$63.75
76801 covers the first fetus in the early complete study; 76802 reports the additional-fetus portion of a multiple-gestation examination.
On this page
CMS RVU26D · Effective 2026-10-01
76801 Obstetric ultrasound Medicare reimbursement rates in Connecticut
Reports a complete ultrasound assessment of a single or first pregnancy before 14 weeks, including early fetal and pregnancy evaluation. Compare 76801 office and facility rates across CMS payment localities in Connecticut.
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 76801 in Connecticut?
Connecticut 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
$124.32
1 of 1 localities have a supported rate.
Payment area: Connecticut
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 76801: Complete first-trimester obstetric ultrasound
Reports a complete ultrasound assessment of a single or first pregnancy before 14 weeks, including early fetal and pregnancy evaluation.
This code describes a complete ultrasound assessment of a pregnancy before 14 weeks for a single fetus or the first fetus in a multiple gestation. It is commonly performed in an obstetric office, radiology department, or maternal-fetal medicine setting to assess early pregnancy, such as dating or viability concerns. The examination may document the gestational sac, embryo, cardiac activity, fetal measurements, and relevant maternal structures. An obstetrician, radiologist, or maternal-fetal medicine specialist may interpret the images.
Select this code for a complete early obstetric study, rather than a limited check or a focused follow-up examination. The report should support the gestational age, number of fetuses, images and findings assessed, and the clinical reason for the study. For additional fetuses, report the applicable additional-fetus code with the primary study. CMS recognizes professional and technical components: modifier 26 identifies the interpretation, modifier TC identifies equipment and staff, and reporting without a modifier represents the global service.
CMS billing rules for 76801
- 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 · 28%
- Practice expense (office) RVU2.47 · 71%
- Malpractice RVU0.06 · 2%
4.7K
Medicare services in 2024 · #1909 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.
76801 compared with similar codes
Office rates for Connecticut, from the same CMS release.
$144.87
76805 is the complete single-fetus obstetric study for pregnancies at 14 weeks or later; 76801 is for before 14 weeks.
$193.02
76811 is for a detailed fetal anatomic examination, not the routine complete early pregnancy assessment represented by 76801.
$86.80
76815 represents a limited obstetric ultrasound; 76801 is selected when a complete early obstetric examination is performed.
Compare 76801 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
Connecticut →
Office / nonfacility
$124.32
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 76801 in Connecticut.
PPRRVU2026_Oct_nonQPP.csv
8,763
- Code
- 76801
- Physician work
- 0.97
- Practice expense
- 2.47
- Malpractice
- 0.06
GPCI2026.csv
38
- Locality
- Connecticut
- Physician work
- 1.020
- Practice expense
- 1.077
- Malpractice
- 1.210
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.97 | × 1.020 | 0.9894 |
| Practice expense | 2.47 | × 1.077 | 2.6602 |
| Malpractice | 0.06 | × 1.210 | 0.0726 |
| Total RVUs | 3.7222 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Connecticut$124.32
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.97 | 1.02 |
| Practice expense | 2.47 | 1.077 |
| Malpractice | 0.06 | 1.21 |
(0.97 × 1.02 + 2.47 × 1.077 + 0.06 × 1.21) × $33.4009 = $124.32
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.
76801 billing questions
When is 76801 reported instead of 76815?
Use 76801 for a complete early obstetric ultrasound before 14 weeks. A limited examination addressing a narrower question is represented by 76815.
How is an additional fetus reported?
For a multiple gestation, report 76801 for the first fetus and 76802 for each additional fetus when the additional-fetus study is performed.
What do modifiers 26 and TC identify?
Modifier 26 reports the professional interpretation, while TC reports the technical service, including equipment and staff. Without either modifier, the claim represents the global service.
What documentation supports 76801?
Document the indication, gestational age, number of fetuses, examination performed, images and findings, and the interpretation. The record should support a complete early pregnancy assessment rather than a limited or focused study.
How does 76801 differ from 76817?
76801 represents a complete early obstetric ultrasound. 76817 is used for an obstetric ultrasound performed by the transvaginal approach; the approach and service performed should be clear in the record.
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.
8,76076800,,Us exam spinal canal,A,,1.10,4.36,,4.36,NA,0.24,5.70,5.70,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,3.79,3.79,0.24
8,76176800,26,Us exam spinal canal,A,,1.10,0.60,,0.60,,0.23,1.93,1.93,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
8,76276800,TC,Us exam spinal canal,A,,0.00,3.76,,3.76,NA,0.01,3.77,3.77,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,01,0,99,3.19,3.19,0.01
8,76376801,,Ob us < 14 wks single fetus,A,,0.97,2.47,,2.47,NA,0.06,3.50,3.50,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,3.55,3.55,0.07
8,76476801,26,Ob us < 14 wks single fetus,A,,0.97,0.37,,0.37,,0.05,1.39,1.39,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
8,76576801,TC,Ob us < 14 wks single fetus,A,,0.00,2.10,,2.10,NA,0.01,2.11,2.11,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,01,0,99,3.18,3.18,0.02
8,76676802,,Ob us < 14 wks addl fetus,A,,0.81,0.96,,0.96,NA,0.04,1.81,1.81,1,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
3501112,CA,70,YUBA CITY,1.017,1.096,0.536
3601112,CA,75,REST OF CALIFORNIA,1.017,1.096,0.536
3704112,CO,01,COLORADO,1.012,1.064,0.781
3813102,CT,00,CONNECTICUT,1.020,1.077,1.210
3912202,DC,01,DC + MD/VA SUBURBS,1.054,1.178,1.113
4012102,DE,01,DELAWARE,1.005,0.988,0.899
4109102,FL,03,FORT LAUDERDALE,1.000,1.013,1.808