CPT code 76816: Obstetric ultrasound, follow-up, each fetus2026 Medicare rate & RVUs

Medicare pays $111.22 for 76816 nationally in the office. Local office rates run $98.88–$149.67.

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

What 76816 covers

CPT 76816 covers a transabdominal follow-up ultrasound of the pregnant uterus, reported for each fetus evaluated. It is commonly used when a clinician needs interval assessment of fetal growth or amniotic fluid, such as during surveillance for suspected growth concerns or after a prior study identified a finding requiring reassessment. An obstetrician, maternal-fetal medicine specialist, or radiologist may perform and interpret the diagnostic study; a sonographer may acquire the images under the provider’s direction.

Report this code for a follow-up examination, not as a substitute for a complete initial survey or a limited examination addressing a narrower question. The record should support the reason for reassessment and document the fetus-specific measurements and findings, with the interpretation and image documentation. CMS recognizes separately priced professional and technical components: modifier 26 identifies interpretation, modifier TC identifies equipment and staff, and billing without either 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 76816 pays more and less

The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.

109 of 109 payment localities

76816 rates by state

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

How the 76816 rate is calculated

Each of 76816’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.

Payment rules and modifiers for 76816

The CMS indicators that decide how 76816 is paid alongside other services.

What modifiers do to the payment

When to use modifier 26

76816 compared with similar codes

How to choose

76805Obstetric ultrasoundSingle fetus, 14 weeks or later

76805 is the standard complete obstetric survey; 76816 is a follow-up study reassessing growth, fluid, or a previously evaluated finding.

76815Obstetric ultrasoundLimited assessment

76815 is limited to a focused question or portion of the examination. Choose 76816 when the service is a follow-up reassessment rather than a limited study.

76811Obstetric ultrasoundDetailed single gestation

76811 is a detailed fetal anatomic examination. It is selected for that comprehensive targeted survey, not simply for interval monitoring.

76810Obstetric ultrasound14 weeks or later

76810 covers a standard complete survey of an additional fetus; 76816 reports follow-up reassessment for each fetus evaluated.

Codes related to 76816

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

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

Open CMS sourceHow we calculate rates