CPT 76802Radiology

Ob us < 14 wks addl fetus

CPT code 76802 covers an ultrasound examination of each additional fetus during early pregnancy (before 14 weeks). This is an add-on code used when performing ultrasounds on twins, triplets, or other multiple pregnancies.

Showing rates for

National Average

Base Medicare rate

$57.90

This calculator gives a typical-case estimate using standard Medicare modifier rules. Actual payment depends on payer policies, documentation, code-specific CMS status indicators, and locality. Verify before billing.

RVU breakdown

Work RVU

0.83

PE RVU (NF)

0.93

MP RVU

0.03

Total RVU

1.79

Conversion factor: 32.3465 · Source: CMS MPFS RVU25A · Confidence: High

NCCI bundling edits

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Billing tips

Always bill 76802 with primary code 76801, never as a standalone code; this is an add-on code (indicated by '+' symbol in CPT manual)
Impact: Billing alone results in 100% denial and $0 reimbursement; proper pairing ensures full $57.90 per additional fetus
Report 76802 once for each additional fetus beyond the first (e.g., for triplets, bill 76801 x1 and 76802 x2)
Impact: Correct unit reporting for twins yields $57.90 additional; triplets yield $115.80 additional (2 units)
Document each fetus separately with individual measurements, cardiac activity, and anatomic findings to support multiple units
Impact: Inadequate individual fetus documentation causes denials of 76802 units, losing $57.90 per denied unit
Verify gestational age is documented as less than 14 weeks; use 76815/76816 for second/third trimester multiple gestations
Impact: Age-inappropriate coding results in denial; correct code selection maintains reimbursement and avoids recoupment
Use place of service code 22 for outpatient hospital to receive non-facility rate ($57.90); code 11 for office yields same rate for this code
Impact: For 76802, both facility and non-facility rates are identical at $57.90, so setting does not affect reimbursement
Check payer-specific policies on global OB package inclusion; some payers bundle first trimester ultrasounds into global maternity care
Impact: Bundled services yield $0 separate payment; verifying carve-outs before billing prevents claim denials and AR delays

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Frequently asked questions

What is CPT code 76802 used for?

CPT 76802 is used to bill for ultrasound examination of each additional fetus beyond the first in a multiple gestation pregnancy before 14 weeks gestational age. It is an add-on code that must be billed with the primary first trimester ultrasound code 76801.

How much does Medicare pay for CPT 76802 in 2025?

Medicare pays $57.90 for CPT 76802 in 2025 under the national average non-facility rate. The facility rate is also $57.90. The total RVU is 1.79 (work RVU 0.83, PE RVU 0.93, MP RVU 0.03) multiplied by the 2025 conversion factor of 32.3465.

Can CPT 76802 be billed alone?

No, CPT 76802 cannot be billed alone. It is an add-on code (designated with a '+' in the CPT manual) that must be reported with the primary code 76801 (first trimester obstetric ultrasound, single fetus). Billing 76802 without 76801 will result in claim denial.

How many times can you bill CPT 76802 for twins?

For twins, you bill CPT 76802 one time. You report 76801 once for the first fetus and 76802 once for the second (additional) fetus. For triplets, you would bill 76801 once and 76802 twice (one unit for each additional fetus beyond the first).

What is the difference between CPT 76802 and 76816?

CPT 76802 is for additional fetus ultrasound before 14 weeks gestation, while CPT 76816 is for additional fetus ultrasound after 14 weeks (second or third trimester). The gestational age at time of examination determines which code to use; both are add-on codes requiring a primary ultrasound code.

What documentation is required to bill CPT 76802?

Documentation must include gestational age under 14 weeks, total number of fetuses, individual identification of each fetus (A, B, C), separate cardiac activity confirmation for each, individual measurements (CRL or gestational sac), location of each sac, and a complete physician interpretation. Each additional fetus must be documented separately to support multiple units.

Is CPT 76802 included in the global OB package?

This depends on payer policy. Some commercial payers include first trimester ultrasounds in the global maternity package, while others carve them out for separate payment. Medicare does not have a global OB package. Verify payer-specific policies before billing; many payers allow separate payment for multiple gestation ultrasounds even when singleton ultrasounds are bundled.