CPT 76812Radiology

Ob us detailed addl fetus

CPT code 76812 is used when a detailed ultrasound examination is performed on an additional baby in a multiple pregnancy (twins, triplets, etc.), beyond the first baby. This is an add-on code used only when a detailed anatomical survey is performed on each additional fetus.

Showing rates for

National Average

Base Medicare rate

$183.40

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

1.78

PE RVU (NF)

3.83

MP RVU

0.06

Total RVU

5.67

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

NCCI bundling edits

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Billing tips

Always bill 76812 with the appropriate primary detailed fetal ultrasound code (76811) - 76812 is an add-on code and cannot be billed alone
Impact: Billing 76812 without a primary code results in automatic denial; correct pairing ensures $183.40 reimbursement per additional fetus
Bill one unit of 76812 for each additional fetus beyond the first - for triplets, bill 76811 x1 and 76812 x2
Impact: Proper unit reporting for triplets yields $183.40 x 2 = $366.80 in additional revenue beyond the primary code
Document all required anatomical elements for each fetus separately with distinct measurements and findings
Impact: Complete documentation for each fetus prevents downcoding or denial; audit failures can result in 100% recoupment of the $183.40 per fetus
Verify multiple gestation diagnosis code is included (O30.xx series) and matches the number of 76812 units billed
Impact: Missing or mismatched diagnosis codes trigger automated denials; proper coding ensures clean claims and faster payment
Do not bill 76812 with limited or follow-up fetal ultrasound codes (76815, 76816) - only with detailed studies
Impact: Incorrect code pairing results in bundling denials and loss of the full $183.40 reimbursement
For facility billing, ensure both facility and professional components are captured when services are split
Impact: Split billing errors can result in 50% revenue loss if either component is missed

Common denials

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Frequently asked questions

What is CPT code 76812 used for?

CPT 76812 is an add-on code used for detailed fetal anatomical ultrasound examination of each additional fetus in a multiple pregnancy (twins, triplets, etc.). It is billed in addition to the primary detailed fetal ultrasound code 76811 for the first fetus.

How much does Medicare pay for CPT 76812 in 2025?

Medicare pays $183.40 for CPT 76812 in 2025 based on the national average non-facility rate. The code has 5.67 total RVUs with a work RVU of 1.78.

Can CPT 76812 be billed alone?

No, CPT 76812 cannot be billed alone. It is an add-on code that must be billed with a primary detailed fetal ultrasound code (76811). Billing 76812 without the primary code will result in automatic denial.

How many units of 76812 should I bill for twins?

For twins, bill one unit of CPT 76811 for the first fetus and one unit of CPT 76812 for the second fetus. For triplets, bill 76811 x1 and 76812 x2.

What is the difference between CPT 76812 and 76810?

CPT 76812 is for a detailed anatomical survey of an additional fetus, while 76810 is for a standard/complete (not detailed) ultrasound of each additional fetus. Code 76812 requires more comprehensive anatomical documentation and reimburses at $183.40 compared to lower reimbursement for 76810.

What documentation is required to bill CPT 76812?

Documentation must include a complete detailed anatomical survey for each additional fetus showing head/brain, face, heart, abdomen, spine, and extremities, plus fetal measurements, placental location, amniotic fluid assessment, and clear fetus identification. Each fetus must be documented separately with the same level of detail as the primary fetus.

Can CPT 76812 be billed with modifier 26 for professional component only?

Yes, modifier 26 can be appended to 76812 when billing only the professional component (physician interpretation), such as when the technical component was performed at a different facility. The facility would bill the technical component using modifier TC.