$120.03–$145.94
59000 reports the amniocentesis sampling procedure; 76946 reports the ultrasound guidance used during that procedure.
On this page
CMS RVU26D · Effective 2026-10-01
76946 Amniocentesis guidance Medicare reimbursement rates in California
Reports real-time ultrasound guidance used to direct an amniocentesis needle into the amniotic cavity during prenatal diagnostic sampling. Compare 76946 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 76946 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
$35.80–$44.12
29 of 29 localities have a supported rate.
Lowest: Chico
Highest: San Jose-Sunnyvale-Santa Clara (San Benito Cnty)
A spread of $8.32 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 76946 pays more and less in California
29 payment localities
$35.80 to $44.12
Obstetric ultrasound
About 76946: Ultrasound guidance for amniocentesis
Reports real-time ultrasound guidance used to direct an amniocentesis needle into the amniotic cavity during prenatal diagnostic sampling.
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.
CMS billing rules for 76946
- 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 RVU0.37 · 36%
- Practice expense (office) RVU0.62 · 61%
- Malpractice RVU0.03 · 3%
60
Medicare services in 2024 · #5247 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.
76946 compared with similar codes
Office rates for California, from the same CMS release.
76945
No office rateEcho guide villus sampling
76945 is used for ultrasound guidance during chorionic villus sampling. Use 76946 when the guided procedure is amniocentesis.
$67.82–$84.06
76942 describes ultrasound guidance for needle placement in other procedures, such as biopsy or aspiration. 76946 specifically identifies guidance for amniocentesis.
Compare 76946 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 $35.90 | Facility Unavailable |
| Chico | Office $35.80 | Facility Unavailable |
| El Centro | Office $35.81 | Facility Unavailable |
| Fresno | Office $35.80 | Facility Unavailable |
| Hanford-Corcoran | Office $35.80 | Facility Unavailable |
| Los Angeles-Long Beach-Anaheim (Los Angeles/Orange Cnty) | Office $38.03 | Facility Unavailable |
| Madera | Office $35.80 | Facility Unavailable |
| Merced | Office $35.80 | Facility Unavailable |
| Modesto | Office $35.80 | Facility Unavailable |
| Napa | Office $40.94 | Facility Unavailable |
| Oxnard-Thousand Oaks-Ventura | Office $37.81 | Facility Unavailable |
| Redding | Office $35.80 | Facility Unavailable |
| Rest Of California | Office $35.80 | Facility Unavailable |
| Riverside-San Bernardino-Ontario | Office $36.13 | Facility Unavailable |
| Sacramento-Roseville-Folsom | Office $37.42 | Facility Unavailable |
| Salinas | Office $37.28 | Facility Unavailable |
| San Diego-Chula Vista-Carlsbad | Office $38.04 | Facility Unavailable |
| San Francisco-Oakland-Berkeley (Marin Cnty) | Office $43.19 | Facility Unavailable |
| San Francisco-Oakland-Berkeley (San Francisco/San Mateo/Alameda/Contra Costa Cnty) | Office $43.16 | Facility Unavailable |
| San Jose-Sunnyvale-Santa Clara (San Benito Cnty) | Office $44.12 | Facility Unavailable |
| San Jose-Sunnyvale-Santa Clara (Santa Clara Cnty) | Office $43.98 | Facility Unavailable |
| San Luis Obispo-Paso Robles | Office $36.69 | Facility Unavailable |
| Santa Cruz-Watsonville | Office $38.32 | Facility Unavailable |
| Santa Maria-Santa Barbara | Office $37.39 | Facility Unavailable |
| Santa Rosa-Petaluma | Office $38.70 | Facility Unavailable |
| Stockton | Office $35.80 | Facility Unavailable |
| Vallejo | Office $40.89 | Facility Unavailable |
| Visalia | Office $35.80 | Facility Unavailable |
| Yuba City | Office $35.80 | Facility Unavailable |
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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 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.
8,87476945,,Echo guide villus sampling,C,,0.00,0.00,,0.00,NA,0.00,0.00,0.00,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
8,87576945,26,Echo guide villus sampling,A,,0.65,0.28,,0.28,,0.03,0.96,0.96,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
8,87676945,TC,Echo guide villus sampling,C,,0.00,0.00,,0.00,NA,0.00,0.00,0.00,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,03,0,99,0.00,0.00,0.00
8,87776946,,Echo guide for amniocentesis,A,,0.37,0.62,,0.62,NA,0.03,1.02,1.02,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
8,87876946,26,Echo guide for amniocentesis,A,,0.37,0.16,,0.16,,0.02,0.55,0.55,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
8,87976946,TC,Echo guide for amniocentesis,A,,0.00,0.46,,0.46,NA,0.01,0.47,0.47,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,03,0,99,0.00,0.00,0.00
8,88076948,,Echo guide ova aspiration,A,,0.65,1.77,,1.77,NA,0.04,2.46,2.46,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00