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CPT code 76811: Obstetric ultrasound, detailed single gestation2026 Medicare rate & RVUs in Puerto Rico

Detailed obstetric ultrasound evaluates fetal anatomy and maternal-fetal status in a single gestation, typically when a comprehensive structural survey is indicated.

CMS RVU26DEffective Oct 1, 2026One payment locality2.8K Medicare services in 2024

In Puerto Rico, Medicare pays $183.26 for 76811 in the office.

$183.26Office (non-facility)
Not available in this settingHospital or facility
+0.7%vs the national office rate ($182.03)

Check a contract rate as a % of Medicare · 76811 nationwide

Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.

We’ll open 76811 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Puerto Rico
  2. What 76811 covers
  3. Compared with other areas
  4. Rate map
  5. How it’s calculated
  6. Payment rules
  7. Related codes
  8. Rate history
  9. Where it applies
  10. Billing questions
  11. Sources

What 76811 covers

This transabdominal ultrasound provides a detailed survey of fetal anatomy along with maternal and fetal evaluation. It is commonly performed in the mid-trimester when a structural anomaly is suspected, a prior pregnancy involved a fetal anomaly, or screening findings support a comprehensive anatomic assessment. Obstetric sonographers acquire and document the images; an obstetrician, maternal-fetal medicine specialist, or radiologist interprets the study and reports the findings.

Select this code for a detailed anatomic examination of one gestation, rather than a routine complete survey, a limited study, or a follow-up scan. The report should document the examination performed, image findings, and clinical reason for the detailed assessment. CMS recognizes professional and technical components: append modifier 26 for interpretation only, modifier TC for equipment and staff only, or bill without either modifier for the global service when both components are furnished. For multiple gestations, 76812 describes the detailed examination of an additional fetus.

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.

How Puerto Rico compares for 76811

Across 109 of 109 payment localities, the office rate for 76811 runs from $163.82 in Arkansas to $238.65 in San Benito County, CA. Puerto Rico pays $183.26. The RVUs are the same everywhere; the geographic indexes change the dollars.

76811 in Puerto Rico vs other payment areas
  1. Puerto Rico · this page$183.26
  2. Los Angeles, CA · California$204.67+$21.41
  3. Washington, DC area · District of Columbia$206.54+$23.28
  4. Miami, FL · Florida$192.43+$9.17
  5. Chicago, IL · Illinois$187.81+$4.55
  6. Manhattan, NY · New York$207.03+$23.77
  7. Alaska · Alaska$218.86+$35.60

Other areas in Puerto Rico first, then benchmark localities. Bars start at $0.

Every other payment area

76811 in every other Medicare payment locality
Payment localityOfficeFacility
AlabamaAlabama$165.87—
ArkansasArkansas$163.82—
ArizonaArizona$177.89—
Bakersfield, CACalifornia$192.96—
Chico, CACalifornia$192.57—
El Centro, CACalifornia$192.59—
Fresno, CACalifornia$192.57—
Hanford, CACalifornia$192.57—

76811 rates by state

Office rate range in each state. Select a state to see its payment localities.

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

Explore a state

Local rates. Clear comparisons.

Hover or focus a tile to see its rate range. Select it to open the state’s fee schedule.

$163.82

$218.86

Color shows the midpoint of each state’s locality range.

View every state and territory as a table
76811 office rate range by state
State / territoryOffice rate rangeLocalities
AK$218.861
AL$165.871
AR$163.821
AZ$177.891
CA$192.57–$238.6529
CO$189.431
CT$193.021
DC$206.541
DE$180.571
FL$178.75–$192.433
GA$170.15–$184.822
GU$196.461
HI$196.461
IA$169.911
ID$170.771
IL$173.96–$188.454
IN$171.641
KS$169.021
KY$168.781
LA$168.48–$175.662
MA$188.46–$206.782
MD$183.75–$206.543
ME$171.32–$179.632
MI$172.37–$180.482
MN$182.831
MO$165.85–$176.453
MS$164.871
MT$182.031
NC$172.901
ND$179.851
NE$170.771
NH$186.351
NJ$195.59–$204.832
NM$173.101
NV$181.541
NY$175.12–$211.175
OH$171.921
OK$168.741
OR$180.48–$195.022
PA$172.27–$188.642
PR$183.261
RI$186.661
SC$172.621
SD$179.601
TN$169.731
TX$171.28–$188.508
UT$174.671
VA$178.97–$206.542
VI$183.261
VT$179.051
WA$188.14–$210.912
WI$174.601
WV$168.351
WY$181.081

See 76811 in every payment locality

How the 76811 rate is calculated

Each of 76811’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 · 76811

RVUs × geographic indexes × conversion factor

Office or facility?

Work1.85

1.85 RVUs× 1.000 GPCI

Practice expense3.49

3.49 RVUs× 1.000 GPCI

Malpractice0.11

0.11 RVUs× 1.000 GPCI

Adjusted RVUs

5.4500

Conversion factor

$33.4009

Medicare rate

$182.03

Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.

The exact Puerto Rico inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

8,775

Code
76811
Physician work
1.85
Practice expense
3.49
Malpractice
0.11

GPCI2026.csv

91

Locality
Puerto Rico
Physician work
1.000
Practice expense
1.011
Malpractice
0.985
Office calculation for 76811 in Puerto Rico
ComponentRVULocality factorAdjusted
Physician work1.85× 1.0001.8500
Practice expense3.49× 1.0113.5284
Malpractice0.11× 0.9850.1084
Total RVUs5.4867
Conversion factor× 33.4009

Office rate, Puerto Rico$183.26

Office: (1.85 × 1 + 3.49 × 1.011 + 0.11 × 0.985) × $33.4009 = $183.26

Open 76811 in the RVU calculator

Payment rules and modifiers for 76811

The CMS indicators that decide how 76811 is paid alongside other services.

CMS payment indicators · 76811

Obstetric ultrasound, detailed single gestation

RuleCMS valueWhat it means
Global periodXXXThe global surgery concept doesn’t apply.
Multiple procedures0No multiple-procedure reduction.
Bilateral (modifier 50)0The 150% bilateral adjustment doesn’t apply.
Assistant at surgery (80/81/82/AS)0Not paid without supporting documentation.
Co-surgeons (62)0Not permitted.
Team surgery (66)0Not permitted.
Professional/technical1Diagnostic test with separate professional (26) and technical (TC) components.

What modifiers do to the payment

Modifier 26 · payment effect

With and without the modifier

76811 without 26 · national office

$182.03

Obstetric ultrasound, detailed single gestation

76811-26 · Professional component

$90.52

Pays only the interpretation and report.

When to use modifier 26

Codes related to 76811

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 76811
CodeHow it relatesOffice range, Puerto Rico
Add-on codes
76812Detailed OB ultrasound, each additional fetusAdd-on code for the detailed anatomic examination of an additional fetus.$195.81
Used instead
76805Obstetric ultrasound, single fetus, 14 weeks or laterRoutine complete obstetric ultrasound at or after 14 weeks, rather than a detailed survey.$137.02
76816Obstetric ultrasound, follow-up, each fetusFollow-up obstetric ultrasound when reassessing growth or previously evaluated findings.$112.10
76813Nuchal translucency, single or first gestationNuchal translucency measurement for a first-trimester screening examination.$116.36
76801Obstetric ultrasound, under 14 weeks, single fetusRoutine obstetric ultrasound for a single fetus before 14 weeks.$117.78

How 76811 has changed in Puerto Rico

76811 · Office / nonfacility

$183.26

Effective 2026-10-01

The base rate is $10.46 higher than on 2025-10-01, moving from $172.80 to $183.26 (6.1%).

It is unchanged from the immediately preceding available release, effective 2026-07-01.

Base rate by release · bars start at $0 · select a bar to compare

One bar per available release, ordered by effective date. Missing rates remain gaps. These comparisons hold the code, setting and locality identifiers constant; they do not isolate which policy or input caused a change.

What changed, release by release

  1. January 1, 2026

    RVU26A

    $172.80changed to$183.26

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 1.90 changed to 1.85
    • Practice expense RVU 3.35 changed to 3.49
    • Malpractice RVU 0.07 changed to 0.11
    • Practice expense GPCI 1.007 changed to 1.011
    • Malpractice GPCI 0.982 changed to 0.985

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $177.83changed to$172.80

    • Conversion factor 33.2875 changed to 32.3465

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $174.93changed to$177.83

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $179.43changed to$174.93

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 3.29 changed to 3.35
    • Malpractice RVU 0.08 changed to 0.07
    • Practice expense GPCI 1.008 changed to 1.007
    • Malpractice GPCI 0.984 changed to 0.982

  5. October 1, 2023

    RVU23D

    $178.59changed to$179.43

    • Practice expense GPCI 1.000 changed to 1.008
    • Malpractice GPCI 1.000 changed to 0.984

  6. January 1, 2023

    RVU23A

    $180.43changed to$178.59

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 3.18 changed to 3.29
    • Malpractice RVU 0.11 changed to 0.08
    • Practice expense GPCI 1.008 changed to 1.000
    • Malpractice GPCI 0.986 changed to 1.000

    Held through RVU23B, RVU23C.

  7. January 1, 2022

    RVU22A

    $180.55changed to$180.43

    • Conversion factor 34.8931 changed to 34.6062
    • Malpractice RVU 0.07 changed to 0.11

    Held through RVU22B, RVU22C, RVU22D.

  8. January 1, 2021

    RVU21A

    $181.65changed to$180.55

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 3.03 changed to 3.18
    • Malpractice RVU 0.08 changed to 0.07
    • Malpractice GPCI 0.988 changed to 0.986

    Held through RVU21B, RVU21C, RVU21D.

  9. January 1, 2020

    RVU20A

    $185.22changed to$181.65

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 3.04 changed to 3.03
    • Malpractice RVU 0.18 changed to 0.08
    • Practice expense GPCI 1.007 changed to 1.008
    • Malpractice GPCI 0.990 changed to 0.988

    Held through RVU20B, RVU20C, RVU20D.

  10. January 1, 2019

    RVU19A

    $188.64changed to$185.22

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 3.14 changed to 3.04

    Held through RVU19B, RVU19C, RVU19D.

  11. January 1, 2018

    RVU18AR1

    $169.41changed to$188.64

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 3.16 changed to 3.14
    • Practice expense GPCI 0.856 changed to 1.007
    • Malpractice GPCI 0.642 changed to 0.990

    Held through RVU18B, RVU18C, RVU18D.

  12. January 1, 2017

    RVU17A

    $147.91changed to$169.41

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 3.09 changed to 3.16
    • Practice expense GPCI 0.705 changed to 0.856
    • Malpractice GPCI 0.293 changed to 0.642

    Held through RVU17B, RVU17C, RVU17D.

  13. January 1, 2016

    RVU16A

    $148.05changed to$147.91

    • Conversion factor 35.9335 changed to 35.8043
    • Practice expense RVU 3.07 changed to 3.09
    • Malpractice RVU 0.19 changed to 0.18

    Held through RVU16B, RVU16C, RVU16D.

  14. July 1, 2015

    RVU15C

    $147.31changed to$148.05

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  15. January 1, 2015

    RVU15A

    $149.71changed to$147.31

    • Conversion factor 35.8228 changed to 35.7547
    • Practice expense RVU 3.27 changed to 3.07
    • Malpractice RVU 0.06 changed to 0.19
    • Practice expense GPCI 0.692 changed to 0.705
    • Malpractice GPCI 0.271 changed to 0.293

    Held through RVU15B.

  16. January 1, 2014

    RVU14A

    $148.43changed to$149.71

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 3.61 changed to 3.27
    • Practice expense GPCI 0.678 changed to 0.692
    • Malpractice GPCI 0.249 changed to 0.271

    Held through RVU14B, RVU14C, RVU14D.

  17. January 1, 2013

    RVU13AR

    Earliest loaded release: $148.43

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$183.26Not available in this settingRVU26D
2026-07-01$183.26Not available in this settingRVU26C
2026-04-01$183.26Not available in this settingRVU26B
2026-01-01$183.26Not available in this settingRVU26A
2025-10-01$172.80Not available in this settingRVU25D
2025-07-01$172.80Not available in this settingRVU25C
2025-04-01$172.80Not available in this settingRVU25B
2025-01-01$172.80Not available in this settingRVU25A
2024-10-01$177.83Not available in this settingRVU24D
2024-07-01$177.83Not available in this settingRVU24C
2024-04-01$177.83Not available in this settingRVU24B
2024-03-09$177.83Not available in this settingRVU24AR
2024-01-01$174.93Not available in this settingRVU24A
2023-10-01$179.43Not available in this settingRVU23D
2023-07-01$178.59Not available in this settingRVU23C
2023-04-01$178.59Not available in this settingRVU23B
2023-01-01$178.59Not available in this settingRVU23A
2022-10-01$180.43Not available in this settingRVU22D
2022-07-01$180.43Not available in this settingRVU22C
2022-04-01$180.43Not available in this settingRVU22B
2022-01-01$180.43Not available in this settingRVU22A
2021-10-01$180.55Not available in this settingRVU21D
2021-07-01$180.55Not available in this settingRVU21C
2021-04-01$180.55Not available in this settingRVU21B
2021-01-01$180.55Not available in this settingRVU21A
2020-10-01$181.65Not available in this settingRVU20D
2020-07-01$181.65Not available in this settingRVU20C
2020-04-01$181.65Not available in this settingRVU20B
2020-01-01$181.65Not available in this settingRVU20A
2019-10-01$185.22Not available in this settingRVU19D
2019-07-01$185.22Not available in this settingRVU19C
2019-04-01$185.22Not available in this settingRVU19B
2019-01-01$185.22Not available in this settingRVU19A
2018-10-01$188.64Not available in this settingRVU18D
2018-07-01$188.64Not available in this settingRVU18C
2018-04-01$188.64Not available in this settingRVU18B
2018-01-01$188.64Not available in this settingRVU18AR1
2017-10-01$169.41Not available in this settingRVU17D
2017-07-01$169.41Not available in this settingRVU17C
2017-04-01$169.41Not available in this settingRVU17B
2017-01-01$169.41Not available in this settingRVU17A
2016-10-01$147.91Not available in this settingRVU16D
2016-07-01$147.91Not available in this settingRVU16C
2016-04-01$147.91Not available in this settingRVU16B
2016-01-01$147.91Not available in this settingRVU16A
2015-10-01$148.05Not available in this settingRVU15D
2015-07-01$148.05Not available in this settingRVU15C
2015-04-01$147.31Not available in this settingRVU15B
2015-01-01$147.31Not available in this settingRVU15A
2014-10-01$149.71Not available in this settingRVU14D
2014-07-01$149.71Not available in this settingRVU14C
2014-04-01$149.71Not available in this settingRVU14B
2014-01-01$149.71Not available in this settingRVU14A
2013-10-01$148.43Not available in this settingRVU13D
2013-07-01$148.43Not available in this settingRVU13C
2013-04-01$148.43Not available in this settingRVU13B
2013-01-01$148.43Not available in this settingRVU13AR

Price 76811 for an earlier date of service

Where the Puerto Rico rate applies

Puerto Rico is a Medicare payment area, not a city. Our Census mapping connects it to 292 cities and communities in Puerto Rico. Some span more than one payment area; confirm with the service ZIP.

  • Aceitunas
  • Adjuntas
  • Aguada
  • Aguadilla
  • Aguas Buenas
  • Aguas Claras
  • Aguilita
  • Aibonito

Browse all communities in Puerto Rico

76811 billing questions

How does this differ from 76805?

Use 76811 for a detailed fetal anatomic survey of a single gestation. Code 76805 describes a routine complete obstetric ultrasound at or after 14 weeks.

Can 76811 and 76805 be reported for the same examination?

Do not report both codes to describe the same complete examination. Choose the code that matches the documented scope: detailed anatomic assessment or routine complete survey.

How are the professional and technical services reported?

Report modifier 26 for the interpretation, modifier TC for the technical service, or neither modifier when billing the global service.

What code applies to an additional fetus in a multiple gestation?

Code 76812 describes the detailed anatomic examination for an additional fetus when 76811 is reported for the primary fetus.

What documentation supports selecting 76811?

Document the clinical reason for a detailed survey, the fetal anatomy evaluated, image findings, and the number of gestations examined.

When is 76816 a better fit?

Use 76816 for a follow-up obstetric ultrasound, such as reassessment of growth or previously evaluated findings, rather than a detailed anatomic survey.

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

Show the CMS file lines behind this rate
RVUs for 76811PPRRVU2026_Oct_nonQPP.csv, line 8,775 (RVU26D)
Geographic factors for Puerto RicoGPCI2026.csv, line 91 (RVU26D)

Open CMS sourceHow we calculate rates

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