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CPT code 76946: Amniocentesis guidance, ultrasound needle guidance2026 Medicare rate & RVUs in Queens, NY

Reports real-time ultrasound guidance used to direct an amniocentesis needle into the amniotic cavity during prenatal diagnostic sampling.

CMS RVU26DEffective Oct 1, 2026One payment locality60 Medicare services in 2024

In Queens, NY, Medicare pays $39.07 for 76946 in the office.

$39.07Office (non-facility)
Not available in this settingHospital or facility
+14.7%vs the national office rate ($34.07)

Check a contract rate as a % of Medicare · 76946 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 76946 for the payment locality that covers the ZIP.

On this page 11 sections
  1. Rate in Queens, NY
  2. What 76946 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 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.

How Queens, NY compares for 76946

Across 109 of 109 payment localities, the office rate for 76946 runs from $30.66 in Arkansas to $44.12 in San Benito County, CA. Queens, NY pays $39.07. The RVUs are the same everywhere; the geographic indexes change the dollars.

76946 in Queens, NY vs other payment areas
  1. Queens, NY · this page$39.07
  2. Manhattan, NY · New York$38.80−$0.27
  3. NYC suburbs and Long Island, NY · New York$39.63+$0.56
  4. Poughkeepsie and northern NYC suburbs, NY · New York$36.80−$2.27
  5. Rest of New York · New York$32.74−$6.33
  6. Los Angeles, CA · California$38.03−$1.04
  7. Washington, DC area · District of Columbia$38.54−$0.53

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

Every other payment area

76946 in every other Medicare payment locality
Payment localityOfficeFacility
Miami, FLFlorida$36.45—
Chicago, ILIllinois$35.56—
AlaskaAlaska$41.14—
AlabamaAlabama$31.05—
ArkansasArkansas$30.66—
ArizonaArizona$33.28—
Bakersfield, CACalifornia$35.90—
Chico, CACalifornia$35.80—

76946 rates by state

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

MEWIVTNHMTNDMNMINYMARIWAIDWYSDIAILINOHPANJCTORNVUTCONEMOKYWVVAMDDECAAZNMKSOKARTNNCSCDCTXLAMSALGAFLAKHI

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
76946 office rate range by state
State / territoryOffice rate rangeLocalities
AK$41.141
AL$31.051
AR$30.661
AZ$33.281
CA$35.80–$44.1229
CO$35.321
CT$36.121
DC$38.541
DE$33.781
FL$33.66–$36.453
GA$32.02–$34.642
GU$36.481
HI$36.481
IA$31.701
ID$31.881
IL$32.83–$35.564
IN$32.041
KS$31.581
KY$31.691
LA$31.65–$32.982
MA$35.16–$38.482
MD$34.36–$38.543
ME$32.03–$33.512
MI$32.40–$34.032
MN$33.961
MO$31.19–$33.083
MS$30.931
MT$34.071
NC$32.321
ND$33.471
NE$31.851
NH$34.791
NJ$36.57–$38.232
NM$32.551
NV$33.921
NY$32.74–$39.635
OH$32.281
OK$31.631
OR$33.69–$36.312
PA$32.32–$35.332
PR$34.281
RI$34.881
SC$32.341
SD$33.401
TN$31.721
TX$32.13–$35.188
UT$32.721
VA$33.42–$38.542
VI$34.281
VT$33.371
WA$35.09–$39.202
WI$32.511
WV$31.791
WY$33.811

See 76946 in every payment locality

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

Office or facility?

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.

The exact Queens, NY inputs and CMS source lines

PPRRVU2026_Oct_nonQPP.csv

8,877

Code
76946
Physician work
0.37
Practice expense
0.62
Malpractice
0.03

GPCI2026.csv

81

Locality
Queens, NY
Physician work
1.064
Practice expense
1.182
Malpractice
1.442
Office calculation for 76946 in Queens, NY
ComponentRVULocality factorAdjusted
Physician work0.37× 1.0640.3937
Practice expense0.62× 1.1820.7328
Malpractice0.03× 1.4420.0433
Total RVUs1.1698
Conversion factor× 33.4009

Office rate, Queens, NY$39.07

Office: (0.37 × 1.064 + 0.62 × 1.182 + 0.03 × 1.442) × $33.4009 = $39.07

Open 76946 in the RVU calculator

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

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

76946 without 26 · national office

$34.07

Amniocentesis guidance, ultrasound needle guidance

76946-26 · Professional component

$18.37

Pays only the interpretation and report.

When to use modifier 26

Codes related to 76946

Related codes aren’t interchangeable: bill the code that matches the service performed.

Codes related to 76946
CodeHow it relatesOffice range, Queens, NY
Often billed with
59000Amniocentesis, diagnostic fluid samplingReports the amniocentesis procedure performed with this ultrasound guidance.$139.89
Used instead
76945CVS ultrasound guidance, during CVSGuidance code for chorionic villus sampling rather than amniocentesis.No office rate
76942Ultrasound needle guidance, biopsy, aspiration, injection, or localizationGeneral ultrasound-guided needle placement for procedures other than amniocentesis.$73.59

How 76946 has changed in Queens, NY

76946 · Office / nonfacility

$39.07

Effective 2026-10-01

The base rate is $1.84 higher than on 2025-10-01, moving from $37.23 to $39.07 (4.9%).

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

    $37.23changed to$39.07

    • Conversion factor 32.3465 changed to 33.4009
    • Work RVU 0.38 changed to 0.37
    • Practice expense RVU 0.60 changed to 0.62
    • Malpractice RVU 0.02 changed to 0.03
    • Work GPCI 1.065 changed to 1.064
    • Practice expense GPCI 1.195 changed to 1.182
    • Malpractice GPCI 1.462 changed to 1.442

    Held through RVU26B, RVU26C, RVU26D.

  2. January 1, 2025

    RVU25A

    $38.31changed to$37.23

    • Conversion factor 33.2875 changed to 32.3465

    Held through RVU25B, RVU25C, RVU25D.

  3. March 9, 2024

    RVU24AR

    $37.69changed to$38.31

    • Conversion factor 32.7442 changed to 33.2875

    Held through RVU24B, RVU24C, RVU24D.

  4. January 1, 2024

    RVU24A

    $38.88changed to$37.69

    • Conversion factor 33.8872 changed to 32.7442
    • Practice expense RVU 0.58 changed to 0.60
    • Work GPCI 1.061 changed to 1.065
    • Practice expense GPCI 1.212 changed to 1.195
    • Malpractice GPCI 2.061 changed to 1.462

  5. January 1, 2023

    RVU23A

    $39.10changed to$38.88

    • Conversion factor 34.6062 changed to 33.8872
    • Practice expense RVU 0.55 changed to 0.58
    • Work GPCI 1.056 changed to 1.061
    • Practice expense GPCI 1.228 changed to 1.212
    • Malpractice GPCI 2.661 changed to 2.061

    Held through RVU23B, RVU23C, RVU23D.

  6. January 1, 2022

    RVU22A

    $39.43changed to$39.10

    • Conversion factor 34.8931 changed to 34.6062

    Held through RVU22B, RVU22C, RVU22D.

  7. January 1, 2021

    RVU21A

    $38.52changed to$39.43

    • Conversion factor 36.0896 changed to 34.8931
    • Practice expense RVU 0.51 changed to 0.55
    • Work GPCI 1.054 changed to 1.056
    • Practice expense GPCI 1.214 changed to 1.228
    • Malpractice GPCI 2.391 changed to 2.661

    Held through RVU21B, RVU21C, RVU21D.

  8. January 1, 2020

    RVU20A

    $39.09changed to$38.52

    • Conversion factor 36.0391 changed to 36.0896
    • Practice expense RVU 0.50 changed to 0.51
    • Malpractice RVU 0.04 changed to 0.02
    • Work GPCI 1.052 changed to 1.054
    • Practice expense GPCI 1.200 changed to 1.214
    • Malpractice GPCI 2.121 changed to 2.391

    Held through RVU20B, RVU20C, RVU20D.

  9. January 1, 2019

    RVU19A

    $39.48changed to$39.09

    • Conversion factor 35.9996 changed to 36.0391
    • Practice expense RVU 0.51 changed to 0.50

    Held through RVU19B, RVU19C, RVU19D.

  10. January 1, 2018

    RVU18AR1

    $39.40changed to$39.48

    • Conversion factor 35.8887 changed to 35.9996
    • Malpractice GPCI 2.151 changed to 2.121

    Held through RVU18B, RVU18C, RVU18D.

  11. January 1, 2017

    RVU17A

    $39.33changed to$39.40

    • Conversion factor 35.8043 changed to 35.8887
    • Practice expense GPCI 1.199 changed to 1.200
    • Malpractice GPCI 2.181 changed to 2.151

    Held through RVU17B, RVU17C, RVU17D.

  12. January 1, 2016

    RVU16A

    $39.47changed to$39.33

    • Conversion factor 35.9335 changed to 35.8043

    Held through RVU16B, RVU16C, RVU16D.

  13. July 1, 2015

    RVU15C

    $39.28changed to$39.47

    • Conversion factor 35.7547 changed to 35.9335

    Held through RVU15D.

  14. January 1, 2015

    RVU15A

    $37.57changed to$39.28

    • Conversion factor 35.8228 changed to 35.7547
    • Malpractice RVU 0.02 changed to 0.04
    • Work GPCI 1.057 changed to 1.052
    • Practice expense GPCI 1.197 changed to 1.199
    • Malpractice GPCI 1.836 changed to 2.181

    Held through RVU15B.

  15. January 1, 2014

    RVU14A

    $37.51changed to$37.57

    • Conversion factor 34.0230 changed to 35.8228
    • Practice expense RVU 0.56 changed to 0.51
    • Work GPCI 1.062 changed to 1.057
    • Practice expense GPCI 1.195 changed to 1.197
    • Malpractice GPCI 1.491 changed to 1.836

    Held through RVU14B, RVU14C, RVU14D.

  16. January 1, 2013

    RVU13AR

    Earliest loaded release: $37.51

    Held through RVU13B, RVU13C, RVU13D.

Rates in every CMS release
Effective fromOfficeFacilityCMS release
2026-10-01$39.07Not available in this settingRVU26D
2026-07-01$39.07Not available in this settingRVU26C
2026-04-01$39.07Not available in this settingRVU26B
2026-01-01$39.07Not available in this settingRVU26A
2025-10-01$37.23Not available in this settingRVU25D
2025-07-01$37.23Not available in this settingRVU25C
2025-04-01$37.23Not available in this settingRVU25B
2025-01-01$37.23Not available in this settingRVU25A
2024-10-01$38.31Not available in this settingRVU24D
2024-07-01$38.31Not available in this settingRVU24C
2024-04-01$38.31Not available in this settingRVU24B
2024-03-09$38.31Not available in this settingRVU24AR
2024-01-01$37.69Not available in this settingRVU24A
2023-10-01$38.88Not available in this settingRVU23D
2023-07-01$38.88Not available in this settingRVU23C
2023-04-01$38.88Not available in this settingRVU23B
2023-01-01$38.88Not available in this settingRVU23A
2022-10-01$39.10Not available in this settingRVU22D
2022-07-01$39.10Not available in this settingRVU22C
2022-04-01$39.10Not available in this settingRVU22B
2022-01-01$39.10Not available in this settingRVU22A
2021-10-01$39.43Not available in this settingRVU21D
2021-07-01$39.43Not available in this settingRVU21C
2021-04-01$39.43Not available in this settingRVU21B
2021-01-01$39.43Not available in this settingRVU21A
2020-10-01$38.52Not available in this settingRVU20D
2020-07-01$38.52Not available in this settingRVU20C
2020-04-01$38.52Not available in this settingRVU20B
2020-01-01$38.52Not available in this settingRVU20A
2019-10-01$39.09Not available in this settingRVU19D
2019-07-01$39.09Not available in this settingRVU19C
2019-04-01$39.09Not available in this settingRVU19B
2019-01-01$39.09Not available in this settingRVU19A
2018-10-01$39.48Not available in this settingRVU18D
2018-07-01$39.48Not available in this settingRVU18C
2018-04-01$39.48Not available in this settingRVU18B
2018-01-01$39.48Not available in this settingRVU18AR1
2017-10-01$39.40Not available in this settingRVU17D
2017-07-01$39.40Not available in this settingRVU17C
2017-04-01$39.40Not available in this settingRVU17B
2017-01-01$39.40Not available in this settingRVU17A
2016-10-01$39.33Not available in this settingRVU16D
2016-07-01$39.33Not available in this settingRVU16C
2016-04-01$39.33Not available in this settingRVU16B
2016-01-01$39.33Not available in this settingRVU16A
2015-10-01$39.47Not available in this settingRVU15D
2015-07-01$39.47Not available in this settingRVU15C
2015-04-01$39.28Not available in this settingRVU15B
2015-01-01$39.28Not available in this settingRVU15A
2014-10-01$37.57Not available in this settingRVU14D
2014-07-01$37.57Not available in this settingRVU14C
2014-04-01$37.57Not available in this settingRVU14B
2014-01-01$37.57Not available in this settingRVU14A
2013-10-01$37.51Not available in this settingRVU13D
2013-07-01$37.51Not available in this settingRVU13C
2013-04-01$37.51Not available in this settingRVU13B
2013-01-01$37.51Not available in this settingRVU13AR

Price 76946 for an earlier date of service

Where the Queens, NY rate applies

Queens, NY is a Medicare payment area, not a city. Our Census mapping connects it to 1 cities and communities in New York. Some span more than one payment area; confirm with the service ZIP.

Browse all communities in New York

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

Show the CMS file lines behind this rate
RVUs for 76946PPRRVU2026_Oct_nonQPP.csv, line 8,877 (RVU26D)
Geographic factors for Queens, NYGPCI2026.csv, line 81 (RVU26D)

Open CMS sourceHow we calculate rates

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