$124.51
76805 is the routine complete survey at or after 14 weeks; 76811 is selected when a detailed fetal anatomic examination is performed.
On this page
CMS RVU26D · Effective 2026-10-01
76811 Obstetric ultrasound Medicare reimbursement rates in Kentucky
Detailed obstetric ultrasound evaluates fetal anatomy and maternal-fetal status in a single gestation, typically when a comprehensive structural survey is indicated. Compare 76811 office and facility rates across CMS payment localities in Kentucky.
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 76811 in Kentucky?
Kentucky 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
$168.78
1 of 1 localities have a supported rate.
Payment area: Kentucky
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 76811: Detailed single-gestation fetal anatomy ultrasound
Detailed obstetric ultrasound evaluates fetal anatomy and maternal-fetal status in a single gestation, typically when a comprehensive structural survey is indicated.
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.
CMS billing rules for 76811
- 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 RVU1.85 · 34%
- Practice expense (office) RVU3.49 · 64%
- Malpractice RVU0.11 · 2%
2.8K
Medicare services in 2024 · #2224 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.
76811 compared with similar codes
Office rates for Kentucky, from the same CMS release.
$179.35
76811 covers the detailed examination for one gestation; 76812 is used for each additional fetus in a multiple gestation.
$102.00
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.
$107.06
76813 measures nuchal translucency as part of a first-trimester screening examination; 76811 is a detailed fetal anatomy study.
Compare 76811 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
Kentucky →
Office / nonfacility
$168.78
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 76811 in Kentucky.
PPRRVU2026_Oct_nonQPP.csv
8,775
- Code
- 76811
- Physician work
- 1.85
- Practice expense
- 3.49
- Malpractice
- 0.11
GPCI2026.csv
55
- Locality
- Kentucky
- Physician work
- 1.000
- Practice expense
- 0.889
- Malpractice
- 0.915
| Component | RVU | Locality factor | Adjusted |
|---|---|---|---|
| Physician work | 1.85 | × 1.000 | 1.8500 |
| Practice expense | 3.49 | × 0.889 | 3.1026 |
| Malpractice | 0.11 | × 0.915 | 0.1007 |
| Total RVUs | 5.0533 | ||
| Conversion factor | × 33.4009 | ||
Office / nonfacility rate, Kentucky$168.78
Explore RVUs, geographic factors and the full formula
Office / nonfacility
| Component | RVU | Local GPCI |
|---|---|---|
| Work | 1.85 | 1 |
| Practice expense | 3.49 | 0.889 |
| Malpractice | 0.11 | 0.915 |
(1.85 × 1 + 3.49 × 0.889 + 0.11 × 0.915) × $33.4009 = $168.78
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.
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 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.
8,77276810,,Ob us >/= 14 wks addl fetus,A,,0.96,1.63,,1.63,NA,0.06,2.65,2.65,1,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
8,77376810,26,Ob us >/= 14 wks addl fetus,A,,0.96,0.40,,0.40,,0.05,1.41,1.41,1,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
8,77476810,TC,Ob us >/= 14 wks addl fetus,A,,0.00,1.23,,1.23,NA,0.01,1.24,1.24,1,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,01,0,99,0.00,0.00,0.00
8,77576811,,Ob us detailed sngl fetus,A,,1.85,3.49,,3.49,NA,0.11,5.45,5.45,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,8.00,8.00,0.16
8,77676811,26,Ob us detailed sngl fetus,A,,1.85,0.78,,0.78,,0.08,2.71,2.71,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
8,77776811,TC,Ob us detailed sngl fetus,A,,0.00,2.71,,2.71,NA,0.03,2.74,2.74,1,XXX,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,01,0,99,7.22,7.22,0.08
8,77876812,,Ob us detailed addl fetus,A,,1.74,3.98,,3.98,NA,0.10,5.82,5.82,1,ZZZ,0.00,0.00,0.00,0,0,0,0,0,9,,33.4009,09,0,99,0.00,0.00,0.00
5208102,IN,00,INDIANA,1.000,0.927,0.486
5305102,IA,00,IOWA,1.000,0.915,0.397
5405202,KS,00,KANSAS,1.000,0.904,0.504
5515102,KY,00,KENTUCKY,1.000,0.889,0.915
5607202,LA,01,NEW ORLEANS,1.000,0.941,1.136
5707202,LA,99,REST OF LOUISIANA,1.000,0.885,0.958
5814112,ME,03,SOUTHERN MAINE,1.000,0.991,0.631