CPT code 76817: OB ultrasound, transvaginal approach2026 Medicare rate & RVUs in South Dakota
Reports real-time obstetric ultrasound performed through the vagina to evaluate a pregnancy, including early pregnancy location or viability when clinically indicated.
In South Dakota, Medicare pays $91.75 for 76817 in the office.
Check a contract rate as a % of Medicare · 76817 nationwide
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 11 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.
How South Dakota compares for 76817
Across 109 of 109 payment localities, the office rate for 76817 runs from $82.63 in Arkansas to $124.29 in San Benito County, CA. South Dakota pays $91.75. The RVUs are the same everywhere; the geographic indexes change the dollars.
- South Dakota · this page$91.75
- Los Angeles, CA · California$105.52+$13.77
- Washington, DC area · District of Columbia$106.25+$14.50
- Miami, FL · Florida$98.15+$6.40
- Chicago, IL · Illinois$95.52+$3.77
- Manhattan, NY · New York$106.22+$14.47
- Alaska · Alaska$108.64+$16.89
Other areas in South Dakota first, then benchmark localities. Bars start at $0.
Every other payment area
| Payment locality | Office | Facility |
|---|---|---|
| AlabamaAlabama | $83.78 | — |
| ArkansasArkansas | $82.63 | — |
| ArizonaArizona | $90.54 | — |
| Bakersfield, CACalifornia | $99.08 | — |
| Chico, CACalifornia | $98.91 | — |
| El Centro, CACalifornia | $98.92 | — |
| Fresno, CACalifornia | $98.91 | — |
| Hanford, CACalifornia | $98.91 | — |
| Madera, CACalifornia | $98.91 | — |
| Merced, CACalifornia | $98.91 | — |
| Modesto, CACalifornia | $98.91 | — |
| Napa, CACalifornia | $114.81 | — |
| Oxnard, CACalifornia | $105.07 | — |
| Redding, CACalifornia | $98.91 | — |
| Rest of CaliforniaCalifornia | $98.91 | — |
| Riverside, CACalifornia | $99.46 | — |
| Sacramento, CACalifornia | $103.85 | — |
| Salinas, CACalifornia | $103.46 | — |
| San Diego, CACalifornia | $105.91 | — |
| Marin County, CACalifornia | $121.66 | — |
| San Francisco, CACalifornia | $121.60 | — |
| San Benito County, CACalifornia | $124.29 | — |
| Santa Clara County, CACalifornia | $124.06 | — |
| San Luis Obispo, CACalifornia | $101.78 | — |
| Santa Cruz, CACalifornia | $106.95 | — |
| Santa Maria, CACalifornia | $103.85 | — |
| Santa Rosa, CACalifornia | $108.04 | — |
| Stockton, CACalifornia | $98.91 | — |
| Vallejo, CACalifornia | $114.73 | — |
| Visalia, CACalifornia | $98.91 | — |
| Yuba City, CACalifornia | $98.91 | — |
| ColoradoColorado | $97.06 | — |
| ConnecticutConnecticut | $98.84 | — |
| DelawareDelaware | $92.01 | — |
| Fort Lauderdale, FLFlorida | $95.07 | — |
| Rest of FloridaFlorida | $90.76 | — |
| Atlanta, GAGeorgia | $94.33 | — |
| Rest of GeorgiaGeorgia | $85.96 | — |
| Hawaii, Guam, HIHawaii | $101.30 | — |
| IowaIowa | $86.17 | — |
| IdahoIdaho | $86.63 | — |
| East St. Louis, ILIllinois | $89.20 | — |
| Rest of IllinoisIllinois | $87.98 | — |
| Suburban Chicago, ILIllinois | $96.12 | — |
| IndianaIndiana | $87.12 | — |
| KansasKansas | $85.61 | — |
| KentuckyKentucky | $85.30 | — |
| New Orleans, LALouisiana | $89.14 | — |
| Rest of LouisianaLouisiana | $85.10 | — |
| Metropolitan Boston, MAMassachusetts | $106.63 | — |
| Rest of MassachusettsMassachusetts | $96.45 | — |
| Baltimore area, MDMaryland | $98.52 | — |
| Rest of MarylandMaryland | $93.76 | — |
| Rest of MaineMaine | $86.88 | — |
| Southern Maine, MEMaine | $91.64 | — |
| Detroit, MIMichigan | $91.66 | — |
| Rest of MichiganMichigan | $87.26 | — |
| MinnesotaMinnesota | $93.62 | — |
| Metropolitan Kansas City, MOMissouri | $88.74 | — |
| Metropolitan St. Louis, MOMissouri | $89.65 | — |
| Rest of MissouriMissouri | $83.59 | — |
| MississippiMississippi | $83.13 | — |
| MontanaMontana | $92.85 | — |
| North CarolinaNorth Carolina | $87.78 | — |
| North DakotaNorth Dakota | $91.86 | — |
| NebraskaNebraska | $86.67 | — |
| New HampshireNew Hampshire | $95.38 | — |
| Northern New JerseyNew Jersey | $105.19 | — |
| Rest of New JerseyNew Jersey | $100.14 | — |
| New MexicoNew Mexico | $87.65 | — |
| NevadaNevada | $92.64 | — |
| NYC suburbs and Long Island, NYNew York | $108.47 | — |
| Poughkeepsie and northern NYC suburbs, NYNew York | $100.65 | — |
| Queens, NYNew York | $107.31 | — |
| Rest of New YorkNew York | $89.02 | — |
| OhioOhio | $87.06 | — |
| OklahomaOklahoma | $85.33 | — |
| Portland, OROregon | $100.23 | — |
| Rest of OregonOregon | $92.09 | — |
| Metropolitan Philadelphia, PAPennsylvania | $96.35 | — |
| Rest of PennsylvaniaPennsylvania | $87.28 | — |
| Puerto RicoPuerto Rico | $93.56 | — |
| Rhode IslandRhode Island | $95.34 | — |
| South CarolinaSouth Carolina | $87.53 | — |
| TennesseeTennessee | $86.00 | — |
| Austin, TXTexas | $96.59 | — |
| Beaumont, TXTexas | $86.72 | — |
| Brazoria, TXTexas | $92.08 | — |
| Dallas, TXTexas | $92.57 | — |
| Fort Worth, TXTexas | $91.92 | — |
| Galveston, TXTexas | $92.29 | — |
| Houston, TXTexas | $93.21 | — |
| Rest of TexasTexas | $89.29 | — |
| UtahUtah | $88.68 | — |
| VirginiaVirginia | $91.23 | — |
| Virgin Islands, VIUnited States Virgin Islands | $93.56 | — |
| VermontVermont | $91.36 | — |
| Rest of WashingtonWashington | $96.31 | — |
| King County, WAWashington | $108.93 | — |
| WisconsinWisconsin | $88.89 | — |
| West VirginiaWest Virginia | $84.82 | — |
| WyomingWyoming | $92.42 | — |
76817 rates by state
Office rate range in each state. Select a state to see its payment localities.
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.
$82.63
$111.60
Color shows the midpoint of each state’s locality range.
View every state and territory as a table
| State / territory | Office rate range | Localities |
|---|---|---|
| AK | $108.64 | 1 |
| AL | $83.78 | 1 |
| AR | $82.63 | 1 |
| AZ | $90.54 | 1 |
| CA | $98.91–$124.29 | 29 |
| CO | $97.06 | 1 |
| CT | $98.84 | 1 |
| DC | $106.25 | 1 |
| DE | $92.01 | 1 |
| FL | $90.76–$98.15 | 3 |
| GA | $85.96–$94.33 | 2 |
| GU | $101.30 | 1 |
| HI | $101.30 | 1 |
| IA | $86.17 | 1 |
| ID | $86.63 | 1 |
| IL | $87.98–$96.12 | 4 |
| IN | $87.12 | 1 |
| KS | $85.61 | 1 |
| KY | $85.30 | 1 |
| LA | $85.10–$89.14 | 2 |
| MA | $96.45–$106.63 | 2 |
| MD | $93.76–$106.25 | 3 |
| ME | $86.88–$91.64 | 2 |
| MI | $87.26–$91.66 | 2 |
| MN | $93.62 | 1 |
| MO | $83.59–$89.65 | 3 |
| MS | $83.13 | 1 |
| MT | $92.85 | 1 |
| NC | $87.78 | 1 |
| ND | $91.86 | 1 |
| NE | $86.67 | 1 |
| NH | $95.38 | 1 |
| NJ | $100.14–$105.19 | 2 |
| NM | $87.65 | 1 |
| NV | $92.64 | 1 |
| NY | $89.02–$108.47 | 5 |
| OH | $87.06 | 1 |
| OK | $85.33 | 1 |
| OR | $92.09–$100.23 | 2 |
| PA | $87.28–$96.35 | 2 |
| PR | $93.56 | 1 |
| RI | $95.34 | 1 |
| SC | $87.53 | 1 |
| SD | $91.75 | 1 |
| TN | $86.00 | 1 |
| TX | $86.72–$96.59 | 8 |
| UT | $88.68 | 1 |
| VA | $91.23–$106.25 | 2 |
| VI | $93.56 | 1 |
| VT | $91.36 | 1 |
| WA | $96.31–$108.93 | 2 |
| WI | $88.89 | 1 |
| WV | $84.82 | 1 |
| WY | $92.42 | 1 |
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.
The exact South Dakota inputs and CMS source lines
PPRRVU2026_Oct_nonQPP.csv
8,793
- Code
- 76817
- Physician work
- 0.73
- Practice expense
- 2.00
- Malpractice
- 0.05
GPCI2026.csv
94
- Locality
- South Dakota
- Physician work
- 1.000
- Practice expense
- 1.000
- Malpractice
- 0.336
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.73 | × 1.000 | 0.7300 |
| Practice expense | 2.00 | × 1.000 | 2.0000 |
| Malpractice | 0.05 | × 0.336 | 0.0168 |
| Total RVUs | 2.7468 | ||
| Conversion factor | × 33.4009 | ||
Office rate, South Dakota$91.75
Office: (0.73 × 1 + 2 × 1 + 0.05 × 0.336) × $33.4009 = $91.75
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.
How 76817 has changed in South Dakota
76817 · Office / nonfacility
$91.75
Effective 2026-10-01
The base rate is $3.60 higher than on 2025-10-01, moving from $88.15 to $91.75 (4.1%).
It is unchanged from the immediately preceding available release, effective 2026-07-01.
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
January 1, 2026
RVU26A
$88.15changed to$91.75
- Conversion factor 32.3465 changed to 33.4009
- Work RVU 0.75 changed to 0.73
- Practice expense RVU 1.96 changed to 2.00
- Malpractice RVU 0.04 changed to 0.05
- Malpractice GPCI 0.382 changed to 0.336
Held through RVU26B, RVU26C, RVU26D.
January 1, 2025
RVU25A
$91.72changed to$88.15
- Conversion factor 33.2875 changed to 32.3465
- Practice expense RVU 1.99 changed to 1.96
Held through RVU25B, RVU25C, RVU25D.
March 9, 2024
RVU24AR
$90.22changed to$91.72
- Conversion factor 32.7442 changed to 33.2875
Held through RVU24B, RVU24C, RVU24D.
January 1, 2024
RVU24A
$93.47changed to$90.22
- Conversion factor 33.8872 changed to 32.7442
- Malpractice RVU 0.05 changed to 0.04
- Malpractice GPCI 0.364 changed to 0.382
January 1, 2023
RVU23A
$95.42changed to$93.47
- Conversion factor 34.6062 changed to 33.8872
- Malpractice GPCI 0.347 changed to 0.364
Held through RVU23B, RVU23C, RVU23D.
January 1, 2022
RVU22A
$97.26changed to$95.42
- Conversion factor 34.8931 changed to 34.6062
- Practice expense RVU 2.02 changed to 1.99
Held through RVU22B, RVU22C, RVU22D.
January 1, 2021
RVU21A
$96.53changed to$97.26
- Conversion factor 36.0896 changed to 34.8931
- Practice expense RVU 1.91 changed to 2.02
- Malpractice RVU 0.04 changed to 0.05
- Malpractice GPCI 0.368 changed to 0.347
Held through RVU21B, RVU21C, RVU21D.
January 1, 2020
RVU20A
$97.07changed to$96.53
- Conversion factor 36.0391 changed to 36.0896
- Practice expense RVU 1.92 changed to 1.91
- Malpractice RVU 0.06 changed to 0.04
- Malpractice GPCI 0.389 changed to 0.368
Held through RVU20B, RVU20C, RVU20D.
January 1, 2019
RVU19A
$98.40changed to$97.07
- Conversion factor 35.9996 changed to 36.0391
- Practice expense RVU 1.96 changed to 1.92
Held through RVU19B, RVU19C, RVU19D.
January 1, 2018
RVU18AR1
$98.47changed to$98.40
- Conversion factor 35.8887 changed to 35.9996
- Practice expense RVU 1.97 changed to 1.96
- Malpractice GPCI 0.395 changed to 0.389
Held through RVU18B, RVU18C, RVU18D.
January 1, 2017
RVU17A
$97.53changed to$98.47
- Conversion factor 35.8043 changed to 35.8887
- Practice expense RVU 1.95 changed to 1.97
- Malpractice GPCI 0.400 changed to 0.395
Held through RVU17B, RVU17C, RVU17D.
January 1, 2016
RVU16A
$97.67changed to$97.53
- Conversion factor 35.9335 changed to 35.8043
- Practice expense RVU 1.94 changed to 1.95
- Malpractice RVU 0.07 changed to 0.06
Held through RVU16B, RVU16C, RVU16D.
July 1, 2015
RVU15C
$97.18changed to$97.67
- Conversion factor 35.7547 changed to 35.9335
Held through RVU15D.
January 1, 2015
RVU15A
$101.97changed to$97.18
- Conversion factor 35.8228 changed to 35.7547
- Practice expense RVU 2.08 changed to 1.94
- Malpractice RVU 0.04 changed to 0.07
- Malpractice GPCI 0.416 changed to 0.400
Held through RVU15B.
January 1, 2014
RVU14A
No ratechanged to$101.97
Held through RVU14B, RVU14C, RVU14D.
January 1, 2013
RVU13AR
Earliest loaded release: No rate
Held through RVU13B, RVU13C, RVU13D.
| Effective from | Office | Facility | CMS release |
|---|---|---|---|
| 2026-10-01 | $91.75 | Not available in this setting | RVU26D |
| 2026-07-01 | $91.75 | Not available in this setting | RVU26C |
| 2026-04-01 | $91.75 | Not available in this setting | RVU26B |
| 2026-01-01 | $91.75 | Not available in this setting | RVU26A |
| 2025-10-01 | $88.15 | Not available in this setting | RVU25D |
| 2025-07-01 | $88.15 | Not available in this setting | RVU25C |
| 2025-04-01 | $88.15 | Not available in this setting | RVU25B |
| 2025-01-01 | $88.15 | Not available in this setting | RVU25A |
| 2024-10-01 | $91.72 | Not available in this setting | RVU24D |
| 2024-07-01 | $91.72 | Not available in this setting | RVU24C |
| 2024-04-01 | $91.72 | Not available in this setting | RVU24B |
| 2024-03-09 | $91.72 | Not available in this setting | RVU24AR |
| 2024-01-01 | $90.22 | Not available in this setting | RVU24A |
| 2023-10-01 | $93.47 | Not available in this setting | RVU23D |
| 2023-07-01 | $93.47 | Not available in this setting | RVU23C |
| 2023-04-01 | $93.47 | Not available in this setting | RVU23B |
| 2023-01-01 | $93.47 | Not available in this setting | RVU23A |
| 2022-10-01 | $95.42 | Not available in this setting | RVU22D |
| 2022-07-01 | $95.42 | Not available in this setting | RVU22C |
| 2022-04-01 | $95.42 | Not available in this setting | RVU22B |
| 2022-01-01 | $95.42 | Not available in this setting | RVU22A |
| 2021-10-01 | $97.26 | Not available in this setting | RVU21D |
| 2021-07-01 | $97.26 | Not available in this setting | RVU21C |
| 2021-04-01 | $97.26 | Not available in this setting | RVU21B |
| 2021-01-01 | $97.26 | Not available in this setting | RVU21A |
| 2020-10-01 | $96.53 | Not available in this setting | RVU20D |
| 2020-07-01 | $96.53 | Not available in this setting | RVU20C |
| 2020-04-01 | $96.53 | Not available in this setting | RVU20B |
| 2020-01-01 | $96.53 | Not available in this setting | RVU20A |
| 2019-10-01 | $97.07 | Not available in this setting | RVU19D |
| 2019-07-01 | $97.07 | Not available in this setting | RVU19C |
| 2019-04-01 | $97.07 | Not available in this setting | RVU19B |
| 2019-01-01 | $97.07 | Not available in this setting | RVU19A |
| 2018-10-01 | $98.40 | Not available in this setting | RVU18D |
| 2018-07-01 | $98.40 | Not available in this setting | RVU18C |
| 2018-04-01 | $98.40 | Not available in this setting | RVU18B |
| 2018-01-01 | $98.40 | Not available in this setting | RVU18AR1 |
| 2017-10-01 | $98.47 | Not available in this setting | RVU17D |
| 2017-07-01 | $98.47 | Not available in this setting | RVU17C |
| 2017-04-01 | $98.47 | Not available in this setting | RVU17B |
| 2017-01-01 | $98.47 | Not available in this setting | RVU17A |
| 2016-10-01 | $97.53 | Not available in this setting | RVU16D |
| 2016-07-01 | $97.53 | Not available in this setting | RVU16C |
| 2016-04-01 | $97.53 | Not available in this setting | RVU16B |
| 2016-01-01 | $97.53 | Not available in this setting | RVU16A |
| 2015-10-01 | $97.67 | Not available in this setting | RVU15D |
| 2015-07-01 | $97.67 | Not available in this setting | RVU15C |
| 2015-04-01 | $97.18 | Not available in this setting | RVU15B |
| 2015-01-01 | $97.18 | Not available in this setting | RVU15A |
| 2014-10-01 | $101.97 | Not available in this setting | RVU14D |
| 2014-07-01 | $101.97 | Not available in this setting | RVU14C |
| 2014-04-01 | $101.97 | Not available in this setting | RVU14B |
| 2014-01-01 | $101.97 | Not available in this setting | RVU14A |
| 2013-10-01 | Additional calculation required | Not available in this setting | RVU13D |
| 2013-07-01 | Additional calculation required | Not available in this setting | RVU13C |
| 2013-04-01 | Additional calculation required | Not available in this setting | RVU13B |
| 2013-01-01 | Additional calculation required | Not available in this setting | RVU13AR |
Where the South Dakota rate applies
South Dakota is a Medicare payment area, not a city. Our Census mapping connects it to 485 cities and communities in South Dakota. Some span more than one payment area; confirm with the service ZIP.
- Aberdeen
- Agar
- Agency Village
- Akaska
- Albee
- Alcester
- Alexandria
- Allen
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
Show the CMS file lines behind this rate
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