CPT code 76805: Obstetric ultrasound, single fetus, 14 weeks or later2026 Medicare rate & RVUs in Missouri
Reports a standard transabdominal obstetric ultrasound for one fetus at 14 weeks or later, including fetal and maternal evaluation with image documentation.
Medicare pays $121.91–$131.09 for 76805 in the office in Missouri, from Rest of Missouri to Metropolitan St. Louis, MO. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
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On this page 9 sections
What 76805 covers
This service is a standard transabdominal ultrasound for evaluating a pregnancy with one fetus at 14 weeks or later. A sonographer acquires and documents the images; an obstetrician, radiologist, or other qualified practitioner interprets them. It is commonly used for a second-trimester fetal survey and may assess fetal number and presentation, placental location, amniotic fluid, fetal measurements, and anatomy appropriate to the examination. A targeted, detailed fetal anomaly evaluation is a different service.
Report 76805 for the standard examination when the pregnancy is at least 14 weeks and one fetus is evaluated. The report and retained images should support the gestational age, the single-fetus examination, the clinical reason, and the findings assessed. For a multiple gestation, this code represents the first fetus; 76810 is the add-on for each additional fetus. CMS recognizes professional and technical components: modifier 26 identifies the interpretation, modifier TC identifies the equipment-and-staff service, and no modifier represents the global service.
This summary was written with AI assistance from CMS physician fee schedule data and checked against the CMS billing rules shown here. Rates on this page come directly from CMS files.
Where 76805 pays more and less in Missouri
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
3 payment localities
$121.91 to $131.09
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | $129.71 | Unavailable |
| Metropolitan St. Louis, MO | $131.09 | Unavailable |
| Rest of Missouri | $121.91 | Unavailable |
How the 76805 rate is calculated
Each of 76805’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 76805
RVUs × geographic indexes × conversion factor
Work0.97
0.97 RVUs× 1.000 GPCI
Practice expense3.03
3.03 RVUs× 1.000 GPCI
Malpractice0.07
0.07 RVUs× 1.000 GPCI
Adjusted RVUs
4.0700
Conversion factor
$33.4009
Medicare rate
$135.94
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 76805
The CMS indicators that decide how 76805 is paid alongside other services.
CMS payment indicators · 76805
Obstetric ultrasound, single fetus, 14 weeks or later
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 1 | Diagnostic test with separate professional (26) and technical (TC) components. |
What modifiers do to the payment
Modifier 26 · payment effect
With and without the modifier
76805 without 26 · national office
$135.94
Obstetric ultrasound, single fetus, 14 weeks or later
76805-26 · Professional component
$47.10
Pays only the interpretation and report.
76805 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 76801Obstetric ultrasoundUnder 14 weeks, single fetus
- Both describe standard obstetric ultrasound examinations, but 76801 is for before 14 weeks; 76805 is for 14 weeks or later.
- 76810Obstetric ultrasound14 weeks or later
- 76810 reports each additional fetus in a multiple gestation; 76805 reports the first fetus.
- 76811Obstetric ultrasoundDetailed single gestation
- 76811 is for a detailed fetal anatomic examination. Use 76805 for the standard evaluation when a detailed study is not performed.
- 76816Obstetric ultrasoundFollow-up, each fetus
- 76816 describes a follow-up study per fetus, while 76805 describes the standard examination at 14 weeks or later.
76805 billing questions
When should 76805 be used instead of 76801?
Use 76805 for a standard obstetric ultrasound at 14 weeks or later. Code 76801 is for the corresponding standard examination before 14 weeks.
How is an additional fetus reported?
Report 76805 for the first fetus and 76810 for each additional fetus evaluated. Documentation should identify the gestation and findings for each fetus.
When is 76811 more appropriate?
Use 76811 when a detailed fetal anatomic examination is performed, rather than the standard evaluation represented by 76805. The examination performed and documented determines the code.
How should the professional and technical work be billed?
Use modifier 26 for the professional interpretation and modifier TC for the technical service. Billing without either modifier represents the global service.
What documentation supports 76805?
The record should support gestational age, the single-fetus evaluation, the reason for the study, and the findings and images from the examination, such as fetal measurements and relevant maternal and fetal observations.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense and malpractice RVUs, adjusted by each locality’s geographic indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
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