CPT code 76817: OB ultrasound, transvaginal approach2026 Medicare rate & RVUs in Missouri
Reports real-time obstetric ultrasound performed through the vagina to evaluate a pregnancy, including early pregnancy location or viability when clinically indicated.
Medicare pays $83.59–$89.65 for 76817 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 76817 covers
This service uses an endovaginal ultrasound transducer to obtain real-time images of the pregnant uterus and related structures. It is commonly performed in an obstetric or gynecologic office, emergency department, or hospital imaging setting, often when early pregnancy structures are not adequately assessed abdominally or when a closer view is needed. A sonographer may acquire the images, with a qualified practitioner interpreting the study and documenting the findings.
Report 76817 when the documented obstetric examination uses the transvaginal route; the approach and clinical question should be clear in the record and supported by the images and interpretation. It may be reported with a transabdominal obstetric study when both distinct examinations are performed and documented. CMS recognizes professional and technical components: modifier 26 identifies interpretation, modifier TC identifies equipment and staff, 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 76817 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
$83.59 to $89.65
| Payment locality | Office | Facility |
|---|---|---|
| Metropolitan Kansas City, MO | $88.74 | Unavailable |
| Metropolitan St. Louis, MO | $89.65 | Unavailable |
| Rest of Missouri | $83.59 | Unavailable |
How the 76817 rate is calculated
Each of 76817’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 · 76817
RVUs × geographic indexes × conversion factor
Work0.73
0.73 RVUs× 1.000 GPCI
Practice expense2.00
2.00 RVUs× 1.000 GPCI
Malpractice0.05
0.05 RVUs× 1.000 GPCI
Adjusted RVUs
2.7800
Conversion factor
$33.4009
Medicare rate
$92.85
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 76817
The CMS indicators that decide how 76817 is paid alongside other services.
CMS payment indicators · 76817
OB ultrasound, transvaginal approach
| 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
76817 without 26 · national office
$92.85
OB ultrasound, transvaginal approach
76817-26 · Professional component
$35.40
Pays only the interpretation and report.
76817 compared with similar codes
Compare codes · National
5 codes, side by side
How to choose
- 76801Obstetric ultrasoundUnder 14 weeks, single fetus
- 76801 is a first-trimester transabdominal obstetric examination. Choose 76817 for the transvaginal examination; both can be appropriate when both approaches are performed and documented.
- 76830Pelvic ultrasoundTransvaginal, nonobstetric
- 76830 describes transvaginal pelvic ultrasound outside an obstetric examination. Use 76817 when the study evaluates a pregnancy.
- 76815Obstetric ultrasoundLimited assessment
- 76815 is selected for a limited obstetric ultrasound. 76817 identifies an obstetric examination performed transvaginally, not simply a limited study.
- 76816Obstetric ultrasoundFollow-up, each fetus
- 76816 describes follow-up obstetric ultrasound assessment per fetus. 76817 is distinguished by its transvaginal approach, not by follow-up status.
76817 billing questions
How is 76817 different from 76801?
76817 identifies an obstetric examination performed transvaginally. 76801 is a first-trimester transabdominal obstetric examination; both may be reported when both approaches are performed and documented.
Can 76817 be reported with a transabdominal obstetric ultrasound?
Yes, when the transabdominal and transvaginal examinations are both medically indicated, actually performed, and separately supported by the record. Document the approach and findings for each.
Which modifiers identify the components?
Use modifier 26 for the professional interpretation and modifier TC for the technical service, including equipment and staff. Without either modifier, the claim represents the global service.
When should 76830 be used instead?
76830 is for a transvaginal pelvic ultrasound in a non-obstetric context. Use 76817 when the transvaginal examination is an obstetric study of a pregnancy.
What documentation supports 76817?
The record should identify the pregnancy-related reason for the examination, the transvaginal approach, and the findings in the interpretation. Retain the study images and report.
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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