CPT code 76856: Pelvic ultrasound, complete, nonobstetric2026 Medicare rate & RVUs

Medicare pays $105.21 for 76856 nationally in the office. Local office rates run $92.96–$142.77.

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

What 76856 covers

This service is a complete ultrasound examination of the nonpregnant pelvis, most often performed transabdominally by a sonographer and interpreted by a physician. Common reasons include pelvic pain, abnormal uterine bleeding, suspected fibroids or ovarian cysts, and evaluation of a pelvic mass. The study typically assesses the uterus, endometrium, ovaries, adnexa, and other relevant pelvic structures, with saved images and a written interpretation.

Select the complete study when the examination evaluates the relevant pelvic structures rather than only a limited question or region. The report should identify the structures assessed and document findings supporting the medical need. A separately performed transvaginal nonobstetric examination may be reported with 76830 when the documentation supports both services. CMS recognizes professional and technical components: report modifier 26 for interpretation, TC for equipment and staff, or neither for the global service. The diagnostic imaging multiple procedure reduction applies to both the technical and professional components.

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 76856 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

76856 rates by state

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

How the 76856 rate is calculated

Each of 76856’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 76856

The CMS indicators that decide how 76856 is paid alongside other services.

What modifiers do to the payment

When to use modifier 26

76856 compared with similar codes

How to choose

76857Pelvic ultrasoundLimited or follow-up

76856 represents a complete pelvic examination; 76857 is for a limited study addressing a focused question or selected structures.

76830Pelvic ultrasoundTransvaginal, nonobstetric

76830 describes nonobstetric transvaginal imaging. It may accompany 76856 when both the transabdominal complete study and transvaginal examination are performed.

76817OB ultrasoundTransvaginal approach

76817 is for transvaginal obstetric ultrasound. Use 76856 for a complete nonobstetric pelvic study.

Codes related to 76856

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