CPT 76810Radiology

Ob us >= 14 wks addl fetus

CPT code 76810 is used for ultrasound imaging of each additional baby (beyond the first) in a multiple pregnancy when performed at 14 weeks gestation or later. This is an add-on code that cannot be billed alone.

Showing rates for

National Average

Base Medicare rate

$83.78

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

0.98

PE RVU (NF)

1.58

MP RVU

0.03

Total RVU

2.59

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

NCCI bundling edits

Loading bundling edits…

Billing tips

Always bill 76810 with a primary obstetric ultrasound code (76805 or 76811); never bill standalone
Impact: Prevents 100% automatic denial as 76810 is an add-on code with status 'ZZZ' in CMS database
Report 76810 once per each additional fetus beyond the first (twins = 1 unit, triplets = 2 units, quadruplets = 3 units)
Impact: Correct unit reporting ensures full reimbursement: $83.78 per additional fetus
Ensure documentation specifies fetal number and includes complete anatomic survey findings for each fetus separately
Impact: Prevents medical necessity denials and supports audit defense; missing fetal-specific documentation causes 30-40% of post-payment recoupments
Verify gestational age is 14 weeks or greater in documentation; use 76815 for multiple gestation under 14 weeks
Impact: Wrong code selection for gestational age results in denial and delayed payment; may require corrected claim submission
For limited follow-up ultrasounds of additional fetuses, use 76816 instead of 76810 to avoid overcoding
Impact: Prevents up-coding allegations; 76810 requires complete examination while 76816 reimburses at lower rate for limited studies
Document fetal presentation, cardiac activity, and specific anatomic structures visualized for each fetus to support medical necessity
Impact: Comprehensive documentation reduces denial rate by approximately 25-35% based on payer audits

Common denials

Live Field Datano reports yet

Real billers contribute denial patterns and appeal strategies for this code. Once 5+ reports come in, you’ll see live aggregated data here — the only place this exists, free.

Working with CPT 76810?

Get the free Revenue Protection Toolkit — the denial triggers, modifier pitfalls, and bundling conflicts that quietly cost you reimbursement. Instant download.

Help build the field knowledge

MedPayIQ gets smarter as billers contribute. If you've had this code denied, share what happened so others learn from it. Anonymous, no patient info.

Related actions

Frequently asked questions

What is CPT code 76810 used for?

CPT 76810 is used for a complete ultrasound examination of each additional fetus (beyond the first) in a multiple pregnancy when performed at 14 weeks gestation or later. It's an add-on code that must be billed with a primary obstetric ultrasound code.

How much does Medicare pay for CPT 76810 in 2025?

Medicare pays $83.78 for CPT 76810 in 2025 based on the national average rate. The code has a total RVU of 2.59 (Work RVU 0.98, PE RVU 1.58, MP RVU 0.03) multiplied by the 2025 conversion factor of 32.3465.

Can CPT 76810 be billed alone?

No, CPT 76810 cannot be billed alone. It is an add-on code that must be reported with a primary obstetric ultrasound code such as 76805 (standard OB ultrasound) or 76811 (detailed fetal anatomic examination). Billing 76810 standalone results in automatic denial.

How many units of 76810 should I bill for twins?

For twins, bill one unit of 76810 (for the second fetus). The primary code covers the first fetus, and 76810 is reported once for each additional fetus. For triplets, report 2 units; for quadruplets, report 3 units.

What's the difference between CPT 76810 and 76815?

CPT 76810 is for additional fetus ultrasound at 14 weeks or greater gestation, while 76815 is for limited obstetric ultrasound (any gestational age). Code 76810 requires a complete fetal anatomic survey of the additional fetus, whereas 76815 is used for focused or follow-up examinations with specific limited objectives.

What primary codes can be billed with 76810?

CPT 76810 is typically billed with CPT 76805 (complete obstetric ultrasound, single or first fetus) or 76811 (detailed fetal anatomic examination, single or first fetus). These primary codes cover the examination of the first fetus in a multiple gestation.

Does CPT 76810 require a modifier?

Modifiers are generally not required for routine billing of 76810, but modifier 26 (professional component) or TC (technical component) may be needed when splitting services. Modifier 59 may be appropriate for higher-order multiples to prevent bundling, and modifier 52 if the examination is reduced in scope.