Billing code 76811: Obstetric ultrasoundMedicare rate & RVUs in Guam
Detailed obstetric ultrasound evaluates fetal anatomy and maternal-fetal status in a single gestation, typically when a comprehensive structural survey is indicated.
Medicare pays $196.46 for 76811 in the office in Guam (Hawaii, Guam). 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 76811 covers
This transabdominal ultrasound provides a detailed survey of fetal anatomy along with maternal and fetal evaluation. It is commonly performed in the mid-trimester when a structural anomaly is suspected, a prior pregnancy involved a fetal anomaly, or screening findings support a comprehensive anatomic assessment. Obstetric sonographers acquire and document the images; an obstetrician, maternal-fetal medicine specialist, or radiologist interprets the study and reports the findings.
Select this code for a detailed anatomic examination of one gestation, rather than a routine complete survey, a limited study, or a follow-up scan. The report should document the examination performed, image findings, and clinical reason for the detailed assessment. CMS recognizes professional and technical components: append modifier 26 for interpretation only, modifier TC for equipment and staff only, or bill without either modifier for the global service when both components are furnished. For multiple gestations, 76812 describes the detailed examination of an additional fetus.
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.
76811 in Hawaii, Guam
| Payment locality | Office | Facility |
|---|---|---|
| Hawaii, Guam | $196.46 | Unavailable |
How the 76811 rate is calculated
Each of 76811’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 · 76811
RVUs × geographic indexes × conversion factor
Swap in your local Medicare rate.
Work 1.85Practice expense 3.49Malpractice 0.11
All indexes start at 1.000 (the national rate). Enter a ZIP or drag a slider.
Payment rules and modifiers for 76811
The CMS indicators that decide how 76811 is paid alongside other services.
CMS payment indicators · 76811
Obstetric ultrasound
| Rule | CMS value | What it means |
|---|---|---|
| Global period | XXX | The global surgery concept doesn’t apply. |
| Multiple procedures | 0 | No multiple-procedure reduction. |
| 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
76811 without 26 · national office
$182.03
Obstetric ultrasound
76811-26 · Professional component
$90.52
Pays only the interpretation and report.
76811 compared with similar codes
Compare codes
76811 vs 76805 vs 76812 vs 76816 vs 76813: national Medicare rates
Swap in your local Medicare rate.
How to choose
- 76805Obstetric ultrasound
- 76805 is the routine complete survey at or after 14 weeks; 76811 is selected when a detailed fetal anatomic examination is performed.
- 76812Detailed OB ultrasound
- 76811 covers the detailed examination for one gestation; 76812 is used for each additional fetus in a multiple gestation.
- 76816Obstetric ultrasound
- 76816 is for a follow-up study, such as reassessing growth or a finding. It does not represent the detailed anatomic survey described by 76811.
- 76813Nuchal translucency
- 76813 measures nuchal translucency as part of a first-trimester screening examination; 76811 is a detailed fetal anatomy study.
76811 billing questions
How does this differ from 76805?
Use 76811 for a detailed fetal anatomic survey of a single gestation. Code 76805 describes a routine complete obstetric ultrasound at or after 14 weeks.
Can 76811 and 76805 be reported for the same examination?
Do not report both codes to describe the same complete examination. Choose the code that matches the documented scope: detailed anatomic assessment or routine complete survey.
How are the professional and technical services reported?
Report modifier 26 for the interpretation, modifier TC for the technical service, or neither modifier when billing the global service.
What code applies to an additional fetus in a multiple gestation?
Code 76812 describes the detailed anatomic examination for an additional fetus when 76811 is reported for the primary fetus.
What documentation supports selecting 76811?
Document the clinical reason for a detailed survey, the fetal anatomy evaluated, image findings, and the number of gestations examined.
When is 76816 a better fit?
Use 76816 for a follow-up obstetric ultrasound, such as reassessment of growth or previously evaluated findings, rather than a detailed anatomic survey.
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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