$112.26
76856 represents a complete nonobstetric pelvic examination. Choose 76857 when the documented study is focused or performed for follow-up.
On this page
CMS RVU26D · Effective 2026-10-01
76857 Pelvic ultrasound Medicare reimbursement rates in Connecticut
Reports a focused, nonobstetric pelvic ultrasound with image documentation, such as a targeted assessment or follow-up of a known pelvic finding. Compare 76857 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 76857 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
$54.28
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.
Diagnostic imaging
About 76857: Limited nonobstetric pelvic ultrasound
Reports a focused, nonobstetric pelvic ultrasound with image documentation, such as a targeted assessment or follow-up of a known pelvic finding.
This code represents a focused real-time ultrasound examination of the nonpregnant pelvis, with images documented. It may be used when the clinical question calls for assessment of selected pelvic structures, such as a known ovarian cyst or pelvic fluid, rather than a complete survey. A sonographer commonly acquires the images in an imaging department or office; a radiologist or other qualified physician interprets the study and documents the findings.
Choose the limited code when the examination is focused or performed as follow-up, and use the complete pelvic study code when a complete examination is documented. The report should identify the clinical indication, structures assessed, images obtained, and interpretation. The global service includes both the technical and professional work; modifier 26 identifies the interpretation, while modifier TC identifies the equipment and staff service. The diagnostic imaging multiple-procedure reduction applies to both the technical and professional components when applicable.
CMS billing rules for 76857
- 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.
- Multiple procedures
- Diagnostic imaging multiple procedure reduction applies to the technical and professional components.
Where the value comes from
- Work RVU0.49 · 32%
- Practice expense (office) RVU1.00 · 65%
- Malpractice RVU0.04 · 3%
210.6K
Medicare services in 2024 · #375 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.
76857 compared with similar codes
Office rates for Connecticut, from the same CMS release.
$125.62
76830 is for a nonobstetric transvaginal ultrasound. 76857 identifies a limited or follow-up pelvic examination, not that specific transvaginal approach.
$86.80
76815 is a limited obstetric ultrasound in a pregnancy. 76857 is for a nonobstetric pelvic examination.
Compare 76857 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
$54.28
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 76857 in Connecticut.
PPRRVU2026_Oct_nonQPP.csv
8,829
- Code
- 76857
- Physician work
- 0.49
- Practice expense
- 1.00
- Malpractice
- 0.04
GPCI2026.csv
38
- Locality
- Connecticut
- Physician work
- 1.020
- Practice expense
- 1.077
- Malpractice
- 1.210
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.49 | × 1.020 | 0.4998 |
| Practice expense | 1.00 | × 1.077 | 1.0770 |
| Malpractice | 0.04 | × 1.210 | 0.0484 |
| Total RVUs | 1.6252 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Connecticut$54.28
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.49 | 1.02 |
| Practice expense | 1 | 1.077 |
| Malpractice | 0.04 | 1.21 |
(0.49 × 1.02 + 1 × 1.077 + 0.04 × 1.21) × $33.4009 = $54.28
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.
76857 billing questions
How does 76857 differ from a complete pelvic ultrasound?
Use 76857 for a focused or follow-up examination. A documented complete pelvic survey is reported with 76856.
When should modifier 26 or TC be used?
Use modifier 26 for the professional interpretation and report, and modifier TC for the technical service. Without either modifier, the code represents the global service.
Can a limited and complete pelvic ultrasound be reported for the same examination?
Select the code that matches the documented scope of the examination; do not divide one study into limited and complete services.
What documentation supports a limited study?
Document the clinical question, the structures examined, the images obtained, and the interpretation. The record should show why the examination was focused or performed for follow-up.
Does the multiple-procedure reduction affect only the technical service?
No. The CMS diagnostic imaging multiple-procedure reduction applies to both the technical and professional components.
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.
8,82676856,,Us exam pelvic complete,A,,0.67,2.43,,2.43,NA,0.05,3.15,3.15,1,XXX,0.00,0.00,0.00,4,0,0,0,0,9,,33.4009,09,0,88,3.44,3.44,0.05
8,82776856,26,Us exam pelvic complete,A,,0.67,0.26,,0.26,,0.04,0.97,0.97,1,XXX,0.00,0.00,0.00,4,0,0,0,0,9,,33.4009,09,0,88,0.00,0.00,0.00
8,82876856,TC,Us exam pelvic complete,A,,0.00,2.17,,2.17,NA,0.01,2.18,2.18,1,XXX,0.00,0.00,0.00,4,0,0,0,0,9,,33.4009,01,0,88,3.18,3.18,0.01
8,82976857,,Us exam pelvic limited,A,,0.49,1.00,,1.00,NA,0.04,1.53,1.53,1,XXX,0.00,0.00,0.00,4,0,0,0,0,9,,33.4009,09,0,88,3.35,3.35,0.07
8,83076857,26,Us exam pelvic limited,A,,0.49,0.19,,0.19,,0.03,0.71,0.71,1,XXX,0.00,0.00,0.00,4,0,0,0,0,9,,33.4009,09,0,88,0.00,0.00,0.00
8,83176857,TC,Us exam pelvic limited,A,,0.00,0.81,,0.81,NA,0.01,0.82,0.82,1,XXX,0.00,0.00,0.00,4,0,0,0,0,9,,33.4009,01,0,88,3.16,3.16,0.04
8,83276870,,Us exam scrotum,A,,0.62,2.28,,2.28,NA,0.05,2.95,2.95,1,XXX,0.00,0.00,0.00,4,0,0,0,0,9,,33.4009,09,0,88,3.41,3.41,0.06
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