CPT code 76946: Amniocentesis guidance, ultrasound needle guidance2026 Medicare rate & RVUs
Reports real-time ultrasound guidance used to direct an amniocentesis needle into the amniotic cavity during prenatal diagnostic sampling.
Medicare pays $34.07 for 76946 nationally in the office. Local office rates run $30.66–$44.12.
Medicare rate · 76946
Amniocentesis guidance, ultrasound needle guidance
- Work RVUs
- 0.37
- Total RVUs
- 1.02
- Global days
- XXX
National rate · 2026
$34.07
Office setting, before claim adjustments.
See every locality for 76946 →Billed by an NP, PA or therapist? →
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 10 sections
What 76946 covers
This service uses real-time ultrasound to help guide the needle into the amniotic cavity during amniocentesis, commonly for prenatal diagnostic sampling. The operator uses imaging to assess the needle path and its position during the procedure. Obstetricians, maternal-fetal medicine specialists, and radiologists may perform the guidance in an office or hospital setting.
Report this guidance with the amniocentesis service when both are performed; the amniocentesis itself is reported separately. Documentation should identify the guidance performed and include the interpreting clinician’s findings. CMS recognizes professional and technical components: modifier 26 identifies the interpretation, modifier TC identifies the equipment and staff, and reporting without either modifier represents the global service. Use the component modifier that matches how the service was furnished and billed.
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 76946 pays more and less
The same RVUs, adjusted for each area’s costs. Open a locality for its calculation, history and nearby areas.
109 payment localities
$30.66 to $44.12
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $31.05 | Unavailable |
| Alaska | $41.14 | Unavailable |
| Arizona | $33.28 | Unavailable |
| Arkansas | $30.66 | Unavailable |
| Atlanta, GA | $34.64 | Unavailable |
| Austin, TX | $35.18 | Unavailable |
| Bakersfield, CA | $35.90 | Unavailable |
| Baltimore area, MD | $36.02 | Unavailable |
| Beaumont, TX | $32.13 | Unavailable |
| Brazoria, TX | $33.76 | Unavailable |
| Chicago, IL | $35.56 | Unavailable |
| Chico, CA | $35.80 | Unavailable |
| Colorado | $35.32 | Unavailable |
| Connecticut | $36.12 | Unavailable |
| Dallas, TX | $33.96 | Unavailable |
| Delaware | $33.78 | Unavailable |
| Detroit, MI | $34.03 | Unavailable |
| East St. Louis, IL | $33.43 | Unavailable |
| El Centro, CA | $35.81 | Unavailable |
| Fort Lauderdale, FL | $35.15 | Unavailable |
| Fort Worth, TX | $33.76 | Unavailable |
| Fresno, CA | $35.80 | Unavailable |
| Galveston, TX | $33.85 | Unavailable |
| Hanford, CA | $35.80 | Unavailable |
| Hawaii, Guam, HI | $36.48 | Unavailable |
| Houston, TX | $34.40 | Unavailable |
| Idaho | $31.88 | Unavailable |
| Indiana | $32.04 | Unavailable |
| Iowa | $31.70 | Unavailable |
| Kansas | $31.58 | Unavailable |
| Kentucky | $31.69 | Unavailable |
| King County, WA | $39.20 | Unavailable |
| Los Angeles, CA | $38.03 | Unavailable |
| Madera, CA | $35.80 | Unavailable |
| Manhattan, NY | $38.80 | Unavailable |
| Marin County, CA | $43.19 | Unavailable |
| Merced, CA | $35.80 | Unavailable |
| Metropolitan Boston, MA | $38.48 | Unavailable |
| Metropolitan Kansas City, MO | $32.78 | Unavailable |
| Metropolitan Philadelphia, PA | $35.33 | Unavailable |
| Metropolitan St. Louis, MO | $33.08 | Unavailable |
| Miami, FL | $36.45 | Unavailable |
| Minnesota | $33.96 | Unavailable |
| Mississippi | $30.93 | Unavailable |
| Modesto, CA | $35.80 | Unavailable |
| Montana | $34.07 | Unavailable |
| Napa, CA | $40.94 | Unavailable |
| Nebraska | $31.85 | Unavailable |
| Nevada | $33.92 | Unavailable |
| New Hampshire | $34.79 | Unavailable |
| New Mexico | $32.55 | Unavailable |
| New Orleans, LA | $32.98 | Unavailable |
| North Carolina | $32.32 | Unavailable |
| North Dakota | $33.47 | Unavailable |
| Northern New Jersey | $38.23 | Unavailable |
| NYC suburbs and Long Island, NY | $39.63 | Unavailable |
| Ohio | $32.28 | Unavailable |
| Oklahoma | $31.63 | Unavailable |
| Oxnard, CA | $37.81 | Unavailable |
| Portland, OR | $36.31 | Unavailable |
| Poughkeepsie and northern NYC suburbs, NY | $36.80 | Unavailable |
| Puerto Rico | $34.28 | Unavailable |
| Queens, NY | $39.07 | Unavailable |
| Redding, CA | $35.80 | Unavailable |
| Rest of California | $35.80 | Unavailable |
| Rest of Florida | $33.66 | Unavailable |
| Rest of Georgia | $32.02 | Unavailable |
| Rest of Illinois | $32.83 | Unavailable |
| Rest of Louisiana | $31.65 | Unavailable |
| Rest of Maine | $32.03 | Unavailable |
| Rest of Maryland | $34.36 | Unavailable |
| Rest of Massachusetts | $35.16 | Unavailable |
| Rest of Michigan | $32.40 | Unavailable |
| Rest of Missouri | $31.19 | Unavailable |
| Rest of New Jersey | $36.57 | Unavailable |
| Rest of New York | $32.74 | Unavailable |
| Rest of Oregon | $33.69 | Unavailable |
| Rest of Pennsylvania | $32.32 | Unavailable |
| Rest of Texas | $32.92 | Unavailable |
| Rest of Washington | $35.09 | Unavailable |
| Rhode Island | $34.88 | Unavailable |
| Riverside, CA | $36.13 | Unavailable |
| Sacramento, CA | $37.42 | Unavailable |
| Salinas, CA | $37.28 | Unavailable |
| San Benito County, CA | $44.12 | Unavailable |
| San Diego, CA | $38.04 | Unavailable |
| San Francisco, CA | $43.16 | Unavailable |
| San Luis Obispo, CA | $36.69 | Unavailable |
| Santa Clara County, CA | $43.98 | Unavailable |
| Santa Cruz, CA | $38.32 | Unavailable |
| Santa Maria, CA | $37.39 | Unavailable |
| Santa Rosa, CA | $38.70 | Unavailable |
| South Carolina | $32.34 | Unavailable |
| South Dakota | $33.40 | Unavailable |
| Southern Maine, ME | $33.51 | Unavailable |
| Stockton, CA | $35.80 | Unavailable |
| Suburban Chicago, IL | $35.49 | Unavailable |
| Tennessee | $31.72 | Unavailable |
| Utah | $32.72 | Unavailable |
| Vallejo, CA | $40.89 | Unavailable |
| Vermont | $33.37 | Unavailable |
| Virgin Islands, VI | $34.28 | Unavailable |
| Virginia | $33.42 | Unavailable |
| Visalia, CA | $35.80 | Unavailable |
| Washington, DC area | $38.54 | Unavailable |
| West Virginia | $31.79 | Unavailable |
| Wisconsin | $32.51 | Unavailable |
| Wyoming | $33.81 | Unavailable |
| Yuba City, CA | $35.80 | Unavailable |
76946 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.
$30.66
$41.14
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 | $41.14 | 1 |
| AL | $31.05 | 1 |
| AR | $30.66 | 1 |
| AZ | $33.28 | 1 |
| CA | $35.80–$44.12 | 29 |
| CO | $35.32 | 1 |
| CT | $36.12 | 1 |
| DC | $38.54 | 1 |
| DE | $33.78 | 1 |
| FL | $33.66–$36.45 | 3 |
| GA | $32.02–$34.64 | 2 |
| GU | $36.48 | 1 |
| HI | $36.48 | 1 |
| IA | $31.70 | 1 |
| ID | $31.88 | 1 |
| IL | $32.83–$35.56 | 4 |
| IN | $32.04 | 1 |
| KS | $31.58 | 1 |
| KY | $31.69 | 1 |
| LA | $31.65–$32.98 | 2 |
| MA | $35.16–$38.48 | 2 |
| MD | $34.36–$38.54 | 3 |
| ME | $32.03–$33.51 | 2 |
| MI | $32.40–$34.03 | 2 |
| MN | $33.96 | 1 |
| MO | $31.19–$33.08 | 3 |
| MS | $30.93 | 1 |
| MT | $34.07 | 1 |
| NC | $32.32 | 1 |
| ND | $33.47 | 1 |
| NE | $31.85 | 1 |
| NH | $34.79 | 1 |
| NJ | $36.57–$38.23 | 2 |
| NM | $32.55 | 1 |
| NV | $33.92 | 1 |
| NY | $32.74–$39.63 | 5 |
| OH | $32.28 | 1 |
| OK | $31.63 | 1 |
| OR | $33.69–$36.31 | 2 |
| PA | $32.32–$35.33 | 2 |
| PR | $34.28 | 1 |
| RI | $34.88 | 1 |
| SC | $32.34 | 1 |
| SD | $33.40 | 1 |
| TN | $31.72 | 1 |
| TX | $32.13–$35.18 | 8 |
| UT | $32.72 | 1 |
| VA | $33.42–$38.54 | 2 |
| VI | $34.28 | 1 |
| VT | $33.37 | 1 |
| WA | $35.09–$39.20 | 2 |
| WI | $32.51 | 1 |
| WV | $31.79 | 1 |
| WY | $33.81 | 1 |
How the 76946 rate is calculated
Each of 76946’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 · 76946
RVUs × geographic indexes × conversion factor
Work0.37
0.37 RVUs× 1.000 GPCI
Practice expense0.62
0.62 RVUs× 1.000 GPCI
Malpractice0.03
0.03 RVUs× 1.000 GPCI
Adjusted RVUs
1.0200
Conversion factor
$33.4009
Medicare rate
$34.07
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 76946
The CMS indicators that decide how 76946 is paid alongside other services.
CMS payment indicators · 76946
Amniocentesis guidance, ultrasound needle guidance
| 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
76946 without 26 · national office
$34.07
Amniocentesis guidance, ultrasound needle guidance
76946-26 · Professional component
$18.37
Pays only the interpretation and report.
76946 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 59000AmniocentesisDiagnostic fluid sampling
- 59000 reports the amniocentesis sampling procedure; 76946 reports the ultrasound guidance used during that procedure.
- 76945CVS ultrasound guidanceDuring CVS
- 76945 is used for ultrasound guidance during chorionic villus sampling. Use 76946 when the guided procedure is amniocentesis.
- 76942Ultrasound needle guidanceBiopsy, aspiration, injection, or localization
- 76942 describes ultrasound guidance for needle placement in other procedures, such as biopsy or aspiration. 76946 specifically identifies guidance for amniocentesis.
76946 billing questions
Which amniocentesis code is commonly reported with this guidance?
CPT 59000 represents the amniocentesis procedure and is commonly reported for the sampling performed during the same encounter. This code represents the ultrasound guidance.
How is this different from ultrasound guidance for chorionic villus sampling?
Use 76946 for ultrasound guidance during amniocentesis. Code 76945 is for guidance during chorionic villus sampling, a different prenatal sampling procedure.
When should modifier 26 or TC be used?
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.
Does this code represent a complete obstetric ultrasound examination?
No. It describes ultrasound guidance for the amniocentesis needle, not a comprehensive fetal or obstetric examination.
What documentation supports reporting the guidance?
Document that ultrasound was used to guide the amniocentesis, along with the guidance findings and the interpreting clinician’s report. The record should support the component billed when professional and technical services are split.
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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