CPT code 76817: OB ultrasound, transvaginal approach2026 Medicare rate & RVUs in Houston, TX

Reports real-time obstetric ultrasound performed through the vagina to evaluate a pregnancy, including early pregnancy location or viability when clinically indicated.

CMS RVU26DEffective Oct 1, 2026One payment locality7.4K Medicare services in 2024

In Houston, TX, Medicare pays $93.21 for 76817 in the office.

$93.21Office (non-facility)
Not available in this settingHospital or facility
+0.4%vs the national office rate ($92.85)

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.

We’ll open 76817 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Houston, TX
  2. What 76817 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 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 Houston, TX 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. Houston, TX pays $93.21. The RVUs are the same everywhere; the geographic indexes change the dollars.

76817 in Houston, TX vs other payment areas
  1. Houston, TX · this page$93.21
  2. Austin, TX · Texas$96.59+$3.38
  3. Beaumont, TX · Texas$86.72−$6.49
  4. Brazoria, TX · Texas$92.08−$1.13
  5. Dallas, TX · Texas$92.57−$0.64
  6. Fort Worth, TX · Texas$91.92−$1.29
  7. Galveston, TX · Texas$92.29−$0.92

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

Every other payment area

76817 in every other Medicare payment locality
Payment localityOfficeFacility
Rest of TexasTexas$89.29—
Los Angeles, CACalifornia$105.52—
Washington, DC areaDistrict of Columbia$106.25—
Miami, FLFlorida$98.15—
Chicago, ILIllinois$95.52—
Manhattan, NYNew York$106.22—
AlaskaAlaska$108.64—
AlabamaAlabama$83.78—

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
76817 office rate range by state
State / territoryOffice rate rangeLocalities
AK$108.641
AL$83.781
AR$82.631
AZ$90.541
CA$98.91–$124.2929
CO$97.061
CT$98.841
DC$106.251
DE$92.011
FL$90.76–$98.153
GA$85.96–$94.332
GU$101.301
HI$101.301
IA$86.171
ID$86.631
IL$87.98–$96.124
IN$87.121
KS$85.611
KY$85.301
LA$85.10–$89.142
MA$96.45–$106.632
MD$93.76–$106.253
ME$86.88–$91.642
MI$87.26–$91.662
MN$93.621
MO$83.59–$89.653
MS$83.131
MT$92.851
NC$87.781
ND$91.861
NE$86.671
NH$95.381
NJ$100.14–$105.192
NM$87.651
NV$92.641
NY$89.02–$108.475
OH$87.061
OK$85.331
OR$92.09–$100.232
PA$87.28–$96.352
PR$93.561
RI$95.341
SC$87.531
SD$91.751
TN$86.001
TX$86.72–$96.598
UT$88.681
VA$91.23–$106.252
VI$93.561
VT$91.361
WA$96.31–$108.932
WI$88.891
WV$84.821
WY$92.421

See 76817 in every payment locality

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

Office or facility?

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 Houston, TX 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

102

Locality
Houston, TX
Physician work
1.008
Practice expense
0.993
Malpractice
1.376
Office calculation for 76817 in Houston, TX
ComponentRVULocality factorAdjusted
Physician work0.73× 1.0080.7358
Practice expense2.00× 0.9931.9860
Malpractice0.05× 1.3760.0688
Total RVUs2.7906
Conversion factor× 33.4009

Office rate, Houston, TX$93.21

Office: (0.73 × 1.008 + 2 × 0.993 + 0.05 × 1.376) × $33.4009 = $93.21

Open 76817 in the RVU calculator

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

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

76817 without 26 · national office

$92.85

OB ultrasound, transvaginal approach

76817-26 · Professional component

$35.40

Pays only the interpretation and report.

When to use modifier 26

How 76817 has changed in Houston, TX

76817 · Office / nonfacility

$93.21

Effective 2026-10-01

The base rate is $3.20 higher than on 2025-10-01, moving from $90.01 to $93.21 (3.6%).

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

    $90.01changed to$93.21

    • 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
    • Work GPCI 1.014 changed to 1.008
    • Practice expense GPCI 1.003 changed to 0.993
    • Malpractice GPCI 1.409 changed to 1.376

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $93.63changed to$90.01

    • Conversion factor 33.2875 changed to 32.3465
    • Practice expense RVU 1.99 changed to 1.96

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $92.10changed to$93.63

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $96.47changed to$92.10

    • Conversion factor 33.8872 changed to 32.7442
    • Malpractice RVU 0.05 changed to 0.04
    • Work GPCI 1.023 changed to 1.014
    • Practice expense GPCI 1.016 changed to 1.003
    • Malpractice GPCI 1.154 changed to 1.409
  5. January 1, 2023

    RVU23A

    $99.21changed to$96.47

    • Conversion factor 34.6062 changed to 33.8872
    • Work GPCI 1.032 changed to 1.023
    • Practice expense GPCI 1.029 changed to 1.016
    • Malpractice GPCI 0.900 changed to 1.154

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $101.11changed to$99.21

    • Conversion factor 34.8931 changed to 34.6062
    • Practice expense RVU 2.02 changed to 1.99

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $99.41changed to$101.11

    • 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
    • Work GPCI 1.026 changed to 1.032
    • Practice expense GPCI 1.020 changed to 1.029
    • Malpractice GPCI 0.918 changed to 0.900

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $99.62changed to$99.41

    • 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
    • Work GPCI 1.020 changed to 1.026
    • Practice expense GPCI 1.012 changed to 1.020
    • Malpractice GPCI 0.936 changed to 0.918

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $100.97changed to$99.62

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 1.96 changed to 1.92

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $100.83changed to$100.97

    • Conversion factor 35.8887 changed to 35.9996
    • Practice expense RVU 1.97 changed to 1.96
    • Practice expense GPCI 1.009 changed to 1.012
    • Malpractice GPCI 0.946 changed to 0.936

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $99.65changed to$100.83

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense RVU 1.95 changed to 1.97
    • Work GPCI 1.019 changed to 1.020
    • Practice expense GPCI 1.006 changed to 1.009
    • Malpractice GPCI 0.955 changed to 0.946

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $99.99changed to$99.65

    • 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.

  13. July 1, 2015

    RVU15C

    $99.50changed to$99.99

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $103.40changed to$99.50

    • 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
    • Work GPCI 1.014 changed to 1.019
    • Practice expense GPCI 1.004 changed to 1.006
    • Malpractice GPCI 0.939 changed to 0.955

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    No ratechanged to$103.40

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: No rate

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$93.21Not available in this settingRVU26D
2026-07-01$93.21Not available in this settingRVU26C
2026-04-01$93.21Not available in this settingRVU26B
2026-01-01$93.21Not available in this settingRVU26A
2025-10-01$90.01Not available in this settingRVU25D
2025-07-01$90.01Not available in this settingRVU25C
2025-04-01$90.01Not available in this settingRVU25B
2025-01-01$90.01Not available in this settingRVU25A
2024-10-01$93.63Not available in this settingRVU24D
2024-07-01$93.63Not available in this settingRVU24C
2024-04-01$93.63Not available in this settingRVU24B
2024-03-09$93.63Not available in this settingRVU24AR
2024-01-01$92.10Not available in this settingRVU24A
2023-10-01$96.47Not available in this settingRVU23D
2023-07-01$96.47Not available in this settingRVU23C
2023-04-01$96.47Not available in this settingRVU23B
2023-01-01$96.47Not available in this settingRVU23A
2022-10-01$99.21Not available in this settingRVU22D
2022-07-01$99.21Not available in this settingRVU22C
2022-04-01$99.21Not available in this settingRVU22B
2022-01-01$99.21Not available in this settingRVU22A
2021-10-01$101.11Not available in this settingRVU21D
2021-07-01$101.11Not available in this settingRVU21C
2021-04-01$101.11Not available in this settingRVU21B
2021-01-01$101.11Not available in this settingRVU21A
2020-10-01$99.41Not available in this settingRVU20D
2020-07-01$99.41Not available in this settingRVU20C
2020-04-01$99.41Not available in this settingRVU20B
2020-01-01$99.41Not available in this settingRVU20A
2019-10-01$99.62Not available in this settingRVU19D
2019-07-01$99.62Not available in this settingRVU19C
2019-04-01$99.62Not available in this settingRVU19B
2019-01-01$99.62Not available in this settingRVU19A
2018-10-01$100.97Not available in this settingRVU18D
2018-07-01$100.97Not available in this settingRVU18C
2018-04-01$100.97Not available in this settingRVU18B
2018-01-01$100.97Not available in this settingRVU18AR1
2017-10-01$100.83Not available in this settingRVU17D
2017-07-01$100.83Not available in this settingRVU17C
2017-04-01$100.83Not available in this settingRVU17B
2017-01-01$100.83Not available in this settingRVU17A
2016-10-01$99.65Not available in this settingRVU16D
2016-07-01$99.65Not available in this settingRVU16C
2016-04-01$99.65Not available in this settingRVU16B
2016-01-01$99.65Not available in this settingRVU16A
2015-10-01$99.99Not available in this settingRVU15D
2015-07-01$99.99Not available in this settingRVU15C
2015-04-01$99.50Not available in this settingRVU15B
2015-01-01$99.50Not available in this settingRVU15A
2014-10-01$103.40Not available in this settingRVU14D
2014-07-01$103.40Not available in this settingRVU14C
2014-04-01$103.40Not available in this settingRVU14B
2014-01-01$103.40Not available in this settingRVU14A
2013-10-01Additional calculation requiredNot available in this settingRVU13D
2013-07-01Additional calculation requiredNot available in this settingRVU13C
2013-04-01Additional calculation requiredNot available in this settingRVU13B
2013-01-01Additional calculation requiredNot available in this settingRVU13AR

Price 76817 for an earlier date of service

Where the Houston, TX rate applies

Houston, TX is a Medicare payment area, not a city. Our Census mapping connects it to 46 cities and communities in Texas. Some span more than one payment area; confirm with the service ZIP.

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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
RVUs for 76817PPRRVU2026_Oct_nonQPP.csv, line 8,793 (RVU26D)
Geographic factors for Houston, TXGPCI2026.csv, line 102 (RVU26D)

Open CMS sourceHow we calculate rates

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