Billing code 76816: Obstetric ultrasoundMedicare rate & RVUs
Reports a transabdominal follow-up ultrasound to reassess fetal growth, amniotic fluid, or a previously evaluated pregnancy finding for each fetus.
Medicare pays $111.22 for 76816 nationally in the office. Local office rates run $98.88–$149.67.
Medicare rate · 76816
Obstetric ultrasound
Swap in your local Medicare rate.
- Work RVUs
- 0.83
- Total RVUs
- 3.33
- Global days
- XXX
National rate · 2026
$111.22
Office setting, before claim adjustments.
See every locality for 76816 → · 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.
On this page 10 sections
What 76816 covers
billing code 76816 covers a transabdominal follow-up ultrasound of the pregnant uterus, reported for each fetus evaluated. It is commonly used when a clinician needs interval assessment of fetal growth or amniotic fluid, such as during surveillance for suspected growth concerns or after a prior study identified a finding requiring reassessment. An obstetrician, maternal-fetal medicine specialist, or radiologist may perform and interpret the diagnostic study; a sonographer may acquire the images under the provider’s direction.
Report this code for a follow-up examination, not as a substitute for a complete initial survey or a limited examination addressing a narrower question. The record should support the reason for reassessment and document the fetus-specific measurements and findings, with the interpretation and image documentation. CMS recognizes separately priced professional and technical components: modifier 26 identifies interpretation, modifier TC identifies equipment and staff, and billing without either 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.
Where 76816 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
$98.88 to $149.67
109 of 109 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Alabama | $100.27 | Unavailable |
| Alaska* | $129.66 | Unavailable |
| Arizona | $108.45 | Unavailable |
| Arkansas | $98.88 | Unavailable |
| Atlanta | $112.95 | Unavailable |
| Austin | $115.84 | Unavailable |
| Bakersfield | $118.95 | Unavailable |
| Baltimore/Surr. Cntys | $118.04 | Unavailable |
| Beaumont | $103.74 | Unavailable |
| Brazoria | $110.34 | Unavailable |
| Chicago | $113.99 | Unavailable |
| Chico | $118.78 | Unavailable |
| Colorado | $116.43 | Unavailable |
| Connecticut | $118.43 | Unavailable |
| Dallas | $110.91 | Unavailable |
| Dc + Md/Va Suburbs | $127.48 | Unavailable |
| Delaware | $110.21 | Unavailable |
| Detroit | $109.51 | Unavailable |
| East St. Louis | $106.37 | Unavailable |
| El Centro | $118.79 | Unavailable |
| Fort Lauderdale | $113.64 | Unavailable |
| Fort Worth | $110.11 | Unavailable |
| Fresno | $118.78 | Unavailable |
| Galveston | $110.59 | Unavailable |
| Hanford-Corcoran | $118.78 | Unavailable |
| Hawaii, Guam | $121.73 | Unavailable |
| Houston | $111.50 | Unavailable |
| Idaho | $103.80 | Unavailable |
| Indiana | $104.39 | Unavailable |
| Iowa | $103.26 | Unavailable |
| Kansas | $102.54 | Unavailable |
| Kentucky | $102.00 | Unavailable |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | $126.78 | Unavailable |
| Madera | $118.78 | Unavailable |
| Manhattan | $127.23 | Unavailable |
| Merced | $118.78 | Unavailable |
| Metropolitan Boston | $128.05 | Unavailable |
| Metropolitan Kansas City | $106.19 | Unavailable |
| Metropolitan Philadelphia | $115.40 | Unavailable |
| Metropolitan St. Louis | $107.30 | Unavailable |
| Miami | $117.13 | Unavailable |
| Minnesota | $112.42 | Unavailable |
| Mississippi | $99.41 | Unavailable |
| Modesto | $118.78 | Unavailable |
| Montana** | $111.22 | Unavailable |
| Napa | $138.17 | Unavailable |
| Nebraska | $103.89 | Unavailable |
| Nevada** | $111.03 | Unavailable |
| New Hampshire | $114.37 | Unavailable |
| New Mexico | $104.77 | Unavailable |
| New Orleans | $106.62 | Unavailable |
| North Carolina | $105.14 | Unavailable |
| North Dakota** | $110.23 | Unavailable |
| Northern Nj | $126.18 | Unavailable |
| Nyc Suburbs/Long Island | $129.90 | Unavailable |
| Ohio | $104.12 | Unavailable |
| Oklahoma | $102.10 | Unavailable |
| Oxnard-Thousand Oaks-Ventura | $126.27 | Unavailable |
| Portland | $120.32 | Unavailable |
| Poughkpsie/N Nyc Suburbs | $120.60 | Unavailable |
| Puerto Rico | $112.10 | Unavailable |
| Queens | $128.63 | Unavailable |
| Redding | $118.78 | Unavailable |
| Rest Of California | $118.78 | Unavailable |
| Rest Of Florida | $108.46 | Unavailable |
| Rest Of Georgia | $102.71 | Unavailable |
| Rest Of Illinois | $105.05 | Unavailable |
| Rest Of Louisiana | $101.74 | Unavailable |
| Rest Of Maine | $104.05 | Unavailable |
| Rest Of Maryland | $112.35 | Unavailable |
| Rest Of Massachusetts | $115.67 | Unavailable |
| Rest Of Michigan | $104.32 | Unavailable |
| Rest Of Missouri | $99.89 | Unavailable |
| Rest Of New Jersey | $120.02 | Unavailable |
| Rest Of New York | $106.64 | Unavailable |
| Rest Of Oregon | $110.40 | Unavailable |
| Rest Of Pennsylvania | $104.42 | Unavailable |
| Rest Of Texas | $106.89 | Unavailable |
| Rest Of Washington | $115.52 | Unavailable |
| Rhode Island | $114.27 | Unavailable |
| Riverside-San Bernardino-Ontario | $119.33 | Unavailable |
| Sacramento-Roseville-Folsom | $124.79 | Unavailable |
| Salinas | $124.32 | Unavailable |
| San Diego-Chula Vista-Carlsbad | $127.33 | Unavailable |
| San Francisco-Oakland-Berkeley (Marin Cnty) | $146.51 | Unavailable |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | $146.45 | Unavailable |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | $149.67 | Unavailable |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | $149.44 | Unavailable |
| San Luis Obispo-Paso Robles | $122.30 | Unavailable |
| Santa Cruz-Watsonville | $128.63 | Unavailable |
| Santa Maria-Santa Barbara | $124.81 | Unavailable |
| Santa Rosa-Petaluma | $129.94 | Unavailable |
| Seattle (King Cnty) | $130.88 | Unavailable |
| South Carolina | $104.76 | Unavailable |
| South Dakota** | $110.12 | Unavailable |
| Southern Maine | $109.87 | Unavailable |
| Stockton | $118.78 | Unavailable |
| Suburban Chicago | $114.92 | Unavailable |
| Tennessee | $103.01 | Unavailable |
| Utah | $106.14 | Unavailable |
| Vallejo | $138.09 | Unavailable |
| Vermont | $109.58 | Unavailable |
| Virgin Islands | $112.10 | Unavailable |
| Virginia | $109.34 | Unavailable |
| Visalia | $118.78 | Unavailable |
| West Virginia | $101.22 | Unavailable |
| Wisconsin | $106.63 | Unavailable |
| Wyoming** | $110.79 | Unavailable |
| Yuba City | $118.78 | Unavailable |
76816 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.
$98.88
$134.23
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 | $129.66 | 1 |
| AL | $100.27 | 1 |
| AR | $98.88 | 1 |
| AZ | $108.45 | 1 |
| CA | $118.78–$149.67 | 29 |
| CO | $116.43 | 1 |
| CT | $118.43 | 1 |
| DC | $127.48 | 1 |
| DE | $110.21 | 1 |
| FL | $108.46–$117.13 | 3 |
| GA | $102.71–$112.95 | 2 |
| GU | $121.73 | 1 |
| HI | $121.73 | 1 |
| IA | $103.26 | 1 |
| ID | $103.80 | 1 |
| IL | $105.05–$114.92 | 4 |
| IN | $104.39 | 1 |
| KS | $102.54 | 1 |
| KY | $102.00 | 1 |
| LA | $101.74–$106.62 | 2 |
| MA | $115.67–$128.05 | 2 |
| MD | $112.35–$127.48 | 3 |
| ME | $104.05–$109.87 | 2 |
| MI | $104.32–$109.51 | 2 |
| MN | $112.42 | 1 |
| MO | $99.89–$107.30 | 3 |
| MS | $99.41 | 1 |
| MT | $111.22 | 1 |
| NC | $105.14 | 1 |
| ND | $110.23 | 1 |
| NE | $103.89 | 1 |
| NH | $114.37 | 1 |
| NJ | $120.02–$126.18 | 2 |
| NM | $104.77 | 1 |
| NV | $111.03 | 1 |
| NY | $106.64–$129.90 | 5 |
| OH | $104.12 | 1 |
| OK | $102.10 | 1 |
| OR | $110.40–$120.32 | 2 |
| PA | $104.42–$115.40 | 2 |
| PR | $112.10 | 1 |
| RI | $114.27 | 1 |
| SC | $104.76 | 1 |
| SD | $110.12 | 1 |
| TN | $103.01 | 1 |
| TX | $103.74–$115.84 | 8 |
| UT | $106.14 | 1 |
| VA | $109.34–$127.48 | 2 |
| VI | $112.10 | 1 |
| VT | $109.58 | 1 |
| WA | $115.52–$130.88 | 2 |
| WI | $106.63 | 1 |
| WV | $101.22 | 1 |
| WY | $110.79 | 1 |
How the 76816 rate is calculated
Each of 76816’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 · 76816
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 0.83Practice expense 2.45Malpractice 0.05
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 76816
The CMS indicators that decide how 76816 is paid alongside other services.
CMS payment indicators · 76816
Obstetric ultrasound
| 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
76816 without 26 · national office
$111.22
Obstetric ultrasound
76816-26 · Professional component
$40.75
Pays only the interpretation and report.
76816 compared with similar codes
Compare codes
76816 vs 76805 vs 76815 vs 76811 vs 76810: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 76805Obstetric ultrasound
- 76805 is the standard complete obstetric survey; 76816 is a follow-up study reassessing growth, fluid, or a previously evaluated finding.
- 76815Obstetric ultrasound
- 76815 is limited to a focused question or portion of the examination. Choose 76816 when the service is a follow-up reassessment rather than a limited study.
- 76811Obstetric ultrasound
- 76811 is a detailed fetal anatomic examination. It is selected for that comprehensive targeted survey, not simply for interval monitoring.
- 76810Obstetric ultrasound
- 76810 covers a standard complete survey of an additional fetus; 76816 reports follow-up reassessment for each fetus evaluated.
76816 billing questions
When should 76816 be chosen over 76815?
Use 76816 for a follow-up assessment such as interval fetal growth or amniotic fluid reassessment. Use 76815 when the service is a limited examination focused on a narrower question.
How is 76816 reported for a multiple gestation?
The service is reported per fetus evaluated. Documentation should make clear which fetus or fetuses received the follow-up assessment.
How do modifiers 26 and TC affect this code?
Modifier 26 identifies the professional interpretation, and modifier TC identifies the technical service, including equipment and staff. Without either modifier, the claim represents the global service.
How does 76816 differ from 76805?
billing code 76805 describes a standard complete obstetric ultrasound, while 76816 is for a follow-up reassessment. Select based on the examination performed and its purpose, not simply because the patient has had an earlier scan.
What documentation supports a follow-up study?
Document the clinical reason for reassessment, the fetus evaluated, relevant measurements and findings, and the interpreting provider’s report. The record should show that the service was a follow-up rather than a limited or complete initial survey.
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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