Billing code 76857: Pelvic ultrasoundMedicare rate & RVUs in Georgia
Reports a focused, nonobstetric pelvic ultrasound with image documentation, such as a targeted assessment or follow-up of a known pelvic finding.
Medicare pays $47.75–$51.96 for 76857 in the office in Georgia, from Rest Of Georgia to Atlanta. Which amount applies depends on the service address.
Medicare allowed amount for participating (non-QP) physicians, before deductible, coinsurance and claim adjustments. Not a patient’s bill or a hospital charge.
On this page 9 sections
What 76857 covers
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.
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.
Where 76857 pays more and less in Georgia
| Payment locality | Office | Facility |
|---|---|---|
| Atlanta | $51.96 | Unavailable |
| Rest Of Georgia | $47.75 | Unavailable |
How the 76857 rate is calculated
Each of 76857’s three RVUs is multiplied by a geographic index (GPCI) for the payment locality, added up, and multiplied by the conversion factor. Drag the indexes or enter a ZIP to see what moves the rate.
How the rate is built · 76857
RVUs × geographic indexes × conversion factor
Work0.49
0.49 RVUs× 1.000 GPCI
Practice expense1.00
1.00 RVUs× 1.000 GPCI
Malpractice0.04
0.04 RVUs× 1.000 GPCI
Adjusted RVUs
1.5300
Conversion factor
$33.4009
Medicare rate
$51.10
Every GPCI starts at 1.000, the national rate. Enter a ZIP or drag a slider.
Payment rules and modifiers for 76857
The CMS indicators that decide how 76857 is paid alongside other services.
CMS payment indicators · 76857
Pelvic ultrasound
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| Multiple procedures | 4 | Diagnostic imaging reduction applies to the technical component (and professional component) of additional services. |
| Bilateral (modifier 50) | 0 | The 150% bilateral adjustment doesn’t apply. |
| Assistant at surgery (80/81/82/AS) | 0 | Not paid without supporting documentation. |
| Co-surgeons (62) | 0 | Not permitted. |
| Team surgery (66) | 0 | Not permitted. |
| Professional/technical | 1 | Diagnostic test with separate professional (26) and technical (TC) components. |
What modifiers do to the payment
Modifier 26 · payment effect
With and without the modifier
76857 without 26 · national office
$51.10
Pelvic ultrasound
76857-26 · Professional component
$23.71
Pays only the interpretation and report.
76857 compared with similar codes
Compare codes · National
4 codes, side by side
How to choose
- 76856Pelvic ultrasound
- 76856 represents a complete nonobstetric pelvic examination. Choose 76857 when the documented study is focused or performed for follow-up.
- 76830Pelvic ultrasound
- 76830 is for a nonobstetric transvaginal ultrasound. 76857 identifies a limited or follow-up pelvic examination, not that specific transvaginal approach.
- 76815Obstetric ultrasound
- 76815 is a limited obstetric ultrasound in a pregnancy. 76857 is for a nonobstetric pelvic examination.
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 indexes and the conversion factor. Services without a published rate are labeled, never given a made-up amount. Amounts are Medicare allowed amounts before claim adjustments: not a patient’s bill or a commercial rate.
CMS RVU26D · effective Oct 1, 2026 through the day before Jan 1, 2027
Show the CMS file lines behind this rate
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