$148.82
76805 is the standard complete obstetric survey; 76816 is a follow-up study reassessing growth, fluid, or a previously evaluated finding.
On this page
CMS RVU26D · Effective 2026-10-01
76816 Obstetric ultrasound Medicare reimbursement rates in Hawaii
Reports a transabdominal follow-up ultrasound to reassess fetal growth, amniotic fluid, or a previously evaluated pregnancy finding for each fetus. Compare 76816 office and facility rates across CMS payment localities in Hawaii.
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 76816 in Hawaii?
Hawaii 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
$121.73
1 of 1 localities have a supported rate.
Payment area: Hawaii, Guam
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 ultrasound
About 76816: Follow-up obstetric ultrasound per fetus
Reports a transabdominal follow-up ultrasound to reassess fetal growth, amniotic fluid, or a previously evaluated pregnancy finding for each fetus.
CPT 76816 covers a transabdominal follow-up ultrasound of the pregnant uterus, reported for each fetus evaluated. It is commonly used when a clinician needs interval assessment of fetal growth or amniotic fluid, such as during surveillance for suspected growth concerns or after a prior study identified a finding requiring reassessment. An obstetrician, maternal-fetal medicine specialist, or radiologist may perform and interpret the diagnostic study; a sonographer may acquire the images under the provider’s direction.
Report this code for a follow-up examination, not as a substitute for a complete initial survey or a limited examination addressing a narrower question. The record should support the reason for reassessment and document the fetus-specific measurements and findings, with the interpretation and image documentation. CMS recognizes separately priced professional and technical components: modifier 26 identifies interpretation, modifier TC identifies equipment and staff, and billing without either modifier represents the global service.
CMS billing rules for 76816
- 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 RVU0.83 · 25%
- Practice expense (office) RVU2.45 · 74%
- Malpractice RVU0.05 · 2%
9.2K
Medicare services in 2024 · #1522 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.
76816 compared with similar codes
Office rates for Hawaii, from the same CMS release.
$88.85
76815 is limited to a focused question or portion of the examination. Choose 76816 when the service is a follow-up reassessment rather than a limited study.
$196.46
76811 is a detailed fetal anatomic examination. It is selected for that comprehensive targeted survey, not simply for interval monitoring.
$95.13
76810 covers a standard complete survey of an additional fetus; 76816 reports follow-up reassessment for each fetus evaluated.
Compare 76816 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
Hawaii, Guam →
Office / nonfacility
$121.73
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 76816 in Hawaii, Guam.
PPRRVU2026_Oct_nonQPP.csv
8,790
- Code
- 76816
- Physician work
- 0.83
- Practice expense
- 2.45
- Malpractice
- 0.05
GPCI2026.csv
46
- Locality
- Hawaii, Guam
- Physician work
- 1.000
- Practice expense
- 1.137
- Malpractice
- 0.579
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 0.83 | × 1.000 | 0.8300 |
| Practice expense | 2.45 | × 1.137 | 2.7857 |
| Malpractice | 0.05 | × 0.579 | 0.0290 |
| Total RVUs | 3.6446 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Hawaii, Guam$121.73
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 0.83 | 1 |
| Practice expense | 2.45 | 1.137 |
| Malpractice | 0.05 | 0.579 |
(0.83 × 1 + 2.45 × 1.137 + 0.05 × 0.579) × $33.4009 = $121.73
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.
76816 billing questions
When should 76816 be chosen over 76815?
Use 76816 for a follow-up assessment such as interval fetal growth or amniotic fluid reassessment. Use 76815 when the service is a limited examination focused on a narrower question.
How is 76816 reported for a multiple gestation?
The service is reported per fetus evaluated. Documentation should make clear which fetus or fetuses received the follow-up assessment.
How do modifiers 26 and TC affect this code?
Modifier 26 identifies the professional interpretation, and modifier TC identifies the technical service, including equipment and staff. Without either modifier, the claim represents the global service.
How does 76816 differ from 76805?
CPT 76805 describes a standard complete obstetric ultrasound, while 76816 is for a follow-up reassessment. Select based on the examination performed and its purpose, not simply because the patient has had an earlier scan.
What documentation supports a follow-up study?
Document the clinical reason for reassessment, the fetus evaluated, relevant measurements and findings, and the interpreting provider’s report. The record should show that the service was a follow-up rather than a limited or complete initial 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 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.
8,78776815,,Ob us limited fetus(s),A,,0.63,1.76,,1.76,NA,0.05,2.44,2.44,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,3.43,3.43,0.06
8,78876815,26,Ob us limited fetus(s),A,,0.63,0.25,,0.25,,0.04,0.92,0.92,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
8,78976815,TC,Ob us limited fetus(s),A,,0.00,1.51,,1.51,NA,0.01,1.52,1.52,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,01,0,99,3.18,3.18,0.02
8,79076816,,Ob us follow-up per fetus,A,,0.83,2.45,,2.45,NA,0.05,3.33,3.33,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,3.53,3.53,0.06
8,79176816,26,Ob us follow-up per fetus,A,,0.83,0.35,,0.35,,0.04,1.22,1.22,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
8,79276816,TC,Ob us follow-up per 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
8,79376817,,Transvaginal us obstetric,A,,0.73,2.00,,2.00,NA,0.05,2.78,2.78,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,3.47,3.47,0.06
4309102,FL,99,REST OF FLORIDA,1.000,0.956,1.503
4410212,GA,01,ATLANTA,1.003,1.016,1.201
4510212,GA,99,REST OF GEORGIA,1.000,0.892,1.192
4601212,HI,01,"HAWAII, GUAM",1.000,1.137,0.579
4702202,ID,00,IDAHO,1.000,0.920,0.473
4806102,IL,16,CHICAGO,1.007,1.005,2.295
4906102,IL,12,EAST ST. LOUIS,1.000,0.920,2.014