northern Arizona Healthcare Corporation
$84.44Published ratePatricia Wright
Town Center Orthopaedic Associates, P.C.
$37.93Published rate
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Payer Contract Negotiation
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See a sample payer proposalCPT 76831 vs. Other Diagnostic Ultrasound Procedures Codes
The table lists codes related to 76831. Select one to see its fee schedule.
| 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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Frequently Asked Questions
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.
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.
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.
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.
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.
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.
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.