$100.27
76815 answers a focused question, such as fetal position or fluid assessment. 76816 is for follow-up reassessment of fetal growth and is reported per fetus.
On this page
CMS RVU26D · Effective 2026-10-01
76815 Obstetric ultrasound Medicare reimbursement rates in Alabama
Reports a focused obstetric ultrasound to answer a specific clinical question, such as fetal position, cardiac activity, placental location, or amniotic fluid. Compare 76815 office and facility rates across CMS payment localities in Alabama.
Amounts below use the non-QP conversion factor for participating physicians. These are base physician payments before claim-level adjustments, not patient costs or total hospital charges.
What does Medicare pay for 76815 in Alabama?
Alabama has 1 payment locality in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the payment area shown below, using the same CMS release.
Office / nonfacility
$73.43
1 of 1 localities have a supported rate.
Payment area: Alabama
One mapped payment locality.
Facility setting
No supported rate
These are locality ranges, not averages or address-specific quotes. A facility-setting amount covers the physician service; it does not include a hospital’s separate bill. Choose a locality below to inspect its calculation, compare other payment areas, or price a percentage of Medicare.
Obstetric imaging
About 76815: Limited obstetric ultrasound examination
Reports a focused obstetric ultrasound to answer a specific clinical question, such as fetal position, cardiac activity, placental location, or amniotic fluid.
A limited obstetric ultrasound is a focused real-time examination of the pregnant uterus, with image documentation, to assess a specific concern rather than complete a routine anatomic survey. Common clinical questions include fetal cardiac activity, fetal presentation, placental location, or a qualitative assessment of amniotic fluid. Obstetricians, radiologists, and other qualified imaging professionals may perform and interpret the study in an office, imaging center, or hospital.
Report 76815 when the documented examination is limited to the relevant question; it may cover one or more fetuses and is not reported per fetus. A complete survey or a follow-up examination that reassesses fetal growth belongs to a different code. The record should identify the indication, the structures or findings assessed, and the interpretation, supported by retained images. CMS recognizes professional and technical components: modifier 26 identifies interpretation, modifier TC identifies equipment and staff, and no modifier represents the global service.
CMS billing rules for 76815
- Professional and technical components
- Diagnostic test with a professional component (modifier 26, interpretation) and a technical component (modifier TC, equipment and staff); billing without a modifier is the global service.
Where the value comes from
- Work RVU0.63 · 26%
- Practice expense (office) RVU1.76 · 72%
- Malpractice RVU0.05 · 2%
6.9K
Medicare services in 2024 · #1668 by national volume
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.
76815 compared with similar codes
Office rates for Alabama, from the same CMS release.
$122.28
76805 is a complete obstetric ultrasound at or beyond 14 weeks. Choose 76815 when the documented study is limited to a specific clinical question rather than a complete survey.
$110.21
76818 includes a fetal biophysical profile and nonstress test. 76815 describes a focused ultrasound assessment without that combined fetal well-being service.
$83.78
76817 is an obstetric ultrasound performed transvaginally. 76815 identifies a limited obstetric assessment and is not distinguished by the transvaginal approach.
Compare 76815 by payment locality
Find the payment area for your service address, then open its rate page for calculation inputs, release history and the percentage-of-Medicare tool. A city may cross payment-area boundaries; the ZIP lookup above helps resolve the location.
1 of 1 payment localities
Alabama →
Office / nonfacility
$73.43
Facility
Unavailable
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How this local rate is calculated
Each RVU component is multiplied by its own geographic practice cost index (GPCI). The three adjusted components are added, then multiplied by the conversion factor. These are the inputs used for 76815 in Alabama.
PPRRVU2026_Oct_nonQPP.csv
8,787
- Code
- 76815
- Physician work
- 0.63
- Practice expense
- 1.76
- Malpractice
- 0.05
GPCI2026.csv
4
- Locality
- Alabama
- Physician work
- 1.000
- Practice expense
- 0.875
- Malpractice
- 0.566
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.63 | × 1.000 | 0.6300 |
| Practice expense | 1.76 | × 0.875 | 1.5400 |
| Malpractice | 0.05 | × 0.566 | 0.0283 |
| Total RVUs | 2.1983 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Alabama$73.43
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.63 | 1 |
| Practice expense | 1.76 | 0.875 |
| Malpractice | 0.05 | 0.566 |
(0.63 × 1 + 1.76 × 0.875 + 0.05 × 0.566) × $33.4009 = $73.43
The office and facility calculations use their respective practice-expense RVUs. The facility amount here is the physician fee, not a separate hospital or facility bill.
76815 billing questions
When should 76815 be chosen instead of 76816?
Use 76815 for a focused assessment such as fetal position, cardiac activity, placental location, or qualitative amniotic fluid. Use 76816 when the service is a follow-up examination that reassesses fetal growth.
Is 76815 reported once for each fetus?
No. The limited examination may cover one or more fetuses; 76815 is not reported per fetus.
Which component modifier should the claim use?
Use modifier 26 for the professional interpretation or modifier TC for the technical service. Report without either modifier when billing the global service.
Can a limited scan be reported with a complete obstetric ultrasound?
A limited scan should represent a distinct, medically necessary examination, not a subset of a complete study performed during the same encounter. The documentation should show the separate clinical question and work.
What documentation supports 76815?
Document the reason for the focused examination, the specific assessment performed, findings, and interpretation. Retained images should support the documented evaluation.
Where these rates come from
FeeBase calculates base physician payments from CMS work, practice-expense, and malpractice RVUs, adjusted by each locality’s geographic indices and the applicable conversion factor. Unavailable or separately priced services are labeled rather than assigned a made-up amount.
Source: RVU26D. Effective 2026-10-01 through the day before 2027-01-01.
8,78476814,,Ob us nuchal meas add-on,A,,0.97,1.22,,1.22,NA,0.05,2.24,2.24,1,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
8,78576814,26,Ob us nuchal meas add-on,A,,0.97,0.40,,0.40,,0.05,1.42,1.42,1,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
8,78676814,TC,Ob us nuchal meas add-on,A,,0.00,0.82,,0.82,NA,0.00,0.82,0.82,1,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,01,0,99,0.00,0.00,0.00
8,78776815,,Ob us limited fetus(s),A,,0.63,1.76,,1.76,NA,0.05,2.44,2.44,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,3.43,3.43,0.06
8,78876815,26,Ob us limited fetus(s),A,,0.63,0.25,,0.25,,0.04,0.92,0.92,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
8,78976815,TC,Ob us limited fetus(s),A,,0.00,1.51,,1.51,NA,0.01,1.52,1.52,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,01,0,99,3.18,3.18,0.02
8,79076816,,Ob us follow-up per fetus,A,,0.83,2.45,,2.45,NA,0.05,3.33,3.33,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,3.53,3.53,0.06
1ADDENDUM E. FINAL CY 2026 GEOGRAPHIC PRACTICE COST INDICES (GPCIs) BY STATE AND MEDICARE LOCALITY,,,,,,
2,,,,,,
3Medicare Administrative Contractor (MAC),State,Locality Number,Locality Name,2026 PW GPCI (with 1.0 Floor)***,2026 PE GPCI,2026 MP GPCI
410112,AL,00,ALABAMA,1.000,0.875,0.566
502102,AK,01,ALASKA*,1.500,1.065,0.551
603102,AZ,00,ARIZONA,1.000,0.969,0.856
707102,AR,13,ARKANSAS,1.000,0.859,0.515