Both describe standard obstetric ultrasound examinations, but 76801 is for before 14 weeks; 76805 is for 14 weeks or later.
On this page
CMS RVU26D · Effective 2026-10-01
76805 Obstetric ultrasound Medicare reimbursement rates in California
Reports a standard transabdominal obstetric ultrasound for one fetus at 14 weeks or later, including fetal and maternal evaluation with image documentation. Compare 76805 office and facility rates across CMS payment localities in California.
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 76805 in California?
California has 29 payment localities in this comparison. Use the service location to choose the applicable amount. These are the supported base rates for the 29 payment areas shown below, using the same CMS release.
Office / nonfacility
$145.12–$183.15
29 of 29 localities have a supported rate.
Lowest: Chico
Highest: San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
A spread of $38.03 per service.
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.
Where 76805 pays more and less in California
29 payment localities
$145.12 to $183.15
Obstetric imaging
About 76805: Single-fetus complete obstetric ultrasound
Reports a standard transabdominal obstetric ultrasound for one fetus at 14 weeks or later, including fetal and maternal evaluation with image documentation.
This service is a standard transabdominal ultrasound for evaluating a pregnancy with one fetus at 14 weeks or later. A sonographer acquires and documents the images; an obstetrician, radiologist, or other qualified practitioner interprets them. It is commonly used for a second-trimester fetal survey and may assess fetal number and presentation, placental location, amniotic fluid, fetal measurements, and anatomy appropriate to the examination. A targeted, detailed fetal anomaly evaluation is a different service.
Report 76805 for the standard examination when the pregnancy is at least 14 weeks and one fetus is evaluated. The report and retained images should support the gestational age, the single-fetus examination, the clinical reason, and the findings assessed. For a multiple gestation, this code represents the first fetus; 76810 is the add-on for each additional fetus. CMS recognizes professional and technical components: modifier 26 identifies the interpretation, modifier TC identifies the equipment-and-staff service, and no modifier represents the global service.
CMS billing rules for 76805
- 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 RVU0.97 · 24%
- Practice expense (office) RVU3.03 · 74%
- Malpractice RVU0.07 · 2%
2.5K
Medicare services in 2024 · #2286 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.
76805 compared with similar codes
Office rates for California, from the same CMS release.
76810 reports each additional fetus in a multiple gestation; 76805 reports the first fetus.
76811 is for a detailed fetal anatomic examination. Use 76805 for the standard evaluation when a detailed study is not performed.
76816 describes a follow-up study per fetus, while 76805 describes the standard examination at 14 weeks or later.
Compare 76805 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.
29 of 29 payment localities
| Payment locality | Office | Facility |
|---|---|---|
| Bakersfield | Office $145.36 | Facility Unavailable |
| Chico | Office $145.12 | Facility Unavailable |
| El Centro | Office $145.13 | Facility Unavailable |
| Fresno | Office $145.12 | Facility Unavailable |
| Hanford-Corcoran | Office $145.12 | Facility Unavailable |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office $155.00 | Facility Unavailable |
| Madera | Office $145.12 | Facility Unavailable |
| Merced | Office $145.12 | Facility Unavailable |
| Modesto | Office $145.12 | Facility Unavailable |
| Napa | Office $169.02 | Facility Unavailable |
| Oxnard-Thousand Oaks-Ventura | Office $154.39 | Facility Unavailable |
| Redding | Office $145.12 | Facility Unavailable |
| Rest Of California | Office $145.12 | Facility Unavailable |
| Riverside-San Bernardino-Ontario | Office $145.90 | Facility Unavailable |
| Sacramento-Roseville-Folsom | Office $152.52 | Facility Unavailable |
| Salinas | Office $151.95 | Facility Unavailable |
| San Diego-Chula Vista-Carlsbad | Office $155.68 | Facility Unavailable |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office $179.25 | Facility Unavailable |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office $179.17 | Facility Unavailable |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office $183.15 | Facility Unavailable |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office $182.83 | Facility Unavailable |
| San Luis Obispo-Paso Robles | Office $149.48 | Facility Unavailable |
| Santa Cruz-Watsonville | Office $157.30 | Facility Unavailable |
| Santa Maria-Santa Barbara | Office $152.56 | Facility Unavailable |
| Santa Rosa-Petaluma | Office $158.90 | Facility Unavailable |
| Stockton | Office $145.12 | Facility Unavailable |
| Vallejo | Office $168.90 | Facility Unavailable |
| Visalia | Office $145.12 | Facility Unavailable |
| Yuba City | Office $145.12 | Facility Unavailable |
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76805 billing questions
When should 76805 be used instead of 76801?
Use 76805 for a standard obstetric ultrasound at 14 weeks or later. Code 76801 is for the corresponding standard examination before 14 weeks.
How is an additional fetus reported?
Report 76805 for the first fetus and 76810 for each additional fetus evaluated. Documentation should identify the gestation and findings for each fetus.
When is 76811 more appropriate?
Use 76811 when a detailed fetal anatomic examination is performed, rather than the standard evaluation represented by 76805. The examination performed and documented determines the code.
How should the professional and technical work be billed?
Use modifier 26 for the professional interpretation and modifier TC for the technical service. Billing without either modifier represents the global service.
What documentation supports 76805?
The record should support gestational age, the single-fetus evaluation, the reason for the study, and the findings and images from the examination, such as fetal measurements and relevant maternal and fetal observations.
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.
